A5034791930- Global Maternal and Child Health
- COVID-19 epidemiological studies
- Emergency and Acute Care Studies
- Vaccine Coverage and Hesitancy
- SARS-CoV-2 and COVID-19 Research
- Child Nutrition and Water Access
- Pneumonia and Respiratory Infections
- Viral Infections and Outbreaks Research
- Malaria Research and Control
- Mosquito-borne diseases and control
- COVID-19 Clinical Research Studies
- Healthcare Policy and Management
- Immune responses and vaccinations
- Neonatal Respiratory Health Research
- Healthcare Systems and Technology
- Healthcare Systems and Reforms
- COVID-19 diagnosis using AI
- Infant Development and Preterm Care
- Primary Care and Health Outcomes
- COVID-19 and healthcare impacts
- Statistical Methods and Inference
- Electronic Health Records Systems
- Healthcare cost, quality, practices
- Food Security and Health in Diverse Populations
- Neuroscience of respiration and sleep
Kenya Medical Research Institute
2015-2024
London School of Hygiene & Tropical Medicine
2023-2024
Aga Khan University Nairobi
2022-2024
University of London
2023-2024
University of Nairobi
2020-2023
Wellcome Trust
2016-2021
Aga Khan University Hospital
2020
Aga Khan University
2020
Bridge University
2020
Mbale Hospital
2017
Background The RTS,S/AS01E malaria vaccine (RTS,S) was introduced by national immunisation programmes in Ghana, Kenya, and Malawi 2019 large-scale pilot schemes. We aimed to address questions about feasibility impact, assess safety signals that had been observed the phase 3 trial included an excess of meningitis cerebral cases RTS,S recipients, possibility deaths among girls who received than controls, inform decisions wider use. Methods In this prospective evaluation, 158 geographical...
Abstract Background The COVID-19 pandemic and country measures to control it can lead negative indirect health effects. Understanding these effects is important in informing strategies mitigate against them. This paper presents an analysis of the Kenya. Methods We employed a mixed-methods approach, combining secondary quantitative data obtained from Kenya Health Information System database (from January 2019 November 2020) qualitative inquiry involving key informant interviews ( n = 12)...
► Since 2013, Kenya's public health sector has been affected by frequent short strikes, culminating in nationwide strikes lasting a total of 250 days doctors and nurses span 11 months 2016/17.► Health professionals have the right to go on strike, but their crippled services with almost no hospital inpatient being provided, thus violating people's healthcare.► To avoid similar instances future, mechanisms should be established for dispute resolution, anticipating pre-empting changes within...
Policy decisions on COVID-19 interventions should be informed by a local, regional and national understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Epidemic waves may result when restrictions are lifted or poorly adhered to, variants with new phenotypic properties successfully invade, infection spreads to susceptible subpopulations. Three epidemic have been observed in Kenya. Using mechanistic mathematical model, we explain the first two distinct...
In many low income countries health information systems are poorly equipped to provide detailed on hospital care and outcomes. Information is thus rarely used support practice improvement. We describe efforts tackle this challenge foster learning concerning collection use of information. This could improve services in Kenya. developing a Clinical Network, collaboration spanning 14 hospitals, policy makers researchers with the goal improving available quality inpatient paediatric across...
Management of pneumonia in many low-income and middle-income countries is based on WHO guidelines that classify children according to clinical signs define thresholds risk. We aimed establish whether some categorised as eligible for outpatient treatment might have a risk death warranting their hospital.
Background Lack of detailed information about hospital activities, processes and outcomes hampers planning, performance monitoring improvement in low-income countries (LIC). Clinical networks offer one means to advance methods for data collection use, informing wider health system development time, but are rare LIC. We report baseline from a new Information Network (CIN) Kenya seeking promote data-informed learning. Methods Data 13 hospitals engaged the Kenyan CIN between April 2014 March...
The relationship between community prevalence of
In 2002, we identified major shortcomings in the management of sick newborns and children at first referral or district hospital level Kenya.1 Failure dissemination knowledge skills (and thus translation evidence informed policy) was a fundamental problem. To address this challenge between 2005 2012 developed, implemented studied: 1. the national evidence-based clinical practice guidelines form protocol booklets that can be disseminated scale have recently described how process matured over...
