Poster Presenters

Introduction:Cervical cancer remains a leading cause of morbidity and mortality among women in Sub-Saharan Africa, with HIV co-infection markedly increasing risk. This study analyzed data from 4,511 women screened for HPV across Kisumu County and neighboring regions,highlighting epidemiological patterns and operational challenges in program implementation.

Aim: To determine the genotype distribution, and operational gaps in cervical cancer screening among women living with HIV  in Kisumu County.

Methods: We conducted a cross-sectional analysis of HPV samples from HIV-positive women accessing ART, OPD, and MCH/FP services at 62 purposively selected sites in Western Kenya. Cervical cells were clinician-collected using brushes, placed in Roche cell collection medium, and analyzed centrally on Roche Cobas® 6800/8800 Systems. The assay employs real-time PCR to detect 14 high-risk HPV types, including HPV16, HPV18, and 12 additional oncogenic strains[31,33,35,39,45,51,52,56,58,59,66&68].Results were categorized as Positive, Negative, or Invalid. Entry-point proportions and facility-level aggregates were computed, applying Chi-square tests where appropriate.

Results: HPV tests showed significant genotype distribution in women:HPV16 (4.6%), HPV18 (3.3%), and HPV45 (2.2%0. Other High-Risk types[31,33,35,39,45,51,52,56,58,59,66&68]were 22.6%. Overall, 27.9% of women tested positive, underscoring the substantial burden of oncogenic strains in this cohort. Operational indicators highlighted systemic challenges: median turnaround time was 27 days (IQR 15–61) and data completeness was poor. Missing entries for sample type (73.2%) and service entry point (63.1%).

Conclusion: The  high prevalence of HPV among women living with HIV underscores the urgent need for integrated HIV-SRH services and long turnaround times and incomplete data compromise timely linkage to care. Strengthening facility-level data entry capacity through retraining, mentorship, and improved sample management is critical to enhance screening quality and accelerate delivery of results. Addressing these operational gaps will advance equitable cervical cancer prevention within universal health coverage frameworks.

Globally, the high prevalence of infectious diseases, particularly HIV-I, and the possible interaction with autosomal sickle cell disease, has been of great public health concern. Kenya experiences a significant burden of HIV-I. Kisumu County in particular, exhibits a unique epidemiological burden, with reported mortality rates of 50% to 90% among children with sickle cell disease. This is coupled with high prevalence 17.5% of HIV/AIDS among its population, and high malaria endemicity with prevalence of 19%. The overarching aim of this study was to assess the association of HIV-I co-morbidity, viral load and hemoglobinopathies among sickle cell-exposed children in Kisumu County. The study adopted a retrospective study design. Study population comprised of the sickle cell-exposed children in Kisumu County with a sample size of 173. The study used both purposive and simple random sampling techniques. The participation rate was 99.2%. The prevalence of HIV-I among sickle cell-exposed children was 4.65% in Kisumu County. Majority 76.3% sickle cell-exposed children had hemoglobinopathies for sickle cell disease. Age was not a statistically significant factor (p = 0.414). Only 28.5% (n=49) of the children were aged five years or older. Viral load was statistically significant p-value=0.046 in β-thalassemia co-morbidity. The study recommends improved HIV screening and prevention efforts and establishment of routine newborn and early childhood screening for hemoglobinopathies among this vulnerable population..

ICU Hospital-Acquired Pneumonia Audit and Quality Improvement Interventions at Murang’a County Referral Hospital

Background:

Hospital-acquired infections (HAIs), are infections that develop in patients during their stay in healthcare facilities and were not present at admission. Although largely preventable, HAIs remain a major public health concern, affecting approximately 7% of patients in developed countries and 10% in developing countries. They contribute significantly to increased morbidity, mortality, prolonged hospital stays, and higher healthcare costs.

At Murang’a County Referral Hospital, the Patient Safety and Quality Committee conducts routine surveillance of common HAIs. In October and November 2025, a data review revealed a surge in Hospital-Acquired Pneumonia (HAP), with 3 out of 5 patients (60%) who underwent craniotomy surgery developing the infection. This prompted an Infection Prevention and Control (IPC) audit to identify factors associated with the increase and address preventable causes. A Continuous Quality Improvement (CQI) model was adopted to design and implement targeted interventions.

