Do you want to know more about Open Access? Find out about Act on Acceptance & ORCID from an expert? Book a place for our session on Tuesday 23rd August, 2-3pm in Room B at the WTCHG. Juliet Ralph, the Open Access Subject librarian, will be available for your toughest questions.
Posted 30/07/2021. A reliable catchment area is essential to define community needs (education, health care and social care) and population denominators. However, catchments are often implemented based on convenience disregarding implications on accuracy, planning and service seeking behaviour. Peter Macharia and colleagues revisit the issue by considering common approaches, key issues, and best practices in defining a reliable service catchment area
Posted 23/07/2021. Effective management and leadership are essential for everyday health system resilience, but health managers are often under-prepared and under-supported in these roles. Particular challenges have been observed in communication skills, emotional competence and supportive oversight. Jacinta Nzinga and colleagues share their learning from implementing a package of leadership development interventions in Kenya
Posted 13/07/2021. The overwhelming COVID-19 case numbers and deaths expected in African countries, as seen elsewhere following identification of the first COVID-19 cases, have not materialised. However, through serosurveillance of blood donors, Ifedayo Adetifa, Sophie Uyoga and colleagues demonstrate widespread SARS-CoV-2 infection in Kenya despite the lower COVID-19 cases and associated mortality.
Posted 22/06/2021. Diagnosis of bacterial meningitis in low- and middle-income countries is challenging due to limited laboratory capacity. Christina Obiero and colleagues conducted a revalidation study of previously identified signs of meningitis in children aged ≥60 days and found that KCH-2002 signs had lower sensitivity. Although bacterial meningitis is now uncommon following conjugate vaccination in Kenya, identifying cases is more difficult and support for basic cerebrospinal fluid analysis is crucial.
Posted 18/06/2021. Grace Irimu and colleagues show that newborns account for 46% of admissions and 66% of deaths among children 0-13years in Kenyan hospitals. Most deaths are caused by preventable and treatable causes. The authors call for need to prioritize newborn care for Kenya to achieve the SDGs target.
Posted 16/06/2021. The progress made in treatment of malaria is threatened by the emergence of resistance to current first line treatments artemisinin-based combination therapies (ACTs). There are currently no good alternatives for the treatment of uncomplicated malaria in the African setting in the event of resistance emerging to antimalarials that are in the ACTs. Mainga Hamaluba, Rob van der Pluijm and colleagues demonstrate that triple artemisinin combination therapies (TACTs) can potentially be used safely to prevent, delay or manage uncomplicated malaria in our setting.
Posted 08/06/2021. Alice Kamau and colleagues show that passively collected routine health facility data does offer opportunities to detect malaria ‘hotstops’ down to the village level, at an affordable cost. It will be important, however, to refine the current surveillance tools such that they have the potential of collecting information at sufficiently precise scale.
Posted 28/05/2021. Reagan Mogire, Sarah Atkinson and colleagues show that the prevalence of vitamin D deficiency (<50 nmol/L) is low (7.8%) in African children, although 37.1% have insufficient levels (50–75 nmol/L). Risk factors for vitamin D deficiency include high latitude, older age, winter and rainy seasons, Gc2 vitamin D binding protein genotype and malaria.
Posted 12/05/2021. Jacob Kazungu, Edwine Barasa and colleagues examined the level and inequality in health insurance coverage in 36 sub-Saharan African countries. They found that insurance coverage in sub-Saharan Africa is both low and pro-rich; only 8 of the 36 countries examined had a mean level of insurance coverage of above 10%.
Posted 28/04/2021. While Health and Demographic Surveillance Systems (HDSS) involving verbal autopsy provide essential data on deaths, births and other health-related events in LMICs where alternative sources are limited, Vicki Marsh and colleagues argue that current regulatory frameworks do not sufficiently recognise their nature as a form of non-traditional epidemiological research. Ethical challenges include risks of uncompensated burdens that alternative regulatory approaches may more successfully identify.
Posted 23/04/2021. COVID-19 case management is one of the key interventions in country responses to the pandemic. Angela Kairu, Edwine Barasa and colleagues estimate the unit costs for COVID-19 case management in Kenya useful in informing policy decisions around resource allocation, planning and budgeting, and development of appropriate healthcare purchasing arrangements. The findings illustrate that COVID-19 case management costs are substantial, ranging between two and four times the average claims value reported by Kenya’s public health insurer.
