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Dlamini SV, Kosgei RJ, Mkhonta N, Zulu Z, Makadzange K, Zhou S, Owiti P, Sikhondze W, Namboze J, Reid A, Kunene S. Case management of malaria in Swaziland, 2011-2015: on track for elimination? Public Health Action 2018; 8:S3-S7. [PMID: 29713586 DOI: 10.5588/pha.17.0047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023] Open
Abstract
Objective: To assess adherence to malaria diagnosis and treatment guidelines (2010 and 2014) in all health care facilities in Swaziland between 2011 and 2015. Methods: This was a cross-sectional descriptive study involving all health care facilities that diagnosed and managed malaria cases in Swaziland. Patients' age, sex, diagnosis method and type of treatment were analysed. Results: Of 1981 records for severe and uncomplicated malaria analysed, 56% of cases were uncomplicated and 14% had severe malaria. The type of malaria was not recorded for 30% of cases. Approximately 71% of cases were confirmed by rapid diagnostic tests (RDT) alone, 3% by microscopy alone and 26% by both RDT and microscopy. Of the uncomplicated cases, 93% were treated with artemether-lumefantrine (AL) alone, 5% with quinine alone and 2% with AL and quinine. Amongst the severe cases, 11% were treated with AL alone, 44% with quinine alone and 45% with AL and quinine. For severe malaria, clinics and health centres prescribed AL alone more often than hospitals (respectively 13%, 12% and 4%, P = 0.03). Conclusion: RDTs and/or microscopy results are used at all facilities to inform treatment. Poor recording of malaria type causes difficulties in assessing the prescription of antimalarial drugs.
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Affiliation(s)
- S V Dlamini
- Faculty of Health Sciences, University of Swaziland, Mbabane, Swaziland
| | - R J Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - N Mkhonta
- National Malaria Control Programme, Ministry of Health, Mbabane, Swaziland
| | - Z Zulu
- National Malaria Control Programme, Ministry of Health, Mbabane, Swaziland
| | - K Makadzange
- World Health Organization (WHO), Swaziland Country Office, Mbabane, Swaziland
| | - S Zhou
- National Institute for Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - P Owiti
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - W Sikhondze
- National Tuberculosis Control Programme, Ministry of Health, Mbabane, Swaziland
| | - J Namboze
- WHO, African Regional Office and Inter-Country Support Team, Asmara, Eritrea
| | - A Reid
- Operational Research Unit, Operational Centre Brussels, Médecins Sans Frontières, Luxembourg City, Luxembourg
| | - S Kunene
- National Malaria Control Programme, Ministry of Health, Mbabane, Swaziland
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Kosgei RJ, Sitienei JK, Kipruto H, Kimenye K, Gathara D, Odawa FX, Gichangi P, Callens S, Temmerman M, Sitienei JC, Kihara AB, Carter EJ. Gender differences in treatment outcomes among 15-49 year olds with smear-positive pulmonary tuberculosis in Kenya. Int J Tuberc Lung Dis 2016; 19:1176-81. [PMID: 26459529 DOI: 10.5588/ijtld.15.0070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To determine gender differences in treatment outcomes among 15-49 year olds with smear-positive pulmonary tuberculosis (PTB) and factors associated with poor outcomes in Kenya. DESIGN Retrospective descriptive cohort. RESULTS Of 16 056 subjects analysed, 38% were female and 62% male. Females had a higher risk of poor treatment outcome than males (12% vs. 10%, P < 0.001; adjusted OR 1.29, 95%CI 1.16-1.44, P < 0.001). In the first multivariate model, restricting the analysis to human immunodeficiency virus (HIV) positive patients and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor outcome (OR 0.99, 95%CI 0.86-1.13, P = 0.844). In the model restricted to HIV-negative patients, a non-significantly lower risk was found (OR 0.89, 95%CI 0.73-1.09, P = 0.267). In the second model, restricting analysis to patients on antiretroviral therapy (ART) and adjusting for risk factors and clustering, females had a non-significantly lower risk of poor PTB treatment outcomes (OR 0.98, 95%CI 0.84-1.14, P = 0.792). In the model restricted to HIV-positive patients not on ART, a non-significantly higher risk was found (OR 1.15, 95%CI 0.79-1.67, P = 0.461). CONCLUSION Females of reproductive age are likely to have poorer treatment outcomes than males. Among females, not commencing ART during anti-tuberculosis treatment seemed to be associated with poor outcomes.