Methods

The study applied a pre- and post-assessment technique to evaluate healthcare workers’ knowledge, skills, and practices, as well as identify existing gaps. Data collection involved the use of an IPC audit tool, patient medical records, environmental and equipment swabs, and assessment of hand hygiene practices before and after interventions. Data was analyzed using Microsoft Excel.

Results

Results showed significant improvement following the interventions. Initially, three HAI cases were reported; however, after implementation, no new cases were recorded. Hand hygiene compliance among healthcare workers improved from 23.9% to 49%. Additionally, microbial growth from environmental and equipment swabs reduced from 82% (23 out of 28 samples) to 4% (1 out of 28 samples).

Conclusion

Strict adherence to IPC measures, continuous surveillance, and application of CQI strategies are essential in enhancing patient safety and quality of care. 

Background

Sickle cell disease (SCD) is a genetic blood disorder caused by a mutation producing abnormal haemoglobin S, which makes red blood cells rigid, sticky, and sickle-shaped. This leads to complications such as pain, anaemia, fatigue, and infections. The study assessed the impact of point-of-care testing using Gazelle and Sickle Cell SCAN at Homa Bay Referral Hospital.

 Method

 A cross-sectional study (Jan 2025–Jan 2026) evaluated children with suspected SCD at the MCH clinic. Blood samples were collected via venipuncture or finger prick and tested using Gazelle and Sickle Cell SCAN following standard protocols with strict quality control. Point-of-care testing (POCT) enabled rapid diagnosis in a resource-limited setting. Children diagnosed with SCD received immediate treatment, including hydroxyurea and pain management. Those identified with sickle cell trait were offered genetic counseling to guide families on health implications and future reproductive decisions, ensuring improved care, awareness, and timely clinical intervention outcomes

Results:

The study involved 500 children under five years, with 52% male and 48% female. Most (70%) were aged 1–3 years, with a mean age of 2 years. Sickle cell disease (SCD) was diagnosed in 16% of children, while 20% had sickle cell trait. Testing was equally conducted using Gazelle and Sickle Cell SCAN, showing 98% concordance. Parental acceptance of point-of-care testing (POCT) was high at 94%, with 90% expressing confidence in results. Diagnosis time reduced from 5 days to 2 hours. Treatment within 24 hours improved to 75% compared to 30% with traditional methods.

Conclusion:

The heavy burden of managing SCD highlights the urgent need for early screening to prevent long-term complications. Introducing routine newborn screening in hospitals across Homa Bay County would improve early diagnosis, enhance patient outcomes, and reduce morbidity. This strategy could also serve as a model for other regions tackling SCD.

Background
Cholera remains a persistent public health threat in Kenya, exacerbated by inadequate water and sanitation infrastructure, cross-border mobility, and under-resourced health systems. On 12 February 2025, Migori County reported a cholera outbreak, prompting an Early Action Review (EAR) guided by the 7-1-7 framework to evaluate timeliness of detection, notification, and response.

Methods
We conducted a qualitative EAR involving review of outbreak timelines, epidemiological data, and facilitated focus group discussions with 40 stakeholders from county, national, and partner institutions. The outbreak chronology was benchmarked against the 7-1-7 metric: detection within 7 days, notification within 1 day, and response initiation within 7 days. Thematic analysis of six response pillars; surveillance and early warning, coordination, water, sanitation and hygiene (WASH)- infection prevention and control (IPC), risk communication, and community engagement, laboratory systems, and case management was combined with root cause analysis to identify bottlenecks and enablers of the timely response.

Findings
The outbreak lasted 58 days (10 February–8 April 2025), resulting in 53 suspected cases, 16 confirmed, and one death (CFR 1.8%). All 7-1-7 performance targets were met: detection (2 days), notification (

Background:

The Kenya National Tuberculosis Reference Laboratory (KNTRL), in partnership with USAID Kenya, launched Truenat assay proficiency testing using dry tube samples. A pilot in 24 facilities confirmed the quality of in-country panels in 2024. By the end of 2025, 78 facilities were enrolled in Round 2, which used an integrated online system for site enrollment and result reporting. The program aims to strengthen TB diagnosis, improve rifampicin-resistance surveillance, and align with the strategic plan to enroll all molecular testing facilities in proficiency testing.

