Cancer remains a significant global health challenge, with low- and middle-income countries (LMIC) disproportionately burdened by high mortality rates despite a lower overall incidence. Barriers to timely diagnosis and care exacerbate these disparities. This scoping review synthesizes existing literature on barriers for women in LMICs following the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies on women in LMICs reporting barriers to accessing care for breast, colorectal, lung, cervix uteri, thyroid, corpus uteri, and stomach cancers were included. Twenty-nine studies involving 7,031 participants were included. The most common barriers included financial challenges (65.5%), geographic obstacles (34.5%), health system limitations (55.2%), and low health literacy (51.7%). Patients experienced significant delays, averaging 7.4 months from symptom onset to diagnosis and 4.9 months from diagnosis to treatment initiation. Structural issues such as limited diagnostic services, inadequate healthcare infrastructure, and healthcare provider shortages were widespread. Addressing the multifaceted barriers to cancer care in LMICs requires comprehensive strategies, including increasing financial support, decentralizing care services, improving healthcare infrastructure, and enhancing education for patients and providers. Policymakers and stakeholders should prioritize investments in cancer care to reduce disparities and improve outcomes. These findings will inform strategies for improving cancer care in low-resource settings globally.

Introduction Antimicrobial resistance (AMR) is a growing problem globally especially in Sub-Saharan Africa including Kenya. Without any intervention, lower/middle-income countries (LMICs) will be most affected due to already higher AMR levels compared with higher income countries and due to the far higher burden of diseases in the LMICs. Studies have consistently shown that inappropriate use of antimicrobials is the major driver of AMR. To address this challenge, hospitals are now implementing antibiotic stewardship programmes (ASPs), which have been shown to achieve reduced antibiotic usage, to decrease the prevalence of resistance and lead to significant economic benefits. However, the implementation of the guideline is highly dependent on the settings in which they are rolled out. This study, employing an implementation science approach, aims to address the knowledge gap in this area and provide critical data as well as practical experiences when using antibiotic guidelines and stewardship programmes in the public health sector. This will provide evidence of ASP performance and potentially contribute to the county, national and regional policies on antibiotics use. Methods and analysis The study will be conducted in three geographically diverse regions, each represented by two hospitals. A baseline study on antibiotic usage, resistance and de-escalation, duration of hospital stay, rates of readmission and costs will be carried out in the preimplementation phase. The intervention, that is, the use of antibiotic guidelines and ASPs will be instituted for 18 months using a stepwise implementation strategy that will facilitate learning and continuous improvement of stewardship activities and updating of guidelines to reflect the evolving antibiotic needs. Ethics and dissemination Approvals to carry out the study have been obtained from the National Commission for Science, Technology and Innovation and the Mount Kenya University Ethics Review Committee. The approvals from the two institutions were used to obtain permission to conduct the study at each of the participating hospitals. Study findings will be presented to policy stakeholders and published in peer-reviewed scientific journals. It is anticipated that the findings will inform the appropriate antibiotic use guidelines within our local context.

Background: It is projected that by 2030, 70% of all cancer related deaths will occur in low-middle income countries. However, data on the state of cancer in most African countries is scanty. Cancer estimates for Kenya are based on the Nairobi and Eldoret cancer registries, leaving most parts of the country unrepresented. Lacking national coverage, these data do not accurately reflect Kenya’s cancer burden. The paucity of reliable data impedes formulation of effective cancer control strategies and cancer research prioritization. Here, we report the findings of a retrospective study of the cancer state in Meru County, Kenya. Methods: A retrospective analysis of patient files at Meru hospice was carried out. 2349 cancer cases seen at the Meru hospice between 2003 and 2018 were analyzed. Data abstracted from the records included patient age, gender and cancer type. The abstracted data was analyzed by descriptive statistics. Results: Our results indicate that cancer is almost evenly distributed across genders, with men accounting for 49% and women 51%. Stomach cancer rates are strikingly elevated and equal to those in countries with the highest stomach cancer rates globally – making it the commonest cancer in this region (14%). Among men, the most common cancers affect the prostate (18%), stomach (17%), esophagus (14%), head & neck (12%), liver (8%) and colorectum (5%). Among women, the commonest are cancers of the breast (22%), cervix (20%), stomach (11%), esophagus (8%), head & neck (6%) and liver (5%). Breast cancer occurs at a notably early age, with 20% of those affected aged below 40. Lung cancer rates are notably low in this region (1.3%) relative to world estimates. Conclusion: Cancer distribution in Meru is nearly even between sexes. Our analysis suggests that the Meru region is a stomach cancer hotspot and that it also experiences elevated esophageal cancer levels.