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Affiliation(s)
- R J Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - J K Sitienei
- Ministry of Health, Department of Disease Prevention and Control, Nairobi, Kenya; Moi University Department of Epidemiology, Nairobi Campus, Nairobi, Kenya
| | - H Kipruto
- World Health Organization, Nairobi, Kenya
| | - K Kimenye
- Division of Leprosy Tuberculosis and Lung Disease, Ministry of Health, Nairobi, Kenya
| | - D Gathara
- Ruby Medical Centre, Kiambu West, Kenya
| | - F X Odawa
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - P Gichangi
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya, Kenya
| | - S Callens
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - M Temmerman
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - J C Sitienei
- Department of Health Management, Moi University, Eldoret, Kenya
| | - A-B Kihara
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - E-J Carter
- Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
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Zachariah R, Kumar AMV, Reid AJ, Van den Bergh R, Isaakidis P, Draguez B, Delaunois P, Nagaraja SB, Ramsay A, Reeder JC, Denisiuk O, Ali E, Khogali M, Hinderaker SG, Kosgei RJ, van Griensven J, Quaglio GL, Maher D, Billo NE, Terry RF, Harries AD. Open access for operational research publications from low- and middle-income countries: who pays? Public Health Action 2015; 4:142-4. [PMID: 26400799 DOI: 10.5588/pha.14.0028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/13/2014] [Indexed: 11/10/2022] Open
Abstract
Open-access journal publications aim to ensure that new knowledge is widely disseminated and made freely accessible in a timely manner so that it can be used to improve people's health, particularly those in low- and middle-income countries. In this paper, we briefly explain the differences between closed- and open-access journals, including the evolving idea of the 'open-access spectrum'. We highlight the potential benefits of supporting open access for operational research, and discuss the conundrum and ways forward as regards who pays for open access.
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Affiliation(s)
- R Zachariah
- Médecins Sans Frontières (MSF), Operational Centre Brussels, Medical Department, Operations Research Unit (LUXOR), MSF-Luxembourg, Luxembourg
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - A J Reid
- Médecins Sans Frontières (MSF), Operational Centre Brussels, Medical Department, Operations Research Unit (LUXOR), MSF-Luxembourg, Luxembourg
| | - R Van den Bergh
- Médecins Sans Frontières (MSF), Operational Centre Brussels, Medical Department, Operations Research Unit (LUXOR), MSF-Luxembourg, Luxembourg
| | | | - B Draguez
- MSF, Medical Department, Brussels Operational Center, Belgium
| | - P Delaunois
- MSF, General Direction, Luxembourg, Luxembourg
| | - S B Nagaraja
- Department of Community Medicine, Employees State Insurance Corporation Medical College and Post Graduate Institute of Medical Sciences and Research, Bangalore, India
| | - A Ramsay
- United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland ; University of St Andrews Medical School, Scotland, UK
| | - J C Reeder
- United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - O Denisiuk
- International HIV/AIDS Alliance, Kyiv, Ukraine
| | - E Ali
- Médecins Sans Frontières (MSF), Operational Centre Brussels, Medical Department, Operations Research Unit (LUXOR), MSF-Luxembourg, Luxembourg
| | - M Khogali
- Médecins Sans Frontières (MSF), Operational Centre Brussels, Medical Department, Operations Research Unit (LUXOR), MSF-Luxembourg, Luxembourg
| | - S G Hinderaker
- Centre for International Health, University of Bergen, Bergen, Norway
| | - R J Kosgei
- University of Nairobi, Obstetrics and Gynecology, Nairobi, Kenya
| | | | - G L Quaglio
- Science and Technology Option Assessment (STOA), Directorate-General for Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
| | | | - N E Billo
- The Union, Centre for Operational Research, Paris, France
| | - R F Terry
- United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - A D Harries
- The Union, Centre for Operational Research, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