Methods:

National Tuberculosis Reference Laboratory (NTRL), in collaboration with Smart Spot Quality (PTY) LTD, enrolled 38 Truenat testing facilities in a proficiency testing (PT) program between 2022 and 2023. Each facility received four dried card samples (DCS) per cycle, with expected results of either MTB detected, MTB detected with rifampicin resistance, or MTB negative, across six PT cycles. To sustain PT services, NTRL initiated in-house PT production in 2024 by validating Xpert dried tube specimens (DTS) on Truenat platform. We analyze result submission and satisfactory performance across eight PT cycles

Results:

PT enrollment increased from 38 in 2022 to 78 in 2025. Results submission rate ranged from 72% to 100%, with the lowest during the 2024 expansion.satisfactory performance exceeded 80 % range from 82% to 94%,lowest in first 2022 cycle. The sensitivity exceeded 80 % and improved overtime ,indicating better diagnostic accurancy.Gains were likely due to system strengtherning ,including training,increased familiarity with PT processes,and adoption to the expanding network .

Conclusion:

 Initially, the satisfactory performance rate was low at 82%, but it improved over time to 94% as facilities became more used to PT participation. To enhance the quality of testing services, it is essential for all TB testing facilities to be enrolled in the Proficiency Testing programe.

Background: Civil Registration and Vital Statistics (CRVS) systems support governments in planning for equitable health services and monitoring population health in line with achieving universal health coverage. In Kenya, CRVS completeness remains below Sustainable Development Goal targets of 100% birth and 80% death registration, at 70% for births and 45% for deaths (2024). Although general awareness of CRVS has increased, translating knowledge into registration practice remains limited. This study examines the gap between knowledge and practice and identifies factors influencing registration across three demographic surveillance sites in Kenya.

Methods: We conducted a cross-sectional analysis of household-reported births (n = 1,611; 2020–2023) and deaths (n = 1,387; 2022–2023) across the Kilifi, Kisumu, and Nairobi Health and Demographic Surveillance System (HDSS) sites. Knowledge, attitudes, and practices regarding registration were assessed using structured questionnaires. Scores were categorized using Bloom’s cut-offs and dichotomized for regression analyses. Survey-weighted multivariable logistic regression models estimated associations between knowledge, attitudes, and registration practices, including effect modification (knowledge × attitude), adjusting for key socio-demographic covariates.

Results: High knowledge alone was not associated with birth registration practices (weighted OR = 1.04; 95% CI: 0.59–1.85), nor were positive attitudes (weighted OR = 0.59; 95% CI: 0.30–1.17). However, the interaction between knowledge and attitude was significant (weighted OR = 2.50; 95% CI: 1.05–5.97). For death registration, only knowledge was strongly associated with improved practice (weighted OR = 2.67; 95% CI: 1.86–3.83).

Conclusion: While improved knowledge was strongly associated with better death registration practices, birth registration depended on the combined influence of knowledge and favourable attitudes. Strengthening CRVS in Kenya will require interventions that both improve knowledge and address behavioural and structural barriers that prevent households from acting on that knowledge, including costs and access, to improve registration completeness and progress toward universal health coverage.

 Introduction: Transitioning to new health insurance frameworks often poses implementation challenges for facilities.

 By August 2025, Thika Level 5 Hospital reported 0% Social Health Authority (SHA) registration among eligible patients. A baseline assessment of 299 patients revealed three primary barriers: accessibility and process hurdles (29%), negative perceptions regarding SHA benefits (27%) and delays in admission notifications on the digital dashboard (17%).

These gaps resulted in patients’ financial strain, compromised quality of care and hospital revenue loss.

Aim: To increase the percentage of SHA- registered eligible patients at Thika Level 5 Hospital from 0% in August 2025 to 60% by October 30, 2025.

