A5109216716- Malaria Research and Control
- Pneumonia and Respiratory Infections
- Bacterial Infections and Vaccines
- Global Maternal and Child Health
- Child Nutrition and Water Access
- Hemoglobinopathies and Related Disorders
- Epilepsy research and treatment
- Mosquito-borne diseases and control
- Neonatal and Maternal Infections
- Viral gastroenteritis research and epidemiology
- Cancer-related molecular mechanisms research
- Vaccine Coverage and Hesitancy
- Thyroid Cancer Diagnosis and Treatment
- Influenza Virus Research Studies
- Traumatic Brain Injury and Neurovascular Disturbances
- RNA modifications and cancer
- Salmonella and Campylobacter epidemiology
- Pediatric Hepatobiliary Diseases and Treatments
- Parasites and Host Interactions
- Antibiotic Use and Resistance
- Nosocomial Infections in ICU
- Blood donation and transfusion practices
- Reliability and Agreement in Measurement
- Antibiotics Pharmacokinetics and Efficacy
- Infection Control in Healthcare
Kenya Medical Research Institute
1997-2016
University of Cambridge
2009
Imperial College London
2005-2008
University of Oxford
2005-2008
University College London
1997-2008
Wellcome Trust
2008
Churchill Hospital
2008
Institute of Child Health
2005
Kijabe Hospital
2005
There are few epidemiologic data on invasive bacterial infections among children in sub-Saharan Africa. We studied every acute pediatric admission to a rural district hospital Kenya examine the prevalence, incidence, types, and outcome of community-acquired bacteremia.Between August 1998 July 2002, we cultured blood from 19,339 inpatients calculated incidence bacteremia basis population served by hospital.Of total 1783 infants who were under 60 days old, 228 had (12.8 percent), as did 866...
Severe malnutrition has a high mortality rate among hospitalized children in sub-Saharan Africa. However, reports suggest that is often poorly assessed. The World Health Organization recommends using weight for height, but this method problematic and not undertaken practice. Mid upper arm circumference (MUAC) the clinical sign "visible severe wasting" are simple inexpensive methods have been evaluated setting.To evaluate MUAC visible wasting as predictors of inpatient at district hospital...
Nontyphoidal Salmonella spp. are among the leading causes of childhood bacteremia in sub-Saharan Africa, yet there few published clinical series, and risk factors for acquiring infection not fully understood.We examined data from 166 cases nontyphoidal identified during a large prospective study all children admitted to district hospital Kenya. We also investigated importance comorbidities, including current malaria parasitemia, recent (detectable Plasmodium falciparum histidine rich protein...
ContextHaemophilus influenzae type b (Hib) conjugate vaccine is not perceived as a public health priority in Africa because data on Hib disease burden and effectiveness are scarce. immunization was introduced Kenyan infants 2001.ObjectiveTo define invasive incidence program Kenya.Design, Setting, PatientsCulture-based surveillance for at Kilifi District Hospital from 2000 through 2005 linked to demographic of 38 000 children younger than 5 years District, Kenya. Human immunodeficiency virus...
The causes of death and neurological sequelae in African children with cerebral malaria are obscure. Intracranial pressure (ICP) was monitored perfusion (CPP) calculated 23 Kenyan malaria. Four had severe intracranial hypertension (ICP >40 mm Hg, CPP <40 Hg): two died, one an ICP 158 Hg signs transtentorial herniation, the other 42 cardiorespiratory arrest. survived sequelae. Nine intermediate >20 <50 Hg) 10 mild (maximum 10–20 Hg); all without Mannitol controlled hypertension, but it did...
To determine how well antibiotic treatment is targeted by simple clinical syndromes and to what extent drug resistance threatens affordable antibiotics.Observational study involving a priori definition of hierarchy syndromic indications for therapy derived from World Health Organization integrated management childhood illness inpatient guidelines application these rules prospectively collected dataset.Kilifi District Hospital, Kenya.11,847 acute paediatric admissions.Presence invasive...
Computed tomography was performed on 14 unconscious Kenyan children recovering from cerebral malaria (seven of whom had another scan 12-120 days later) to elucidate the cause intracranial hypertension and neurological sequelae. Brain swelling, defined as a loss cerebrospinal fluid spaces, documented in six children, while further two conspicuously small ventricles only. There severe with definite brain swelling pressure monitored. no evidence acute hydrocephalus or vasogenic oedema. Four...
Journal Article Periodicity and space-time clustering of severe childhood malaria on the coast Kenya Get access R.W. Snow, Snow 1Kenya Medical Research Institute, Coastal Unit, P. O. Box 230, Kilifi, Kenya2Nuffield Department Clinical Medicine, University Oxford, John Radcliffe Hospital, Headington, OX3 9DU, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar J.R.M.Armstrong Schellenberg, Schellenberg 3Tropical Health Epidemiology London School Hygiene Tropical...
