KAIRUKI UNIVERSITY REPOSITORY
Welcome to Kairuki University Institutional Repository (KUIR), an open-access digital archive managed by Kairuki University Library. We collect, organize, preserve, showcase, and share digital materials created by Kairuki University scholarly community. Our goal is to offer free access to academic works for researchers and the general public:
Communities in DSpace
Select a community to browse its collections.
Recent Submissions
Feasibility and acceptability of unconditional cash transfers intervention among unemployed young adults with first-episode psychosis in South Africa: a pilot randomized controlled trial
(International journal of mental health, 2026-04-25) Protas,Joyce.
There is a lack of high-quality evidence on cash transfers as an intervention to support young people with first-episode psychosis (FEP) in Africa. To address this gap, we conducted a pilot randomized controlled trial (RCT) with a 3-month follow-up period to assess the feasibility and acceptability of an unconditional cash transfer (UCT) intervention among FEP. We enrolled 60 unemployed young adults (18–29 years) with FEP from three public hospitals in KwaZulu-Natal, SA, and allocated participants into the intervention (n = 30) or the control arm (n = 30) using simple randomization. The intervention arm participants received a monthly transfer of R1,350 for three consecutive months. All 30 participants in the intervention arm completed the three-month follow-up, and 24 (80%) completed follow-up in the control arm. Although the effect of UCT on clinical and social outcomes is not the primary focus of this RCT, we observed significantly greater quality of life (p < 0.05) and medication adherence (p < 0.02) in the intervention group as compared to control group at the 3-month follow-up period. Although personal/social functioning challenge (p = 0.24) and cumulative relapses (p = 0.10) were greater in the control group, no statistically significant group differences were observed. Our study contributes the first evidence on UCT feasibility and acceptability for FEP.
Prevalence of resistance markers of artemisinin, partner drugs, and sulfadoxine-pyrimethamine in Nanyumbu and Masasi Districts, Tanzania between 2020 and 2021
(Antimicrobial Agents and Chemotherapy, 2024-09-12) Mwaiswelo, Richard O.
Regular monitoring of the emergence and spread of Plasmodium falciparum markers of resistance against artemisinin, partner drugs, sulfadoxine, and pyrimethamine is important for the treatment and prevention of malaria in Tanzania. Blood samples were collected from febrile and non-febrile children aged 3 to 59 months in Masasi and Nanyumbu Districts between 2020 and 2021. The samples were subjected to molecular analysis for markers of artemisinin, partner drugs, sulfadoxine, and pyrimethamine resistance, including Plasmodium falciparum kelch (Pfk) 13 gene, P. falciparum chloroquine resistance transporter gene (Pfcrt), P. falciparum multidrug resistance gene (Pfmdr) 1, P. falciparum dihydrofolate reductase (Pfdhfr), and P. falciparum dihydropteroate synthase (Pfdhps). A total of 531 blood samples were involved in the analysis. None of the P. falciparum isolates analyzed for Pfk13 carried any of the validated markers of artemisinin resistance. Pfcrt CVMNK wild-type haplotype occurred in 88.9% (271/305) of the parasites, and the mutant CVIET haplotype occurred only in 0.7% (2/305). Conversely, the majority of the parasites (24.2% [48/198]) were carrying Pfmdr1 NFD haplotype, followed by the wild-type haplotype NYD (19.1% (39/198), and the rest were mixed infections. Quintuple mutation IRNI-SGEAA occurred in 54.4% (62/114), and sextuple mutation IRNI-FAKGS occurred only in 0.9% (1/114) of the parasites. No parasite carried any of the validated markers of artemisinin resistance; however, the prevalence of Pfcrt and Pfmdr1 resistance markers against the partner drugs reached the saturation point. Sextuple Pfdhfr-Pfdhps mutations occurred only in one patient; therefore, SP remains efficacious for IPTp in the Districts.
KEYWORDS prevalence, resistance markers, artemisinin, partner drugs, sulfadoxine-pyrimethamine, Tanzania
Strategies for relapse prevention among people with schizophrenia in KwaZulu-Natal Province, South Africa: Healthcare providers' perspectives
(Plos One, 2025-03-10) Protas,Joyce.
Introduction
Relapse is a significant challenge among people with schizophrenia and is broadly recog-
nized by the aggravation of positive or negative symptoms, the need for re-hospitalization,
more intensive case management, and/or changes in medication. The quality of inpatient
care and proper transition to outpatient care are crucial in reducing the risk of relapse.