Methods: A quality improvement project using quasi-experimental designs conducted, aimed at increasing SHA enrollment and utilization among patients accessing services at Thika level five hospital.

A multidisciplinary Continuous Quality Improvement team formed, comprising hospital management and community health promoters.

Decision matrix used to prioritize quality improvement (QI) project. Desk review and QI tools used for data collection.

Interventions implemented: Established 24-hour registration desks, 43 personnel trained, introduced manual verification protocols, and integrated community education through daily health talks and strategic signage

Interrupted Time Series (ITS) analysis method used to evaluate immediate and sustained project effects.

Results:   By 30th October 2025, SHA uptake rose from 0% to 40.1%. Analysis of weekly run charts showed a consistent upward trend at 27% in week 2 and 67% by week 10.

 Hospital revenue increased from Ksh 27.2 million in August to 31.6 million in October.

Caesarean Surgical site infection reduced from 12% in August to 2% in October 2025.

Conclusion: Low health insurance uptake in public facilities is often a process failure.

 Decentralizing registration and using CHPs overcame registration barriers, while manual backups ensured data integrity.

Continuous quality improvement strategies provide a scalable model for other healthcare settings striving for UHC.

Background

Dispensaries are the first point of contact for most patients and play a critical role in preventing healthcare-associated infections . Weak IPC systems at this level increase the risk of HAI transmission and outbreak among patients and health workers. Despite this, IPC preparedness at dispensary level remains poorly assessed.

Objective

To assess IPC preparedness at Maili Saba Dispensary between July and November 2025, and to identify practical gaps and opportunities for strengthening IPC at primary healthcare level.

Methods

A descriptive facility-based assessment was conducted at Maili Saba Dispensary between July and November 2025. Data were collected using structured observational checklists aligned with the Kenya National IPC Guidelines and key informant interviews with 11 of 15 facility staffs. Areas assessed included PPE availability, hand hygiene facilities, waste management, staff training, and IPC guideline display. Findings were summarised using frequencies and percentages, and interview responses were organised thematically.

Results

Gaps were identified across all assessed areas. PPE availability stood at 52%; gloves were present at critical points but insufficient, and coveralls were only available in the maternity unit. Colour-coded waste bins were present at all 12 disposal points; however, yellow liners were missing at 5 points, forcing use of red liners and compromising segregation. Of 7 handwashing points, only 4 (57%) were functional. IPC guidelines were absent from 4 of 7 designated display areas. Only 8 of 15 staff (53%) had received formal IPC training.

Conclusion

IPC preparedness at Maili Saba Dispensary falls below the standards set by the Kenya National IPC Guidelines, The gaps outlined pose a direct risk to patient safety and increase the facility's vulnerability to HAI transmission. Targeted staff training, reliable supply of PPE and consumables, and embedding IPC into routine supervision are practical steps that can raise standards and protect both patients and health workers.

Background: Malaria remains a major public health challenge in highland epidemic-prone areas with unstable transmission driven by climatic, vector, and health system factors. Monitoring malaria incidence, diagnostic testing coverage, and test positivity rate is critical for evaluating surveillance performance and intervention effectiveness. Objective: To assess trends and relationships in malaria incidence, diagnostic testing coverage, and test positivity rate in Trans Nzoia County (2021–2025).

Methods: A retrospective analytical study was conducted using routine malaria surveillance data from the Kenya Health Information System (KHIS) for 2021–2025, applying a census sampling design of all reported cases. Indicators included malaria incidence per 1,000 population, proportion of suspected cases tested, and test positivity rate. Data were analysed using time series analysis to assess trends and seasonality, and multivariable linear regression to examine relationships between incidence, testing coverage, and positivity rate. Chi-square tests for trend and correlation analysis assessed statistical significance and associations. Confounding factors were addressed by including testing rates and reporting completeness as covariates, with incidence standardized to testing volume. Intervention effects were assessed by incorporating periods of long-lasting insecticidal net (LLIN) distribution and strengthened surveillance into the model. 