Data collected from 200 children admitted to a hospital on the Kenyan coast who met broad definition of severe acute respiratory infection (ARI) indicated that simple clinical signs alone are unable absolutely distinguish ARI and malaria. However, laboratory data showed marked differences exist in pathophysiology unequivocal malaria ARI. Children former group had higher mean oxygen saturation (97 vs. 94, P < 0.001), blood urea level (5.3 1.9 mmol/L, 0.001) geometric lactate (4.5 2.1 lower...
Despite the frequent association of respiratory symptoms and signs with malarial morbidity mortality in sub-Saharan Africa, value individual has rarely been assessed. We have prospectively examined clinical findings summary diagnosis distress, outcome, presence metabolic acidosis children admitted severe malaria to a Kenyan district hospital. Respiratory distress was present 119 350 included study 23 30 deaths (relative risk = 6.5, 95% confidence interval 2.8–14.4). The features history...
Clinical trials of interventions designed to prevent severe falciparum malaria in children require a clear endpoint. The internationally accepted definition is sensitive, and appropriate for clinical purposes. However, this includes individuals with nonmalarial disease coincident parasitaemia, so may lack specificity vaccine trials. Although there no "gold standard" individual test malaria, malaria-attributable fractions (MAFs) can be estimated among groups using logistic model, which we use...
Between October 1990 and November 1991 data were collected on the frequency, causes, nature of epileptic seizures in children admitted to paediatric ward at Kilifi District Hospital, Kenya, from a defined study area. During this period, 1324 studied, whom 15·8% had as part their illness. Malaria was by far commonest cause seizures, accounting for 69·0%; no other single condition caused more than 4·4%. The proportion respiratory infections complicated 4·0% compared 31·3% malaria. Only 25%...
Background. Acute bacterial meningitis (ABM) is an important cause of mortality in Africa, but most studies are based urban referral hospitals. Poor laboratory facilities make diagnosis difficult, and treatment limited to inexpensive antibiotics. Methods. We retrospectively reviewed data from children admitted with ABM a Kenyan district hospital 1994 through 2000. calculated the minimum incidence defined area. also examined antibiotic susceptibility patterns. Results. identified 390 cases...
Hereditary angioedema (HAE) is a rare genetic disorder resulting from deficiency or dysfunction of the C1-esterase inhibitor (C1-INH, C1-inhibitor) protein. It manifests with recurrent cutaneous and submucosal edema involving extremities, abdomen, and/or larynx. Abdominal mimics other acute abdominal conditions including intestinal obstruction, potentially prompting unnecessary surgery if misdiagnosed. Prompt treatment C1-INH typically alleviates symptoms within 24 hours, while untreated...
We have compared the efficacy of artemether versus quinine as treatment for cerebral malaria in children an open randomized clinical trial Kenya. Children admitted to hospital with coma and Plasmodium falciparum parasitaemia were treated either intramuscular (3.2 mg/kg loading dose followed by 1 · 6 daily) or intravenous (20 10 every 8 h). Both drugs well tolerated no significant adverse effect was observed. Parasite clearance times (50% 90%) shorter patients (median [h], interquartile...
Objective. Acute bacterial meningitis remains an important cause of death and neurologic sequelae in African children. The clinical features are often nonspecific this setting may overlap with those malaria. Early diagnosis appropriate antibiotic treatment perhaps the most steps management, but published data suggest that fewer than half cases childhood identified at first assessment hospitals region. objective study was to identify indicators acute by examining components World Health...
We investigated the pathophysiology of hypoglycaemia in severe malaria African children, especially potential importance glycerol as a substrate for gluconeogenesis, and whether limitation contributes to disease. Of 171 children with moderate or malaria, 16% were hypoglycaemic on admission, while at least 9% treated quinine concurrent 4% dextrose infusion had definite episode after admission. Blood levels gluconeogenic precursors are high (alanine lactate) higher (glycerol) those either...
Abstract Background Genetic heterozygosity is increasingly being shown to be a key predictor of fitness in natural populations, both through inbreeding depression, inbred individuals having low heterozygosity, and also chance linkage between marker gene under balancing selection. One important component that often highlighted resistance parasites other pathogens. However, the significance equivalent loci human populations remains unclear. Consequently, we performed case-control study fatal...
Objectives: To determine the pattern of resistance among Gram-negative bacilli causing invasive bacterial disease for antibiotics that are already in common use Kilifi, Kenya and two potential alternatives, ciprofloxacin cefotaxime. Also, to whether prevalence severity was increasing over time, identify patients who particularly at risk resistant infections, explore which factors associated with development our setting.
Respiratory abnormalities are common presentations of malaria and acute respiratory tract infection, both which major causes childhood mortality morbidity in sub-Saharan Africa. Appropriate management depends on accurate assessment disease severity for the majority children must be based clinical signs alone. Choosing best serve this purpose remains a considerable problem particularly endemic areas. As part prospective study to define indicative life threatening video recordings were used...