Posted 26/11/2021. Steven Wambua and colleagues analysed monthly reports in 204 Kenyan hospitals and quantified the impact of COVID-19 on utilization of inpatient services. Data was obtained from the District Health Information Software 2 (DHIS 2). We observed significant drops in monthly volumes of live-births, over-fives admissions for medical, and surgical care with the greatest declines in the under-five\u2019s admissions.
\n \n\n \n \nPosted 04/03/2022. In a secondary analysis of a transfusion trial, Kathryn Maitland and colleagues showed that of 3188 children with severe anaemia (haemoglobin < 6 g/dl) 41% received a whole blood transfusion. Compared with whole blood, children receiving packed cells had a worse haemoglobin correction by 8 hours, required more additional transfusions and had longer hospital stays. We found no adverse effects of whole blood compared to packed cells.
\n \n\n \n \nPosted 02/03/2022. There are many benefits of vaccinating population against COVID-19 including a reduction in transmission, likelihood of severe disease, and pressure on health system. We assessed geographic inequalities in vaccine access in Kenya over the past year and show that despite on-going efforts, only 30% of adult population will have been vaccinate by April 2022, highlighting the disproportionate access to vaccine is Africa population.
\n \n\n \n \nPosted 25/02/2022. The burden of neurological impairments in older children from Africa remains unknown. Modelling empirical and literature estimates, Jonathan Abuga and colleagues demonstrate the high burden of fatal and non-fatal outcomes associated with active and lifetime epilepsy, and moderate/severe impairments in cognitive, motor, vision and hearing functions among older children (5-14) residing in a rural setting along the Kenyan coast. Interventions to prevent premature mortality and improve the wellbeing of these children are needed
\n \n\n \n \nPosted 16/02/2022. Severe malaria is a medical emergency requiring prompt supportive and parenteral (intravenous/intramuscular) treatment. Beatrice Amboko and colleagues showed the inadequacy of the readiness of primary public health facilities to deliver appropriate pre-referral care to children with severe malaria in Kenya between 2017 and 2021.
\n \n\n \n \nPosted 15/02/2022. In this cost of illness study, Aishatu Adamu and colleagues found that in children aged <5 years, a week-long hospitalisation with pneumonia or invasive pneumococcal disease resulted in substantial costs to the health provider and households. Expenses were catastrophic for a third of the households, and for over half of the poorest households.
\n \n\n \n \nPosted 08/02/2022. There has been very little research on the epidemiology of severe malaria for over 20 years. Alice Kamau and colleagues analysed 52,000 malaria admissions from 49 settings across East Africa. Under high transmission, malaria hospitalisation was concentrated in children <5. Severe malaria anaemia is currently the most common severe disease presentation. Spatially and age targeting interventions, including chemoprevention and vaccines, will have the maximum benefit in areas where prevalence of infection is \u226510%.
\n \n\n \n \nPosted 08/12/2021. The prevalence of malaria parasite in the population is a key metric used for disease stratification. At sub-national levels, this prevalence is strikingly heterogenous, transcending national borders in Kenya, Tanzania and Uganda. Approximately 12.7 million people in East Africa continue to live in areas with over 30% prevalence. This mapping by Victor Alegana and colleagues highlights why countries must work together to reduce burden and prevent further malaria deaths.
\n \n\n \n \nPosted 22/09/2021. Kelvin Mokaya, Sarah Atkinson and colleagues found that children with severe malaria anaemia have higher risk of non-typhoidal Salmonella bacteraemia, and lower levels of the iron-regulating hormone, hepcidin (even with Salmonella coinfection) compared to other forms of malaria. Reduced hepcidin may increase iron availability for bacterial growth in the Salmonella-containing vacuole.
\n \n\n \n \nPosted 01/09/2021. Rob Paton, Alice Kamau and colleagues analysed a data series of over 6000 hospital records of malaria admissions among children aged 3 months to 9 years. A 25% reduction in transmission halved the rate of severe malaria hospitalization. Severe malaria remains a burden predominantly in children under 5 years, regardless of the level of malaria transmission.
\n \n\n \n \nPosted 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
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 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 \u226560 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.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 08/06/2021. Alice Kamau and colleagues show that passively collected routine health facility data does offer opportunities to detect malaria \u2018hotstops\u2019 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.
\n \n\n \n \nPosted 28/05/2021. Reagan Mogire, Sarah Atkinson and colleagues show that the prevalence of vitamin D deficiency (<50\u2009nmol/L) is low (7.8%) in African children, although 37.1% have insufficient levels (50\u201375\u2009nmol/L). Risk factors for vitamin D deficiency include high latitude, older age, winter and rainy seasons, Gc2 vitamin D binding protein genotype and malaria.
\n \n\n \n \nPosted 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%.
\n \n\n \n \nPosted 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\u2019s public health insurer.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 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.
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