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Kihara AB, Harries AD, Bissell K, Kizito W, Van Den Berg R, Mueke S, Mwangi A, Sitene JC, Gathara D, Kosgei RJ, Kiarie J, Gichangi P. Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007-2013. Public Health Action 2015; 5:23-9. [PMID: 26400598 DOI: 10.5588/pha.14.0070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/25/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING A rural private health facility, Ruby Medical Centre (RMC), participating in a safe motherhood health voucher system for poor women in Kiambu County, Kenya. OBJECTIVES Between 2007 and 2013, to determine 1) the number of women who delivered at the RMC, their characteristics and pregnancy-related outcomes, and 2) the number of women who received an incomplete antenatal care (ANC) package and associated factors. DESIGN Retrospective cross-sectional study using routine programme data. RESULTS During the study period, 2635 women delivered at the RMC: 50% were aged 16-24 years, 60% transferred in from other facilities and 59% started ANC in the third trimester of pregnancy. Of the 2635 women, 1793 (68%) received an incomplete ANC package: 347 (13%) missed essential blood tests, 312 (12%) missed the tetanus toxoid immunisation and 1672 (65%) had fewer than four visits. Presenting late and starting ANC elsewhere were associated with an incomplete package. One pregnancy-related mortality occurred; the stillbirth rate was 10 per 1000 births. CONCLUSION This first assessment of the health voucher system in rural Kenya showed problems in ANC quality. Despite favourable pregnancy-related outcomes, increased efforts should be made to ensure earlier presentation of pregnant women, comprehensive ANC, and more consistent and accurate monitoring of reproductive indicators and interventions.
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Affiliation(s)
- A-B Kihara
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya ; Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya ; Ruby Medical Centre, Kiambu West, Kenya
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
| | - K Bissell
- International Union Against Tuberculosis and Lung Disease, Paris, France ; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - W Kizito
- Médecins Sans Frontières (MSF) Belgium, Nairobi, Kenya
| | - R Van Den Berg
- Medical Department, Brussels Operational Center, MSF-Luxembourg, Luxembourg
| | - S Mueke
- Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya ; Ministry of Health, Nairobi, Kenya
| | - A Mwangi
- Moi University School of Medicine, Eldoret, Kenya
| | - J C Sitene
- Moi University School of Medicine, Eldoret, Kenya
| | - D Gathara
- Ruby Medical Centre, Kiambu West, Kenya
| | - R J Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya ; Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya
| | - J Kiarie
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya ; Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya
| | - P Gichangi
- Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya ; Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
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Buard V, Van den Bergh R, Tayler-Smith K, Godia P, Sobry A, Kosgei RJ, Szumilin E, Harries AD, Pujades-Rodriguez M. Characteristics, medical management and outcomes of survivors of sexual gender-based violence, Nairobi, Kenya. Public Health Action 2015; 3:109-12. [PMID: 26393011 DOI: 10.5588/pha.13.0012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 02/26/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING Médecins Sans Frontières Clinic for sexual gender-based violence (SGBV), Nairobi, Kenya. OBJECTIVES Among survivors of SGBV in 2011, to describe demographic characteristics and episodes of sexual violence, medical management, pregnancy and human immunodeficiency virus (HIV) related outcomes. DESIGN Retrospective review of clinical records and SGBV register. RESULTS Survivors attending the clinic increased from seven in 2007 to 866 in 2011. Of the 866 survivors included, 92% were female, 34% were children and 54% knew the aggressor; 73% of the assaults occurred inside a home and most commonly in the evening or at night. Post-exposure prophylaxis for HIV was given to 536 (94%), prophylaxis for sexually transmitted infections to 731 (96%) and emergency contraception to 358 (83%) eligible patients. Hepatitis B and tetanus toxoid vaccinations were given to 774 survivors, but respectively only 46% and 14% received a second injection. Eight (4.5%) of 174 women who underwent urine pregnancy testing were positive at 1 month. Of 851 survivors HIV-tested at baseline, 96 (11%) were HIV-positive. None of the 220 (29%) HIV-negative individuals who returned for repeat HIV testing after 3 months was positive. CONCLUSION Acceptable, good quality SGBV medical care can be provided in large cities of sub-Saharan Africa, although further work is needed to improve follow-up interventions.