Healthcare providers play vital roles in ensuring the continuity of care after patients are
discharged from the hospital. Little is known about the roles of preventing relapse from the
perspective of healthcare providers. This study explored the currently existing strategies
for preventing relapse from the perspective of healthcare providers.
Methods
We captured the view of healthcare providers providing services to psychiatric patients
using a qualitative methodological approach with descriptive phenomenology. We con-
ducted audio-recorded, in-depth interviews with 15 consenting clinical providers from a
public psychiatric hospital in Durban, South Africa. To facilitate analysis, we used Dedoose
software (SocioCultural Research Consultants, LLC [www.dedoose.com]), and the themes
were inducted from the data.
Results
Six major themes inducted from the analysis: Preparing patients and caregivers for
discharge; Developing consistent and caring therapeutic relationships; Using an active
approach to transition; Working with patients and caregivers concurrently; Creating and
sustaining interagency connections; and Facilitating alternative forms of treatment.
Conclusions
Discharge planning and preparation are needed to ensure smooth transitions from hos-
pital to outpatient care for relapse prevention. The healthcare system should ensure the
availability of human resources for health at all levels of health facilities, and multidisci-
plinary teamwork will help a successful transition.
Unmet needs of young adults following first-episode psychosis in KwaZulu-Natal, South Africa: Baseline findings from a pilot randomised controlled trial of basic income support
(South African Journal of Psychiatry, 2026-02-26) Protas,Joyce.
BackgroundPeople with psychosis have multiple and complex needs. The first episode of psychosis (FEP), as a distinct health challenge that occurs frequently during adolescence or early adult years, is a serious threat because of high levels of poverty among the youth in South Africa.
AimThis study quantifies the needs among unemployed FEP adults aged 18–29 years in South Africa for potential early intervention targeting.
SettingThe study was conducted at government psychiatric facilities in Msunduzi Municipality, KwaZulu-Natal province, South Africa.
MethodsAs part of a pilot randomised controlled trial of an unconditional cash transfer (UCT) intervention, also known as basic income support (BIS), 60 FEP participants were enrolled, and we assessed their needs using the Camberwell Assessment of Needs, the Household Food Insecurity Access Scale and the Water Insecurity Experience Scale. Descriptive cross-sectional analyses were summarised for various domains of needs.
ResultsMost participants were black people (n = 58, 96.7%), male (n = 47, 78.3%), with a median age of 23 years (interquartile range [IQR] = 20.0–25.5), with half being diagnosed with schizophrenia (n = 30, 50%). The most significant severe unmet need was the inability to access government benefits to which one is entitled. Despite the limited availability of mental health services in South Africa, the majority reported that their need for managing psychotic symptoms was met or partially met.
ConclusionThe needs of youth must go beyond the temporary management of psychotic symptoms.
ContributionThis study highlights the unmet needs of young adults with FEP in resource-constrained environments and underscores the need for integrated interventions.
Experiences of an unconditional cash transfer intervention among young adults with first-episode psychosis in South Africa: qualitative inquiry of patients and their caregivers
(International Journal of Qualitative Studies on Health and Well-Being, 2025-11-25) Protas,Joyce .
Introduction
Strengthening social protection through cash transfers has proven effective in reducing common mental disorders such as anxiety and depression. However, the acceptability of unconditional cash transfer (UCT) interventions, also known as Basic Income Support (BIS) in certain regions, for socially vulnerable young adults who have experienced first-episode psychosis (FEP) in sub-Saharan Africa, including South Africa, remains unknown. This qualitative inquiry explored the experience and acceptability of an unconditional cash transfer (UCT) intervention among patients with FEP and their caregivers.
Methods
The study was conducted at government hospitals in KwaZulu-Natal Province, South Africa. In this descriptive phenomenological qualitative study, we aimed to interview 15 recipients of a UCT intervention with their caregivers based on convenience sampling. An interview guide was designed to explore recipients’ experiences with money utilization and budget decisions, as well as their views on preferred recipients, the effects of UCT, and their recommendations on how much money is needed to cater to their needs. Information saturation was achieved after interviewing ten FEP recipients and their caregivers. NVIVO 14 was used to analyze the data using interpretive phenomenology.
Results
The UCT intervention was well accepted, with funds used for transportation to the hospital and purchasing groceries and food. Indirectly, UCT enhances family relationships and medication adherence and reduces patient and caregiver stress.
Conclusion
The UCT intervention was acceptable and positively experienced by patients with FEP. This study highlights the need to enhance social protection mechanisms to support engagement in mental health treatment for FEP.