Government of Kenya
Ministry of Health

W.H.O.

October, 2002 Nairobi, Kenya
Inquires regarding these Clinical Guidelines should be addressed to:
Director of Medical Services
Ministry of Health
Afya House
P.O. Box 30016
NAIROBI KENYA
Telephone (254-2) 717077 Ext. 45020
FAX (254-2) 715239
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NOTE ON DRUG DOSAGES
Every effort has been made to ensure that drug dosages and treatment schedules are correct and in accordance with current accepted medical practice. However, no responsibility can be taken for errors or omissions. When using an unfamiliar drug, clinicians are urged to confirm dosages before prescribing or administering the drug.
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Printed by The Regal Press Kenya Ltd., Nairobi
The Ministry of Health gratefully acknowledges the financial assistance of the World Health Organisation and the Pharmacy and Poisons Board for the preparation of the second edition and for the printing and implementation of the Guidelines.
First edition, November 1994
Second edition, October 2002
Copyright © October 2002, Ministry of Health, Government of Kenya
Copies of these Clinical Guidelines may be obtained from the office of the Registrar, Pharmacy and Poisons Board, Ministry of Health. Headquarters. P.O. Box 30016, Nairobi.
Sections of this manual may be freely copied and adapted for teaching, private study, research or other purposes provided that such activities are not-for-profit and provided that the source is clearly cited.
EDITORS
Dr. N.A. Kimathi
Dr. J.N. Micheni
Dr. A. Muriithi
CONTRIBUTORS
Unless otherwise noted contributors are within Ministry of Health Programmes. Affiliations listed were those at the time contributions were made.
Dr. J. Aswani, ENT Surgeon, KNH
Dr. C. Halloway, Medical Officer, WHO - Geneva
Dr. F. Kanibuni. Paediatric Surgeon, KNH
Dr. J. Karanja, Obstetrics-Gynaecology, UON
Dr. N. A. Kimathi, Paediatrics, KNDPIP/WHO, Nairobi
Dr. P.N. Kitili, Dermatologist, KNH
Mr. J. Ole Kiu, Chief Clinical Officer, MOH
Mr. H. Masengo, CO Paediatrics, MTC Nakuru
Dr. J. N. Micheni, General Surgeon, KNH
Dr. Kinoti Mugambi, General Surgeon, KNH
Dr. A. Muriithi, Paediatrician/Lecturer, UON
Dr. C.E. Muyodi, Physician, PGH Coast
Dr. Muia Ndavi, Obstetrics-Gynaecology, UON
Dr. P.S. Ochola, Head, Malaria Control Programme
Dr. P.L. Odede, General Surgeon, PGH Coast
Dr. M. Onguti, Senior Maxillofacial Surgeon, MOH
Dr. F.O. Othero, Ophthalmologist, MOH Kisumu
Dr. J.M. Othigo, Obstetrics-Gynaecology, PGH Coast
Dr. Owino, Psychiatrist, Mathari Mental Hospital
Dr. Chris Oyoo, Obstetrics-Gynaecology, PGH Kisumu
Dr. S.K. Sharif, Chief physician/PMO Coast Province
Mrs. Waweru, Reproductive Health Trainer, MOH
LIST OF CONTRIBUTORS TO THE REVISED EDL
Dr. S. Chuchu, Deputy Chief pharmacist. MOH
Dr. A. Indalo, UON
Dr. T. Kahiga,
Dr. E. Kamami, Embu
Dr. C. Kandie, Pharmacist i/c MSCU
Dr. B. Kiama, Chief Pharmacist, KNH
Dr. W. Kiarie,
Prof. G. Kokwaro, UON
Dr. K.C. Koskei, Chief Pharmacist, MOH
Dr. J. Masiga, Pharmacist. MEDS
Prof. G. Muriuki, UON
Dr. O. Naikuni, Pharmacist, PPB
Dr. B. Njue, Deputy Chief Pharmacist, MOH
Dr. J. Ombogo, Beta Healthcare
Prof. C. Ondari, KNDPIP - WHO
Dr. N. Rangara, Pharmacist PPB
Dr. H. M. Thuo, KNDPIP - WHO
PRODUCTION STAFF
C.N. Chiuri, Production Manager. PMO's Office. Nyeri
J. Kimani-Kanyi. MOH, HQ
REVIEWERS
The Editors gratefully acknowledge the expertise and useful suggestions of the following health professionals, who reviewed the Clinical Guidelines manual at various stages in its development. Affiliations listed were those at the time contributions were made.
Dr. B.M. Amira, Head. Curative Services. MOH
Dr. M. Awori, DDMS, MOH
Dr. G.N. Gakiria, Deputy Head NLTP, MOH
Dr. D. Ilako, Ophthalmologist, UON
Dr. K.C. Juma, Chief Drugs Inspector, MOH
Dr. R.R. Juma, Principal Research Officer, KEMRI
Dr. R. Kamau, MOH, Nyeri
Dr. C. Kandie, Pharmacist, MOH
Mrs. G. Kandie, Chief Nursing Officer, MOH
Dr. J. Karimurio, Ophthalmologist, UON
Dr. D.K. Kibuga, Head, NLTP, MOH (2001)
Mr. J.K. Kimitei, CO, Malaria Control Programme, MOH
Dr. W. Kioni, ENT Surgeon, KNH
Mr. Kisoo, CO, NASCOP
Dr. K.C. Koskei, Chief Pharmacist, MOH
Dr. A. Kutwa, Head, NLTP (2002)
Dr. CM. Macharia, ENT Surgeon, UON
Dr. M.D. Maina, Physician-Haematologist, KNH
Dr. J.M.N. Machoki, Obstetric-Gynaecologist and Lecturer, UON
Prof. G.A. Magoha, Dean, Medical School, UON
Prof. J.S. Meme, Permanent Secretary, MOH
Dr. R.O. Muga, Director of Medical Services, MOH
Dr. J. Mugo, Paediatrician, Thika
Dr. P. Mugwe, ENT Surgeon, UON
Prof. Muriuki, UON
Dr. G.K. Museve, Orthopaedics Surgeon, Department of Surgery, UON
Dr. B.K. Njue, Deputy Chief Pharmacist
Dr. J.O. Ombogo, Beta Healthcare
Dr. G.E. Ombuya, Head, Pharmacy Department. KNH
Dr. B.I.A. Rapuoda, National Malaria Control Programme, MOH
Dr. E.K. Ritho, Paediatrician, PGH/Nyeri
Dr. A.W. Wamai, Paediatrician, KNH
Dr. M. Wangai, Deputy Manager, NASCOP
Dr. W.O. Wanyanga, Cosmos Ltd.
Prof. A. Wasunna, Professor of Surgery, UON
Dr. H.W. Waweru, Dermatologist/Director KNH