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Affiliation(s)
- V Buard
- Médecins Sans Frontières (MSF) France, Nairobi, Kenya
| | - R Van den Bergh
- Medical Department-Operational Research Unit, MSF Operational Centre Brussels, Luxembourg, Luxembourg
| | - K Tayler-Smith
- Medical Department-Operational Research Unit, MSF Operational Centre Brussels, Luxembourg, Luxembourg
| | - P Godia
- Division of Reproductive Health, Ministry of Health, Nairobi, Kenya
| | | | - R J Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | | | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
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Kosgei RJ, Szkwarko D, Callens S, Gichangi P, Temmerman M, Kihara AB, Sitienei JJ, Cheserem EJ, Ndavi PM, Reid AJ, Carter EJ. Screening for tuberculosis in pregnancy: do we need more than a symptom screen? Experience from western Kenya. Public Health Action 2015; 3:294-8. [PMID: 26393049 DOI: 10.5588/pha.13.0073] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 09/27/2013] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES 1) To explore the utility of tuberculosis (TB) symptom screening for symptoms of ≥2 weeks' duration in a routine setting, and 2) to compare differences in TB diagnosis between human immunodeficiency virus (HIV) infected and non-HIV-infected pregnant women in western Kenya. DESIGN Comparative cross-sectional study among pregnant women with known HIV status screened for TB from 2010 to 2012, in Eldoret, western Kenya. RESULTS Of 2983 participants, respectively 34 (1%), 1488 (50.5%) and 1461 (49.5%) had unknown, positive and negative HIV status. The median age was respectively 30 years (interquartile range [IQR] 26-35) and 26 years (IQR 24-31) in HIV-infected and non-infected participants. A positive symptom screen was found in respectively 8% (119/1488) and 5% (67/1461) of the HIV-infected and non-infected women. The median CD4 count at enrolment was 377 cells/μl (IQR 244-530) for HIV-infected women. One non-HIV-infected patient was sputum-positive. For HIV-infected women, TB was presumptively treated in 1% (16/1488) based on clinical symptoms and chest X-ray. Cumulatively, anti-tuberculosis treatment was offered to 0.6% (17/2949) of the participants. CONCLUSION This study does not seem to demonstrate the utility of TB symptom screening questionnaires in a routine setting among pregnant women, either HIV-infected or non-infected, in western Kenya.
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Affiliation(s)
- R J Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - D Szkwarko
- AMPATH, Eldoret, Kenya ; The Memorial Hospital of Rhode Island Brown Family Medicine Residency Program, Pawtucket, Rhode Island, USA
| | - S Callens
- University of Ghent School of Medicine, Ghent, Belgium
| | - P Gichangi
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
| | - M Temmerman
- University of Ghent School of Medicine, Ghent, Belgium
| | - A-B Kihara
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - J J Sitienei
- AMPATH, Eldoret, Kenya ; Moi University School of Public Health, Eldoret, Kenya
| | - E J Cheserem
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - P M Ndavi
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - A J Reid
- Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Luxembourg
| | - E J Carter
- AMPATH, Eldoret, Kenya ; Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
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Nakanwagi-Mukwaya A, Reid AJ, Fujiwara PI, Mugabe F, Kosgei RJ, Tayler-Smith K, Kizito W, Joloba M. Characteristics and treatment outcomes of tuberculosis retreatment cases in three regional hospitals, Uganda. Public Health Action 2015; 3:149-55. [PMID: 26393019 DOI: 10.5588/pha.12.0105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 02/25/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING Three regional referral hospitals in Uganda with a high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) cases. OBJECTIVE To determine the treatment outcomes of TB retreatment cases and factors influencing these outcomes. DESIGN A retrospective cohort study of routinely collected National Tuberculosis Programme data between 1 January 2009 and 31 December 2010. RESULTS The study included 331 retreatment patients (68% males), with a median age of 36 years, 93 (28%) of whom were relapse smear-positive, 21 (6%) treatment after failure, 159 (48%) return after loss to follow-up, 26 (8%) relapse smear-negative and 32 (10%) relapse cases with no smear performed. Treatment success rates for all categories of retreatment cases ranged between 28% and 54%. Relapse smear-positive (P = 0.002) and treatment after failure (P = 0.038) cases were less likely to have a successful treatment outcome. Only 32% of the retreatment cases received a Category II treatment regimen; there was no difference in treatment success among patients who received Category II or Category I treatment regimens (P = 0.73). CONCLUSION Management of TB retreatment cases and treatment success for all categories in three referral hospitals in Uganda was poor. Relapse smear-positive or treatment after failure cases were less likely to have a successful treatment outcome.
