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