Posted 31/03/2021. Patient safety is a key goal of WHO but identifying harms and developing strategies to deliver safe care has been given little attention. Mike English and colleague describe a ‘portfolio’ approach to safety improvement in four broad categories: prioritising critical processes, improving the organisation of care, control of risks and enhancing responses to hazardous situations that we believe is relevant to low resource settings. We focus attention on the possible roles of practitioner groups and professional associations as key to advancing patient safety through collaboration and skill development in this field
Posted 26/02/2021. Malaria and iron deficiency are common in Africa and malaria may cause iron deficiency through a hepcidin-mediated block in iron absorption. Using sickle cell trait to proxy malaria exposure, John Muriuki, Sarah Atkinson and colleagues found that an intervention that halves malaria incidence would also reduce iron deficiency by approximately 50% in African children.
Posted 22/02/2021. Paper continues to be an important medium for recording inpatient care in low‐ and middle‐income countries. Naomi Muinga and colleagues synthesise evidence on how paper‐based nursing records have been developed within inpatient settings to support documentation of nursing care, and that a human‐centred design approach might better meet users' needs
Posted 12/02/2021. The majority of digital health projects have failed to translate into scaled, routine services, leaving many health leaders cautious and uncertain of how to proceed. Chris Paton and colleagues identify factors that can influence successful and sustainable integration of digital health within local health systems in low resource settings.
Posted 08/01/2021. Patient safety is much less well studied in low-resource settings than in higher income settings. Mike English and colleagues suggest how concepts being employed to advance patient safety thinking in higher income settings could be usefully applied by practitioners in low-resource settings. The ability to diagnose system weaknesses should become a core skill for those leading teams, wards, departments or facilities in low-resource settings
Posted 07/07/2020. In a country with 25 million newborns, children and adolescents, how many paediatricians are there and where are they? This paper by Mike English and colleagues seeks to start a debate on how to deliver paediatric services in LMIC in the future.
Posted 10/01/2020. Our ethnography aimed to describe Nairobi’s inpatient newborn wards and the busy lives of the nurses who work there. They work long hours with little supervision in ill-designed wards, staffed by far too few nurses given the pressing need. Under these difficult conditions, the collective model of nursing that develops reduces nurses’ exposure to stress and anxiety. Jacob McKnight and colleagues describe how these coping methods have implications for the quality of care and limit the potential for a patient-centred approach.
Posted 26/01/2021. Appropriate and well-resourced medical internship training is important to ensure psychological health and well-being of doctors in training and also to recruit and retain these doctors. Yingxi Zhao and colleagues identified and described a large number of tools designed for measuring medical internship experience, to help medical educators and human resource managers make an evidence-based decision on designing surveys to understand interns’ experience of training.
Posted 03/09/2020. Cian Wade, Mike English and colleagues brought together a large body of evidence to inform recommendations for Kenya on neonatal analgesic guidelines for routine procedures. They describe the process by which a group of local experts translated systematic review and meta-analysis findings into context-specific clinical guidelines. The work emphasises the value of breastfeeding or breast milk as an important and feasible therapeutic strategy for alleviating neonatal pain.
Nguyen Lam Vuong, Sophie Yacoub & colleagues have identified a combination of biological markers in patients with dengue that could predict whether they go on to develop moderate to severe disease. Biomarkers are used to identify the state or risk of a disease in patients; these findings could aid the development of biomarker panels for clinical use and help improve triage and risk prediction in patients with dengue.
The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial has demonstrated that the investigational antibody combination developed by Regeneron reduces the risk of death when given to patients hospitalised with severe COVID-19 who have not mounted a natural antibody response of their own.
The RECOVERY trial was established as a randomised clinical trial to test a range of potential treatments for patients hospitalised with COVID-19. Patients with COVID-19 are at increased risk of blood clots forming in their blood vessels, particularly in the lungs. Between November 2020 and March 2021, the RECOVERY trial included nearly 15,000 patients hospitalised with COVID-19 in an assessment of the effects of aspirin, which is widely used to reduce blood clotting in other diseases. There was no significant difference in the primary endpoint of 28-day mortality
Created in March 2020 to assist policymakers to make use of existing evidence in mathematical and epidemiological models to inform strategies for minimising the impact of COVID-19, the CoMo Consortium brings together mathematical modellers, epidemiologists, health economists and public health experts from more than 40 countries across Africa, Asia and South and North America.
The University of Oxford announces the launch of a centre of global research collaboration and excellence, the Pandemic Sciences Centre. The need for partnership between academic excellence, industry and public health organisations is one of the key lessons learned from the coronavirus pandemic. This centre will unite disciplines, and sectors, to build agile, equitable partnerships that can tackle complex problems and respond to pandemic threats at any time.
Which infections are most common in the Chiangrai region? How should we treat them and how can we improve diagnostic? Which strategies are most effective in directing antibiotic treatment? Blog by Carlo Perrone, research physician based at the Chiang Rai Clinical Research Unit in Chiangrai, Thailand.