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Affiliation(s)
| | - A J Reid
- Médecins Sans Frontières (MSF), Operational Centre Brussels, MSF Luxembourg, Luxembourg
| | - P I Fujiwara
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - F Mugabe
- National Tuberculosis and Leprosy Control Programme, Ministry of Health, Kampala, Uganda
| | - R J Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - K Tayler-Smith
- Médecins Sans Frontières (MSF), Operational Centre Brussels, MSF Luxembourg, Luxembourg
| | - W Kizito
- MSF Operation Centre Brussels, Kenya Mission, Brussels, Belgium
| | - M Joloba
- National Tuberculosis Reference Laboratory, Ministry of Health, Kampala, Uganda
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Edwards JK, Thiongó A, Van den Bergh R, Kizito W, Kosgei RJ, Sobry A, Vandenbulcke A, Zuniga I, Reid AJ. Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya. Public Health Action 2014; 4:122-7. [PMID: 26399212 PMCID: PMC4539038 DOI: 10.5588/pha.14.0009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/21/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING The primary care clinics of Médecins Sans Frontières within the informal settlement of Kibera, Nairobi, Kenya. OBJECTIVE To describe the demographic and clinical characteristics of children clinically diagnosed with rickets from September 2012 to October 2013. DESIGN Descriptive retrospective case review of diagnosis and treatment course with vitamin D and calcium using routine programme data. RESULTS Of the 82 children who met the clinical diagnosis of rickets, 57% were male, with a median age of 12 months and 14 months for females. Children with rickets were found to have ⩽3 hours/week sunlight exposure for 71% of the children and malnutrition in 39%. Clinical findings on presentation revealed gross motor developmental delays in 44%. The loss to follow-up rate during treatment was 40%. CONCLUSIONS This study found that rickets is a common clinical presentation among children living in the informal settlement of Kibera and that there are likely multiple factors within that environment contributing to this condition. As rickets is a simply and inexpensively preventable non-communicable disease, we suggest that routine vitamin D supplementation be formally recommended by the World Health Organization for well-child care in Africa, especially in the contexts of informal settlements.
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Affiliation(s)
| | - A. Thiongó
- Médecins Sans Frontières, Nairobi, Kenya
| | - R. Van den Bergh
- Medical Department, Luxembourg Operational Research Unit (LuxOR), Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - W. Kizito
- Médecins Sans Frontières, Nairobi, Kenya
| | - R. J. Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - A. Sobry
- Médecins Sans Frontières, Nairobi, Kenya
| | | | - I. Zuniga
- Medical Department, Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - A. J. Reid
- Medical Department, Luxembourg Operational Research Unit (LuxOR), Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
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Zachariah R, Reid T, Van den Bergh R, Dahmane A, Kosgei RJ, Hinderaker SG, Tayler-Smith K, Manzi M, Kizito W, Khogali M, Kumar AMV, Baruani B, Bishinga A, Kilale AM, Nqobili M, Patten G, Sobry A, Cheti E, Nakanwagi A, Enarson DA, Edginton ME, Upshur R, Harries AD. Applying the ICMJE authorship criteria to operational research in low-income countries: the need to engage programme managers and policy makers. Trop Med Int Health 2013; 18:1025-8. [DOI: 10.1111/tmi.12133] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Zachariah
- Medical Department (Operational Research Unit); Medecins sans Frontieres; Operational Centre Brussels; MSF-Luxembourg; Luxembourg Luxembourg
| | - T. Reid
- Medical Department (Operational Research Unit); Medecins sans Frontieres; Operational Centre Brussels; MSF-Luxembourg; Luxembourg Luxembourg
| | - R. Van den Bergh
- Medical Department (Operational Research Unit); Medecins sans Frontieres; Operational Centre Brussels; MSF-Luxembourg; Luxembourg Luxembourg
- Department of Molecular and Cellular Interactions; Flemish Institute of Biotechnology; Brussels Belgium
