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.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 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.
\n \n\n \n \nPosted 06/08/2024. Kioko Mwikali, Abdirahman Abdi and colleagues found that the CSF proteome of cerebral malaria is more similar to Alzheimer's Disease than to acute bacterial meningitis, with cerebral malaria showing elevated amyloidosis. This finding might benefit the search for treatment and management of both Alzheimer's Disease and cerebral malaria.
\n \n\n \n \nPosted 02/08/2024. Plasmodium falciparum malaria is a strong predisposing factor for bacteraemia. Silvia Kariuki and colleagues investigated the impact of the rare malaria-protective Dantu blood group variant on susceptibility to bacteraemia. We found that Dantu was significantly protective against bacteraemia only during a high malaria transmission period. This suggested that the protective effect of Dantu on bacteraemia is secondary to its protective effect against malaria.
\n \n\n \n \nPosted 31/05/2024. Tungiasis is a neglected tropical skin disease. Lynne Elson and colleagues aimed to determine its impact on school children in nine counties of Kenya. They found infected children experience considerable pain, itching, difficulty sleeping and feel ashamed, leading to lower school attendance, concentration and exam scores, than uninfected children.
\n \n\n \n \nPosted 21/05/2024. Severe pneumonia is a leading cause of illness and hospitalization in African children, resulting in poor outcomes. Kathryn Maitland and colleagues tested if adding ready-to-use therapeutic food to diets improves the recovery of children in Uganda and Kenya. The study found no significant benefits, suggesting future research should focus on high-risk, undernourished children.
\n \n\n \n \nPosted 05/12/2023. The adoption of \u2018Care Assistants\u2019 in formal hospital settings as a HRH strategy is gaining more traction in the Global North than the Global South. Vincent Kagonya and colleagues highlight their effect on care as well as gaps in the labelling, role assignment, training, clinical governance, and regulation in the clinical environment.
\n \n\n \n \nPosted 29/11/2023. Tungiasis is a highly neglected tropical skin disease for which the global disease burden is unknown. Lynne Elson and colleagues report here on the first ever national prevalence survey which found a 1.3% prevalence in Kenya with 40% of primary schools having at least one case and extreme heterogeneity in distribution.
\n \n\n \n \nPosted 28/11/23. Medical internship is a key period for doctors\u2019 individual career planning and also a transition period for the broader labour market. Daniel Mbuthia and colleagues highlighted how experience during internship shaped medical doctors\u2019 career intentions in Kenya and Uganda, and emphasized the importance of job availability and context in influencing doctors\u2019 career choices.
\n \n\n \n \nPosted 22/11/2023. Routine surveys are used to understand the training quality and experiences of junior doctors but there are lack of tools designed to evaluate the training experiences of interns in LMICs where working conditions and resource constraints are challenging. Yingxi Zhao and colleagues described their process developing and validating a \u201cmedical internship experience scale\u201d.
\n \n\n \n \nPosted 15/11/2023. Medical interns are an important workforce providing first-line healthcare services in hospitals. Yingxi Zhao and colleagues provided an overview of doctors\u2019 internship experience in Kenya and Uganda, and highlighted challenges experienced by interns spanning from burnout, stress, challenging working environment, inadequate support and poor quality of supervision.
\n \n\n \n \nPosted 07/11/2023. As COVID spread globally support for LMIC focused on skilled, technologically enabled ICU care. This ignored fundamental weaknesses in health systems and the need for basic, effective care to save lives in all clinical settings. Whole of system vigilance and response requires reorientation of priorities and effective change management, by Mike English.
\n \n\n \n \nPosted 10/10/2023. Angela Moturi and colleagues evaluate RTS,S/AS01 malaria vaccine coverage in Kenya's pilot phase, showing high EPI (Extended Programme for Immunisation) user coverage (78%) for dose 3, but lower community coverage (57%). The 4th dose at 24 months had low coverage (<39%). Universal coverage of 3 doses of malaria vaccine needs improving. 24-month dosing remains a challenge.
\n \n\n \n \nPosted 29/09/2023. This large study on the pharmacokinetics of single low dose primaquine in young Ugandan and Congolese children will help the MORU team develop an optimal dose for children with falciparum malaria to block malaria transmission and contribute to malaria elimination, especially of resistant falciparum parasites. By Bob Taylor
\n \n\n \n \nPosted 30/08/2023. Alternative Design Trials (ADTs) and Adaptive Platform Trials (APTs) have enabled efficient large-scale testing of biomedical interventions during recent Public Health Emergencies (PHEs). Alun Davies and colleagues aimed to rapidly review evidence on engagement and informed consent for ADTs and APTs during PHE to consider what (if any) recommendations can inform practice.
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