Background Most of the deaths among neonates in low-income and middle-income countries (LMICs) can be prevented through universal access to basic high-quality health services including essential facility-based inpatient care. However, poor routine data undermines data-informed efforts monitor promote improvements quality newborn care across hospitals. Methods Continuously collected patients’ from structured paper record forms for all admissions units (NBUs) 16 purposively selected Kenyan...
A few studies have assessed the epidemiological impact and cost-effectiveness of COVID-19 vaccines in settings where most population had been exposed to SARS-CoV-2 infection.
Severe anemia is a leading indication for blood transfusion and major cause of hospital admission mortality in African children. Failure to initiate rapidly enough contributes deaths sub-Saharan Africa. This article examines delays accessing outcomes transfused children Kenyan hospitals. Children admitted with nonsurgical conditions 10 county hospitals participating the Clinical Information Network who had ordered from September 2013 March 2016 were studied. The delay was calculated date...
Background Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes worker well-being. There are limited data no current WHO standards for staff-to-baby ratios in neonatal units low- middle-income countries (LMICs) to inform policy, planning, investment. Methods In 65 (36 Malawi, 13 Kenya, 7 Tanzania, 9 Nigeria), facility assessment (HFA) SSNC government-led quality improvement (QI) processes were...
Audit and feedback (A&F) is widely used in healthcare but there are few examples of how to deploy it at scale low-income countries. Establishing the Clinical Information Network (CIN) Kenya provided an opportunity examine effect A&F delivered as part a wider set activities promote paediatric guideline adherence.We analysed data collected from medical records on discharge for children aged 2-59 months 14 Kenyan hospitals CIN. Hospitals joined CIN phases each we their initial 25 participation...
An observational study of monitoring vital signs in children admitted to Kenyan hospitals: an insight into the quality nursing care?Background Measurement and correct interpretation is part routine clinical care.Repeated measurement enhances early recognition deterioration, may help prevent morbidity mortality a standard care most countries.Objective To examine documentation by clinicians for admissions paediatric wards hospitals, describe frequency nurses explore factors influencing...
The World Health Organization (WHO) revised its clinical guidelines for management of childhood pneumonia in 2013. Significant delays have occurred during previous introductions new into routine practice low- and middle-income countries (LMIC). We therefore examined whether providing enhanced audit feedback as opposed to standard might accelerate adoption the by teams within hospitals a low-income setting. In this parallel group cluster randomized controlled trial, 12 were assigned either (n...
Abstract Background Understanding the age patterns of disease is necessary to target interventions maximise cost-effective impact. New malaria chemoprevention and vaccine initiatives young children attending routine immunisation services. Here we explore relationships between severity hospitalisation versus transmission intensity. Methods Clinical data from 21 surveillance hospitals in East Africa were reviewed. Malaria admissions aged 1 month 14 years discrete administrative areas since...
Diarrhoea causes many deaths in children younger than 5 years and identification of risk factors for death is considered a global priority. The effectiveness currently recommended fluid management dehydration routine settings has also not been examined.
Up to 90 % of the global burden malaria morbidity and mortality occurs in sub-Saharan Africa children under-five bear a disproportionately high burden. Effective inpatient case management can reduce severe morbidity, but there are few reports how successfully international national recommendations adopted childhood malaria. A descriptive cross-sectional study practices was conducted using data collected over 24 months five hospitals from risk areas participating Clinical Information Network...
The malaria prevalence has declined in western Kenya, resulting the risk of neurological phenotypes older children. This study investigates clinical profile pediatric admissions ahead introduction RTS,S/AS01 vaccine.
Abstract Policy makers in Africa need robust estimates of the current and future spread SARS-CoV-2. Data suitable for this purpose are scant. We used national surveillance PCR test, serological survey mobility data to develop fit a county-specific transmission model Kenya. estimate that SARS-CoV-2 pandemic peaked before end July 2020 major urban counties, with 34 - 41% residents infected, will peak elsewhere country within 2-3 months. Despite penetration, reported severe cases deaths low....
Background We explored who actually provides most admission care in hospitals offering supervised experiential training to graduating clinicians a high mortality setting where practices deviate from guideline recommendations. Methods used large observational data set 13 Kenyan county November 2015 through 2018 patients were linked admitting clinicians. adherence after creating cumulative correctness of Paediatric Admission Quality Care (cPAQC) score on 5-point scale (0–4) which points...
True burden of tuberculosis (TB) in children is unknown. Hospitalised are low-hanging fruit for TB case detection as they within the system. We aimed to explore process recognition and investigation childhood using a guideline-linked cascade care.