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Malaria kills almost 600,000 people a year, most of whom are African children, according to the World Health Organisation. Yet, millions of other people recover from an infected mosquito bite without succumbing to the life-threatening complications, especially with access to effective drug regimens.
Malaria is a cause of iron deficiency in African children
KWTRP
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.
Designing paper‐based records to improve the quality of nursing documentation in hospitals
KWTRP OCGHR
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
Factors influencing the sustainability of digital health interventions in low-resource settings: Lessons from five countries
KWTRP OCGHR
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.
First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
KWTRP OCGHR
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
The paediatrician workforce and its role in addressing neonatal, child and adolescent healthcare in Kenya
KWTRP OCGHR
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.
Collective strategies to cope with work related stress among nurses in resource constrained settings
KWTRP OCGHR
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.
Tools for measuring medical internship experience: a scoping review
KWTRP OCGHR
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.
Development of locally relevant clinical guidelines for procedure-related neonatal analgesic practice in Kenya
KWTRP OCGHR
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.
The importance of supplementary immunisation activities to prevent measles outbreaks during the COVID-19 pandemic in Kenya
KWTRP
Posted 05/02/2021. Measles immunity gaps have widened following disruptions of routine immunisation and supplementary activities due to COVID-19 pandemic in Kenya. While COVID-19 restrictions temporarily reduced the risk of a measles outbreak, Caroline Mburu, Ifedayo Adetifa and colleagues estimate that this risk will rapidly rise once the restrictions are lifted. Implementing delayed supplementary immunisation activities will be critical for prevention of measles outbreaks.
Immunogenicity and safety of fractional doses of yellow fever vaccines
KWTRP
Posted 15/01/2021. Yellow Fever is a re-emerging disease whose incidence has increased globally in the last three decades. Although very successful, the stocks of the YF vaccine are often insufficient. Derick Kimathi, George Warimwe and colleagues assessed the immunogenicity and safety of fractional (1/5th) doses. Our results support fractional dosing of all four WHO-prequalified YF vaccines in general adult population as a dose-sparing strategy.
Malaria infection, disease and mortality among children and adults on the coast of Kenya
KWTRP
Posted 03/07/2020. Under declining malaria transmission on the Kenyan coast Kilifi, Alice Kamau, Bob Snow and colleagues show that children continue to bear the brunt of mild and severe disease. There was no significant malaria disease or mortality burden in adults. This is contrary to current modelled approaches to malaria disease burden among African adults.
Prediction modelling of inpatient neonatal mortality in high-mortality settings
KWTRP
Posted 31/10/2020. Existing neonatal prognostic models are suited for advanced care settings; however, they use parameters that are not available in low-resource settings. Jalemba Aluvaala and colleagues demonstrate that two novel models - NETS and SENSS - using basic routine data can accurately predict in-hospital mortality which may allow us to better understand neonatal mortality.
How severe anaemia might influence the risk of invasive bacterial infections in African children
KWTRP
Posted 09/10/2020. Children with severe anaemia are more likely to get bacterial infections. Kelvin Mokaya, Sarah Atkinson and colleagues discuss how severe anaemia interferes with iron regulation, and how this promotes bacterial growth in blood and dampens immune responses to these bacteria. The authors also suggest possible studies that can be used to explore their hypothesis.
Red blood cell tension protects against severe malaria in the Dantu blood group
KWTRP
Posted 29/09/2020. In a collaborative effort to investigate the mechanism of protection conferred by the rare Dantu blood group variant, found at highest frequency in East Africa, Silvia Kariuki and colleagues found a strong correlation between red blood cell membrane tension and parasite invasion ability. Increased membrane tension led to resistance to parasite invasion, and Dantu red blood cells had higher average membrane tension, meaning that a greater proportion resisted invasion. The findings from this study could inform the design of drugs that imitate this increased membrane tension to prevent or treat malaria.
Initiating a network to support engagement between health researchers and schools: recommendations from an international meeting of schools engagement practitioners held in Kilifi, Kenya
KWTRP
Posted 18/08/2020. In November 2018 twenty-nine participants, representing 21 institutions from 11 countries, participated in a first international “school engagement” workshop hosted by the KEMRI-Wellcome Research Programme in Kilifi, Kenya. Alun Davies and colleagues report on the broad range of goals and approaches for engagement between health researchers and school students.
Enhancing science preparedness for health emergencies in Africa through research capacity building
KWTRP
Posted 17/07/2020. In this editorial, Sam Kinyanjui and colleagues argue that establishing science preparedness, which is an integral component of emergency preparedness, should be embedded within long-term investment in research capacity. They illustrate how African-led research capacity building consortia including IDeAL have contributed to Africa’s preparedness for the COVID-19 pandemic.
Interferon-gamma polymorphisms and risk of iron deficiency and anaemia in Gambian children
KWTRP
Posted 30/06/2020. Interferon-gamma (IFN-g) is upregulated during malaria infection and influences erythropoiesis and iron status. Kelvin Mokaya, Sarah Atkinson and colleagues found that children carrying the IFNG+2200C allele, a variant previously associated with higher IFN-g levels, had a modestly increased risk of anaemia and iron deficiency after the malaria season. Larger studies are needed to validate this finding.
An appeal for practical social justice in the COVID-19 global response in low-income and middle-income countries
KWTRP
Posted 23/06/2020. As the COVID-19 global pandemic escalates in low-income and middle-income countries (LMICs), locally tailored responses addressing socio-economic and health inequities are essential. Edwine Barasa, Sassy Molyneux and colleagues offer five key considerations grounded in principles of social justice to inform decision making, and call for countries to act together, in cooperation, to build resilience.
Routine data for malaria morbidity estimation in Africa: challenges and prospects
KWTRP
Posted 19/06/2020. The true burden of malaria in sub-Saharan Africa remains challenging to measure. In Africa, there is increasing use of routine surveillance data to define national strategic targets, estimate malaria case burdens and measure control progress to identify financing priorities. Victor Alegana and colleagues address some of the challenges and prospects related to using routine data which equally apply to other disease surveillance.
Iron deficiency is associated with reduced levels of Plasmodium falciparum-specific antibodies in African children
KWTRP
Posted 15/06/2020. Iron deficiency and malaria are common among African children and studies suggest that iron may be critical for the development of humoral immunity. Sarah Atkinson and colleagues found that in 1,794 community-based children in Kenya and Uganda, iron-deficiency was associated with lower levels of P. falciparum-specific antibodies even after adjusting for malaria exposure.