- Department of Microbiology; Institute of Tropical Medicine; Antwerp Belgium
| | - A. Dahmane
- Medical Department (Operational Research Unit); Medecins sans Frontieres; Operational Centre Brussels; MSF-Luxembourg; Luxembourg Luxembourg
| | - R. J. Kosgei
- Department of Obstetrics and Gynecology; University of Nairobi; Nairobi Kenya
| | - S. G. Hinderaker
- Centre for International Health; University of Bergen; Bergen Norway
- Center for Operational Research; International Union Against Tuberculosis and Lung Disease; Paris France
| | - K. Tayler-Smith
- Medical Department (Operational Research Unit); Medecins sans Frontieres; Operational Centre Brussels; MSF-Luxembourg; Luxembourg Luxembourg
| | - M. Manzi
- Medical Department (Operational Research Unit); Medecins sans Frontieres; Operational Centre Brussels; MSF-Luxembourg; Luxembourg Luxembourg
| | - W. Kizito
- International Union Against TB and Lung Disease; Kampala Uganda
| | - M. Khogali
- Medecins Sans Frontieres; Addis Ababa Ethiopia
| | - A. M. V. Kumar
- International Union Against Tuberculosis and Lung Disease; South East Asia office; New Delhi India
| | - B. Baruani
- Medecins Sans Frontieres; Somali Mission; Somalia
| | | | - A. M. Kilale
- National Institute for Medical Research; Dar Es Salaam Tanzania
| | - M. Nqobili
- National Tuberculosis Control Programme; Harare Zimbabwe
| | - G. Patten
- Medecins Sans Frontieres; Capetown South Africa
| | - A. Sobry
- Medecins Sans Frontieres; Nairobi Kenya
| | - E. Cheti
- Medecins Sans Frontieres; Nairobi Kenya
| | - A. Nakanwagi
- Medical Department (Operational Research Unit); Medecins sans Frontieres; Operational Centre Brussels; MSF-Luxembourg; Luxembourg Luxembourg
| | - D. A. Enarson
- Center for Operational Research; International Union Against Tuberculosis and Lung Disease; Paris France
| | - M. E. Edginton
- Center for Operational Research; International Union Against Tuberculosis and Lung Disease; Paris France
| | - R. Upshur
- Joint Center for Bioethics; University of Toronto; Toronto Canada
| | - A. D. Harries
- Center for Operational Research; International Union Against Tuberculosis and Lung Disease; Paris France
- London School of Hygiene and Tropical Medicine; London UK
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Kosgei RJ, Ndavi PM, Ong'ech JO, Abuya JM, Siika AM, Wools-Kaloustian K, Mabeya H, Fojo T, Mwangi A, Reid T, Edginton ME, Carter EJ. Symptom screen: diagnostic usefulness in detecting pulmonary tuberculosis in HIV-infected pregnant women in Kenya. Public Health Action 2011; 1:30-3. [PMID: 26392933 DOI: 10.5588/pha.11.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 10/06/2011] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To determine the diagnostic usefulness of tuberculosis (TB) symptom screening to detect active pulmonary TB among human immunodeficiency virus (HIV) infected pregnant women in two PMTCT (prevention of mother-to-child transmission) clinics in western Kenya that are supported by the United States Agency for International Development-Academic Model Providing Access to Healthcare partnership. DESIGN Cross-sectional study. Participants were interviewed for TB symptoms with a standardized questionnaire (cough >2 weeks, fever, night sweats, weight loss or failure to gain weight). Those with cough submitted sputum specimens for smear microscopy for acid-fast bacilli and mycobacterial culture. Women at >14 weeks gestation underwent shielded chest radiography (CXR). RESULTS Of 187 HIV-infected women, 38 (20%) were symptom screen-positive. Of these, 21 had a cough for >2 weeks, but all had negative sputum smears and mycobacterial cultures. CXRs were performed in 26 symptomatic women: three were suggestive of TB (1 miliary, 1 infiltrates and 1 cavitary). Of 149 women with a negative symptom screen, 100 had a CXR and seven had a CXR suggestive of TB (1 cavitary, 2 miliary and 4 infiltrates). CONCLUSION This study did not support the utility of isolated symptom screening in identification of TB disease in our PMTCT setting. CXR was useful in identification of TB suspects in both symptomatic and asymptomatic women.
