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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.
Phenotypic and genotypic insecticide resistance profiles of main malaria vectors in Kwale county, coastal Kenya
Posted 17/06/2025. Marta Maia and colleagues characterised phenotypic and genotypic insecticide resistance of malaria vectors in Coastal Kenya. Multiple mutations associated with resistance mechanisms were detected, including target site (L1014S and L1014F) and metabolic resistance (CYP6P9a, CYP6P9b, 6.5kb S.V, GSTe2-L119F). Resistance has increased since 2017. Evidence supports regular monitoring and the use of PBO-combination nets.
Age structure and parity status determination of Afrotropical malaria vectors using MALDI-TOF MS
Posted 15/05/2025. Understanding the age structure of a mosquito populations is the best way to evaluate how well vector control interventions are working. However, age-grading is hard and usually done through complex dissections. Here Marta Maia and colleagues present a method using MALDI-TOF MS exploiting protein changes associated with senescence for age-grading of malaria vectors.
Creating different global health futures: mapping the health research ecosystem and taking decolonial action
Posted 29/04/2025. Decolonisation in global health emphasises the need to challenge and change entrenched power asymmetries and unfair health research practices. Nadia Tagoe, Sassy Molyneux, Caesar Atuire and colleagues have proposed practical decolonial action using a four-step framework and a reflexive tool that can help transform key domains of the global health knowledge ecosystem.
Putting health facilities on the map: a renewed call to create geolocated, comprehensive, updated, openly licensed dataset of health facilities in sub-Saharan African countries
Posted 15/04/2025. Healthcare service provision and planning depend on the availability of a comprehensive health facility database (HFDB) to adequately meet the healthcare needs of a population. However, the availability of HFDBs has remained a big challenge in sub-Saharan Africa (SSA). Peter Macharia and colleagues elaborate historical developments and the current status of HFDBS while describing the steps required and challenges to overcome for harmonized SSA-wide HFDBs.
Situational analysis of antibiotic prescriptions in Kenyan neonatal units for antimicrobial stewardship: a retrospective longitudinal study
Posted 08/04/2025. High antibiotic use in Kenyan neonatal units may contribute to antimicrobial resistance. A study of 88,000 neonatal admissions in 22 hospitals found 62.6% received antibiotics at admission, mostly first-line drugs. However, non-first-line use was higher in outborn neonates. Monitoring antibiotic patterns at scale feasible and crucial for assessing antimicrobial stewardship and reducing resistance. With Jalemba Aluvaala and Mike English
Strengthening the paediatric clinical trial ecosystem to better inform policy and programmes
Posted 04/04/2025. The first WHO Global Clinical Trials Forum was convened in November 2023 to develop a shared vision of an effective global clinical trial infrastructure. In this paper, the Paediatric Clinical Trials Working Group shares perspectives, identify challenges, and proposes solutions to strengthen the global paediatric clinical trials ecosystem. By James Berkley
Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security
Posted 01/04/2025. Medical oxygen is a critical treatment in severe illness, yet global access remains inequitable, especially in low-income countries. The COVID-19 pandemic highlighted these disparities. The Lancet Global Health Commission emphasizes systemic improvements, investments in infrastructure, workforce training, and affordability. Addressing these gaps can save millions of lives and strengthen global health resilience. With Jacquie Oliwa and Mike English as members of this Lancet Commission.
Effects of health system limitations on the use of blood culture and sensitivity testing in Kenyan county hospitals: an interview-based qualitative study using causal loop diagrams
Posted 02/04/2025. Antibiotic resistance is rising in Africa, but blood culture and sensitivity (BCS) testing faces challenges in Kenyan hospitals. A study using a complex systems approach across eight hospitals found that interconnected issues in both demand and supply, including cost, turnaround time, and logistical barriers undermine the use and sustainability of BCS testing at scale; targeted antimicrobial stewardship may offer a viable alternative. By Jacob McKnight & Mike English with KWTRP colleagues.
Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
Posted 27/03/2025. The photovoice sub-study in the BOHEMIA clinical trial let participants document their experiences and perceptions of the intervention. Their photos captured trial experiences, MDA effects and overlooked community concerns. This provided insights from participants' perspectives, highlighting issues beyond the study's scope that local health authorities and researchers might have missed. By Truphena Onyango
Multiple insecticide resistance in Anopheles funestus from Mopeia, Central Mozambique
Posted 25/03/2025. Malaria vectors in Mopeia, Mozambique were found resistant to all classes of insecticides used in malaria control. New insecticide classes or non-insecticide-based tools are urgently needed. Resistance markers to dieldrin suggest potential selective pressure by agricultural pesticides. Coordinated and rational insecticide usage between health and agriculture sectors is needed. By Marta Maia.
