THE KAREN HOSPITAL
CAPACITY OF CARDIAC CASES IN KENYA & TRAINING
DR.DK GIKONYO
DR.BM GIKONYO
Increasing BMI in Kenya’s Population
Courtesy of WHO Report on Kenya 2010
Overall increase in Adult Mean Systolic BP since 1980 (KENYA)
Key MaleFemale
Courtesy of WHO Report 2010
Prevalence of Diabetes in Kenya
DIABETES
HYPERTENSION
Hypertension Facts:
- Affect 1 billion people worldwide
- A 55yr normotensive person has up to 90% lifetime risk of developing hypertension (vasan2001)
- A leading cause/contributor to death (MI, stroke, vascular disease).
SMOKING IN KENYA
CURRENT TOBACCO SMOKING IN KENYA
Heart Disease in Kenya
• The Ministry of Health estimates that more than 200,000 children under 18 years old suffer from heart disease in Kenya.
• About 50% of these have congenital heart problems (hole in the heart) of various types and severity.
• The other 50% have acquired heart disease – usually Rheumatic in origin, stemming originally from a streptococcal sore throat which was ill managed.
• We have 45 Cardiologist in Kenya
ARGUMENT FOR TRAINING
COUNTRY POPULATION (2015)
KENYA 46.05 MILLION
UGANDA 39.03 MILLION
RWANDA 11.61 MILLION
BURUNDI 11.18 MILLION
SOUTH SUDAN 12.34 MILLION
SOMALIA 10.79 MILLION
ETHIOPIA 99.39 MILLION
TANZANIA 53.47 MILLION
ERITREA 4.79 MILLION
DJIBOUTI 887,861
TOTAL 289.53 MILLION
• 1st cath lab in Kenya, Kenyatta National Hospital, 1974 by Dr David Silverstein
• 2nd cath lab in Kenya, Nairobi Heart clinic, Nairobi Hospital 1993 by Dr Dan & Betty Gikonyo
• 3rd cath lab in Kenya, the Karen Hospital, 2006 by Dr Dan & Betty Gikonyo
ICU Beds in Kenya
• Kenyatta National Hospital (top referral hospital in East Africa) – 21 ICU Beds (edit: Just received word that KNH has converted 15 beds in Accident and Emergency into ICU beds, bringing total to 36)
• Kisumu Referral Hospital – 8 working ones, 6 under construction
• Moi Teaching and referral Hospital – 6 ICU Beds
• Coast General Hospital – 8 ICU Beds
• Machakos Level 5 Hospital – 3 ICU Beds
• Kijabe AIC hospital – 5 ICU Beds
• Kilifi Under construction – 20 ICU Bed facility
• Salgaa – World Bank Project – 5 ICU Bed Facility under construction
• Edit: Nyeri Hospital – 8 ICU Beds
• Current Total: 74Currently Under construction: 31
ICU Beds in Kenya
• The Mater hospital - 9 ICU Beds
• Nairobi hospital - 13 ICU Beds
• Agha Khan hospital - 4 ICU Beds
• MP shah Hospital - 30 ICU Beds
• The Karen hospital - 12 ICU Beds
• Nairobi women hospital - 3 ICU beds
Analyzed data for cardiac cases at The Karen Hospital last 6 months
40
11
3 42
0
5
10
15
20
25
30
35
40
45
MVR DVR AVR CABG ASD
ARGUMENT FOR TRAINING
COUNTRY FACILITY FOR HEART SX CATH LAB SERVICES
KENYA 6 6
UGANDA 2 1
RWANDA 0 0
BURUNDI 0 0
SOUTH SUDAN 0 0
SOMALIA 0 0
ETHIOPIA 1 1
TANZANIA 1 1
ERITREA 0 0
DJIBOUTI 0 0
TOTAL 10 9
SATELITE CLINICS
• Nyeri
• Nairobi CBD
• Nakuru
• Meru
• Karatina
• Ngong
• Kitengela
• Thika
• Rongai
7/5/2017
TEACHERS
• CURRICULUM ALREADY AVAILABLE
• PROVIDE TRAINING IN A MULTI CENTRE APPROACH UNDER THE AUSPICES OF THE KENYA CARDIAC SOCIETY
• CENTRES SUGGESTED SHOULD HAVE BASIC DIAGNOSTICS OF CARDIOLOGY = ECG/ECHO/EST/ HOLTER/ AMBULATORY BP/DOBUTAMINE STRESS ECHO/ ICU/HDU/CATH LAB– KNH/KAREN/AGA KHAN/MATER/NAIROBI HOSP/NAIROBI WEST HOSP/MP SHAH
• STUDENTS ARE REGISTERED AS DEGREE IN CARDIOLOGY AND ATTACHED TO EACH CENTRE FOR 6-12 MONTHS AT A TIME WITH ROTATION TO NEXT FACILITY ON SUCCESSFUL COMPLETION OF EACH STAGE
CARDIAC CATHETERIZATION LABORATORY
• STUDENTS SHOULD BE DEPLOYED TO SATELLITE UNITS FOR PROVISION OF BASIC CARDIOLOGY SERVICES AND WILL EXPOSE THEM TO WIDE RANGE OF PATHOLOGY
• TOTAL TIME OF TRAINING – 3 YRS• ASSESSMENT IS DONE ON CONTINUOS BASIS AND
FAILURE TO SATISFY AT ANY STAGE WILL REQUIRE REPETITION OF THAT STAGE.
• INCOROPORATE PRESENTATION AT THE KENYA CARDIAC SOCIETY CONFERENCES/MEETINGS
• HAVE A 3MONTH PERIOD ATTACHED TO AN EXTERNAL FACILITY (INDIA OR SOUTH AFRICA OR UK) FOR EXPOSURE TO OTHER SERVICES NOT AVAILABLE IN KENYA – KCS CAN FACILITATE THIS BY TALKING TO NECESSARY INSTITUTIONS.
TRAININGS Karen Hospital Experience
• 3 year programme 1. Dr.Anthony Gikonyo2. Dr.Hellen Nguchu3. DR.Daniel Nduiga4. Dr.Kanyeki David5. Dr. Macharia Matu6. Dr. Stephen Omondi
Previous example
• Dr.Robert Mathenge
• Dr. Martin Wanyoike
• Dr. Daniel Githegi
• Dr.David Githanga
• Dr Naomi Gachara
• Dr.Mureithi Nyamu