Results: Malaria incidence declined from 82.29 per 1,000 population in 2021 to 41.34 in 2025, with fluctuations in 2023–2024. Testing coverage increased significantly from 35.04% to 93.97%, while test positivity rate decreased from 22.1% to 15.9%, with a temporary rise in 2024. Regression analysis showed a significant inverse relationship between testing coverage and positivity rate. Periods following LLIN distribution and improved surveillance were associated with reduced incidence. 

Conclusion: Malaria control improved due to enhanced diagnostics, surveillance, and targeted interventions. Adjusted analyses confirm that increased testing and key interventions contributed to reduced transmission. Sustained integrated and climate-informed strategies are essential for long-term malaria control.

Background

Mass Drug Administration (MDA) remains the cornerstone strategy for Preventive Chemotherapy of Neglected Tropical Diseases (PCNTDs) like Schistosomiasis (SCH) and Soil-transmitted helminths (STH) in endemic settings. However, delivery performance and sustenance is heavily dependent on the strength of the supply chain management system. In 2025, Kilifi County piloted in three subcounties an Integrated Mass Drug Administration (iMDA) model embedded within routine community health services where medicine distribution was done house to house via the electronic Community Health Information System (eCHIS) comparing to campaign-based model.

Methods

A mixed-methods cross-sectional comparative study was conducted in Magarini, Malindi, and Rabai sub-counties. The supply chain performance indicators were alignment of procurement processes, last-mile distribution, redistribution frequency, digital reporting, inventory visibility, and reverse logistics timelines. Qualitative data was collected through key informant interviews across the different levels of the health system on the performance of the various supply chain functions, comparing the two delivery models. Quantitative data compared the four-day campaign MDA in 2024 with 2025 iMDA data using historical data from the Joint Request for Select Medicines (JRSM) forecasts with quantities allocated via household registration, the S-11 receipts, and medicine utilization and reverse logistics data on eCHIS and the integrated dashboard (NTD-IDB), respectively.

Results 

The iMDA enabled better alignment of commodity needs that improved allocation precision, last mile distribution, digital traceability and real-time inventory monitoring, supervision, oversight. The iMDA model promoted domestic resource mobilization as the county procured Albendazole tablets used to reach half a million people.

Conclusion

iMDA provides a platform for optimal resource utilisation in the current change in funding landscape. Targeted investments can build responsive resilient end-to-end supply chains.

Recommendation

iMDA model should harmonize quantification, align procurement and donation cycles, embed digital indicators into routine reporting and invest in reverse logistics and supportive supervision to consolidate supply chain gains.

Introduction:
Lymphatic filariasis, a mosquito-borne neglected tropical disease, remains a public health concern in Kenya’s coastal region despite reductions in transmission through mass drug administration. Morbidity management and disability prevention, particularly for hydrocele, lag behind due to limited surgical capacity, weak referral systems, and poor integration within primary health care.

Aim:
This study aimed to assess the effectiveness of an integrated community–facility approach in improving access to hydrocele surgery within primary health care systems.

Methods:
An implementation evaluation was conducted using routinely collected program data between 2024 and 2025 in coastal Kenya. An integrated community-facility care model was implemented within Primary Care Networks, using eCHIS-enabled Community Health Promoters to strengthen active case finding, health education, and digital referrals for NTD patients. A hub-and-spoke referral pathway linked community units to facilities for diagnosis, surgery, and follow-up. Capacity building was conducted through task-sharing and mentorship. Routinely collected program data were descriptively analyzed to assess changes in hydrocele surgical uptake.

Results:
A total of 1,497 hydrocelectomies were performed during the implementation period. The number of patients linkaged to surgery increased from 358 cases identified through routine systems before mapping to 1,139 cases following CHP-led eCHIS mapping, representing a 218% increase in hydrocele surgical uptake. The integrated referral pathway strengthened linkage of identified cases to surgical services and geospatial mapping supported targeted surgical outreaches and camps in high-burden areas.

Conclusion:
Integrating hydrocele management into primary health care improved access to morbidity services for lymphatic filariasis. Strengthened community systems, digital referral tools, and provider capacity support a scalable approach to addressing neglected tropical diseases and advancing elimination efforts.