Globally, the emergence of the coronavirus disease (COVID-19) has had a significant impact on life. The need for ongoing SARS-CoV-2 screening employing inexpensive and quick diagnostic approaches is undeniable, given the ongoing pandemic and variations in vaccine administration in resource-constrained regions. This study presents results as proof of concept to use hybridization chain reaction (HCR) and clustered regularly interspaced short palindromic repeats (CRISPR)/Cas12a complex for detecting SARS-CoV-2. HCR hairpin probes were designed using the NUPACK web-based program and further used to amplify the SARS-CoV-2 N gene in archived nasopharyngeal samples. The results were visualized using agarose gels and CRISPR Cas12a-based lateral flow strips. The assay was evaluated using the gold standard, real-time polymerase chain reaction (RT-PCR), as recommended by the World Health Organization (WHO). The results show the comparative efficiency of HCR to RT-PCR. This study shows that HCR and CRISPR are viable alternatives for diagnosing SARS-CoV-2 in samples.

Background Antibiotic resistance is a growing global health threat worldwide and especially in developing countries. Irrational antibiotic prescription as well as lack of the requisite knowledge and awareness of proper antibiotic use are major drivers of antibiotic resistance. In Kenya, although the Ministry of Health has developed antibiotic use guidelines, these guidelines are not widely followed. Antibiotic prescription is, therefore, hugely at the discretion of the clinician. It is thus necessary to understand the knowledge, attitude, and practices (KAP) of antibiotic prescription among medical practitioners in the country. This study aimed to evaluate the knowledge, attitude, and practices (KAP) among antibiotic prescribers in three counties (Kiambu, Nakuru, and Bungoma) in Kenya. Methods This was a cross-sectional study using a self-administered questionnaire. Simple descriptive statistics were used to generate frequencies, percentages, and proportions. Where necessary, univariate analyses such as Pearson’s chi-square were performed to compare proportions for statistical significance. Results From the three counties, 240 respondents recorded their responses: 30% from Kiambu, 34.6% from Nakuru, and 35.4% from Bungoma. The respondents included 19 (7.9%) consultants, 66 (27.4%) medical officers, 135 (56.3%) clinical officers and 20 (8.3%) pharmacists. Of all respondents, more than 90% agreed or strongly agreed that antibiotic resistance (ABR) is a catastrophe worldwide and in Kenya. However, the proportion of the respondents who either agreed or strongly agreed (71.6%) that antibiotic resistance is a problem in their respective health facilities was significantly lower (ρ=0.013). Conclusion This study revealed that most medical practitioners were aware and knowledgeable about antibiotic resistance. However, there was a disconnect with mitigation measures such as active antibiotic stewardship and laboratory analyses to support judicious prescription. There is, therefore, a need for continuous education and stewardship interventions.

Cancer is a major global public health issue, causing a significant number of premature deaths worldwide. In 2020, the World Health Organization reported that more than 19 million individuals were diagnosed with cancer, and over 10 million lost their lives to the disease. Predictions indicate that cancer-related deaths will exceed 30 million by 2030, with around 75 % occurring in low- and middle-income countries (LMICs) like Kenya. Various factors contribute to this concerning trend, including aging populations, a high prevalence of cancer risk factors, socioeconomic disparities resulting in limited healthcare access, and deficiencies in healthcare systems within LMICs. This study focused on Nyandarua County, Kenya, which lacks a dedicated cancer registry. Without comprehensive incidence data, the county faces challenges in developing targeted programs for cancer prevention, management, and control. The main objective of this investigation was to establish a cancer registry specific to Nyandarua County, capable of continuously gathering accurate cancer data, patient treatment follow-ups and disease outcomes. A demographic survey was conducted to determine the frequency of all-cause and specific cancers among patients who attended selected health facilities between 2013 and 2020. Data were collected from existing hospital records in three main hospitals in the county. A total of 1373 cases were recorded, with 54.9 % of patients being female. North Kinangop Catholic Hospital accounted for the largest number of patients (62 %), followed by JM Kariuki County Memorial Hospital (35 %), while Engineer Hospital contributed the remaining 3 %. The top five cancer sites observed in Nyandarua County were esophagus (16.8 %), cervix uteri (13.4 %), stomach (10.6 %), breast (8.8 %), and prostate (8.6 %). Our findings provide valuable insights into the prevalence and distribution of different types of cancer in the region. With the establishment of this cancer registry, Nyandarua County is now among the pioneering counties in Kenya. It is crucial for the county government to undertake the responsibility of continuously updating the registry to draw inferences regarding cancer prevalence in the region to enhance patients follow up and survival.