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Affiliation(s)
- R J Kosgei
- The United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya ; University of Nairobi School of Medicine, Nairobi, Kenya
| | - P M Ndavi
- University of Nairobi School of Medicine, Nairobi, Kenya ; Kenyatta National Hospital, Nairobi, Kenya
| | - J O Ong'ech
- University of Nairobi School of Medicine, Nairobi, Kenya ; Kenyatta National Hospital, Nairobi, Kenya
| | - J M Abuya
- The United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya
| | - A M Siika
- The United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya
| | - K Wools-Kaloustian
- The United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya ; Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - H Mabeya
- The United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya
| | - T Fojo
- Washington University School of Medicine, St Louis, Missouri, USA
| | - A Mwangi
- The United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya
| | - T Reid
- Operational Research Unit, Médecins Sans Frontières-Operational Centre Brussels, Luxembourg
| | - M E Edginton
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - E J Carter
- The United States Agency for International Development-Academic Model Providing Access to Healthcare Partnership, Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya ; Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
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Kosgei RJ, Wools-Kaloustian KK, Braitstein P, Sidle JE, Sang E, Gitau JN, Sitienei JJ, Owino R, Mamlin JJ, Kimaiyo SN, Siika AM. Task shifting in HIV clinics, Western Kenya. East Afr Med J 2010; 87:299-303. [PMID: 23451549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND United states Agency for International development-Academic Model for Providing Accesses to Healthcare (USAID-AMPATH) cares for over 80,000 HIV-infected patients. Express care (EC) model addresses challenges of: clinically stable patient's adherent to combined-antiretroviral-therapy with minimal need for clinician intervention and high risk patients newly initiated on cART with CD4 counts < or = 100 cells/mm3 with frequent need for clinician intervention. OBJECTIVE To improve patient outcomes without increasing clinic resources. DESIGN A descriptive study of a clinician supervised shared nurse model. SETTING USAID-AMPATH clinics, Western Kenya. RESULTS Four thousand eight hundred and twenty four patients were seen during the pilot period, 90.4% were eligible for EC of whom 34.6% were enrolled. Nurses performed all traditional roles and attended to two thirds and three quarters of stable and high risk patient visits respectively. Clinicians attended to one third and one quarter of stable and high risk patient visits respectively and all visits ineligible for express care. CONCLUSION The EC model is feasible. Task shifting allowed stable patients to receive visits with nurses, while clinicians had more time to concentrate on patients that were new as well as more acutely ill patients.
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Affiliation(s)
- R J Kosgei
- USAID-AMPATH, Partnership, Eldoret, Kenya, Department of Clinical Medicine and Therapeutics, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya
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Abstract
OBJECTIVE To review the literature on coronary heart disease (CHD) and its electrocardiogram (ECG) manifestations in Eastern Africa and provide medical education by increasing awareness and strengthening recognition skills of myocardial infarction (MI) through discussion of key features from representative ECGs selected from the Moi Teaching and Referral Hospital (MTRH) ECG service in Eldoret, Kenya. DATA SOURCE Peer reviewed published articles found using a Medline search. ECGs were reproduced with one complex from each of the 12 standard leads, without patient's name or other identifying information. CONCLUSION CHD and its risk factors are increasing in prevalence in Eastern Africa over recent years. The ECG remains integral to the diagnosis of acute coronary syndromes, including MI. Representative ECGs from MTRH demonstrate the various features of the common anatomical distributions of MI, enabling medical education. Recognition of CHD and its ECG manifestations is one step on the path to decreasing resultant morbidity and mortality.
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Affiliation(s)
- M S Jablonski-Cohen
- Moi University Faculty of Health Sciences, Department of Internal Medicine, Moi Teaching and Referral Hospital, P.O. Box 4606 Eldoret, Kenya
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