Comparing HemoCue® and Quantitative Buffy Coat® and Coulter Counter-measured haemoglobin concentrations in African children with acute uncomplicated malaria: a Bland–Altman analysis
Posted 19/03/2025. Malaria studies often involve blood transfusion to severe malarial anaemic children. Accurate Anaemia diagnosis is crucial for effective management. Hence, important to determine the level of agreement among haemoglobin concentrations measurement methods. HemoCue® should be used with caution in settings where decisions about blood transfusions are made. By Mavuto Mukaka
Catastrophic expenditure associated with childhood hospitalisation for acute illness in Kenya and Uganda: a cross-sectional study
Posted 04/02/2025. In Kenya and Uganda, hospital care for under-fives is intended to be free. James Berkley and colleagues studied families’ healthcare, travel, other costs, and loss of earnings due to child admissions at six hospitals. 74% to 92% of households experienced ‘catastrophic’ expenditure (depending on the definition used) in relation to monthly income.
Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya
Posted 31/01/2025. This is an important finding for Kenya, artemisinin resistance k13 mutations previously identified in Uganda (C469Y and A675V) and SE Asia (P553L) are described. Though at low frequencies, 4%, 1.7% and 1.2%, respectively, they sound the alarm for studies to determine their impact on the efficacy of artemisinin-based combination therapies. By Isabella Oyier
After neonatal care, what next? A qualitative study of mothers’ post-discharge experiences after premature birth in Kenya
Posted 28/01/2025. Each year, 15 million babies are born prematurely, with Sub-Saharan Africa and Asia accounting for over half. Weak healthcare systems and poverty in SSA worsen outcomes for mothers and babies. This study by Justinah Maluni and Dorothy Oluoch explores the challenges mothers face post-discharge and suggests strategies to improve care and reduce mortality and readmission rates.
Understanding health system responsiveness to public feedback at the sub-national level: Insights from Kilifi County, Kenya
Posted 22/01/2025. Nancy Kagwanja and colleagues examined public feedback in health systems, focusing on its forms, channels, processing, and responses. Feedback mechanisms often operated in isolation, excluding vulnerable groups. Organisational challenges, such as inadequate resources, weak policies and power dynamics limited effectiveness. Integrating diverse mechanisms and addressing system capacities are vital for improved responsiveness.
Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic
Posted 13/11/2024. Ruth Lucinde, Anthony Etyang and colleagues conducted a prospective longitudinal hospital-based sentinel surveillance at 16 public hospitals in Kenya during the COVID-19 pandemic to describe the clinical and demographic pattern of patients admitted with severe acute respiratory illness (SARI), and evaluate COVID-19 vaccine effectiveness. They identified key risk factors for mortality and reported a moderate vaccine effectiveness of 59% against progression to inpatient mortality.
Fractional Doses of Pneumococcal Conjugate Vaccine — A Noninferiority Trial
Posted 10/10/2024. Pneumococcal Conjugate Vaccines (PCV) have had a tremendous impact on childhood morbidity but only 2/3 of children receive a PCV. One obstacle to wider protection is cost. Kate Gallagher, Anthony Scott and others at KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya, showed that a 40% fractional dose of PCV13 had non-inferior immunogenicity to a full dose, suggesting similar benefits could be delivered for lower cost.
Public service motivation, public sector preference and employment of Kenyan medical doctor interns: a cross-sectional and prospective study
Posted 11/09/2024. Daniel Mbuthia and colleagues surveyed 356 Kenyan medical doctors, to understand what influences their career choices at labour market entry, specifically understanding the role of public service motivation. They highlighted that nearly all surveyed doctors are public service oriented, many doctors stated intention to work in the public sector but were unable due to lack of job opportunities. Unfortunately, 13% of the doctors were unemployed one year after completing their internship.
The mRNA content of plasma extracellular vesicles provides a window into molecular processes in the brain during cerebral malaria
Posted 06/09/2024. Kioko Mwikali, Abdirahman Abdi and colleagues at KEMRI-Wellcome Trust used extracellular vesicles circulating in plasma to noninvasively study the progression of cerebral malaria in children. This provides a mechanism for identifying diagnostic biomarkers and developing therapeutic strategies.
Examining liminality in professional practice, relational identities, and career prospects in resource-constrained health systems: Findings from an empirical study of medical and nurse interns in Kenya
Posted 03/09/2024. Yingxi Zhao, Stephanie Nzekwu and colleagues examined new Kenyan doctors' and nurses' experiences of transitioning from training to practising as health professionals, drawing on the concept of liminality. The research highlighted three dimensions of liminal experiences in professional practice, relational inter- and intra-professional identity and status, and professional careers.