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A Peculiar Case Of Dengue Hemorrhagic Fever: A Case Report Of Radical Outcomes: A Case Study, Neelam Ubaid-Ur-Raheem

Journal of Asian Midwives (JAM)

Dengue is the arthropod-borne flavivirus infection, its severity increases during pregnancy, and results in worst maternofetal outcomes, which is an alarming issue. Dengue fever (DF) is the most common cause for preterm delivery and abortion. Dengue-related thrombocytopenia increases the risk of bleeding during pregnancy and delivery and can also leads to high maternal mortality rates. Globally 3.9 billion people are at risk of dengue fever, especially in Asia.
This case study focuses on a 22-years old pregnant woman from Pakistan without known co-morbidities. She presented in an emergency department with high fever, nausea, vomiting, and bleeding gum. She was positive …

Harvesting Health: Indigenous Mothers’ Resilience In The Face Of Climate Change And Maternal Nutrition Challenges In Rural Bajaur, Pakistan: A Study Protocol, Ihsan Ullah, Rafat Jan, Dilshad Begum, Kiran Mubeen, Laila Amir Ali Lalji

Journal of Asian Midwives (JAM)

No abstract provided.

International Day Of Midwives: Honoring Midwives' Dedication And Zeal In Gilgit Baltistan, Pakistan, Arusa Lakhani, Rafat Jan, Sadia Karimi, Mehreen Aslam

Journal of Asian Midwives (JAM)

No abstract provided.

Healthy Eating And Physical Activity: Analysing Soweto’S Young Adults’ Perspectives With An Intersectionality Lens, Gudani Mukoma, Edna Bosire, Sonja Klingberg, Shane A. Norris

Brain and Mind Institute

Background and objectives: Non-communicable diseases (NCDs) are taking a toll on Africa’s youth at younger ages than in other regions. These are attributed to risk factors that usually advance in adolescence, such as unhealthy diets and reduced physical activity. Young adults in South Africa, particularly women, tend to be sedentary, consume energy-dense diets low in micronutrients, and are more likely to develop NCDs much earlier in life than those in high-income countries. With an intersectionality perspective, this study explored young adults’ barriers and solutions to addressing these risk factors in Soweto.

Setting: Soweto, Johannesburg, South Africa, is one …

A Health Systems Approach To Critical Care Delivery In Low-Resource Settings: A Narrative Review, Stephen A. Spencer, Faustina Excel Adipa, Tim Baker, Ana Maria Crawford, Paul Dark, Dingase Dula, Stephen B. Gordon, David Oliver Hamilton, Dawit Kebede Huluka, Wangari Siika

Anaesthesiology, East Africa

There is a high burden of critical illness in low-income countries (LICs), adding pressure to already strained health systems. Over the next decade, the need for critical care is expected to grow due to ageing populations with increasing medical complexity; limited access to primary care; climate change; natural disasters; and conflict. In 2019, the 72nd World Health Assembly emphasised that an essential part of universal health coverage is improved access to effective emergency and critical care and to “ensure the timely and effective delivery of life-saving health care services to those in need”. In this narrative review, we examine critical …

Institute For Global Health And Development : Issue 5 - July 2023, Institute For Global Health And Development

IGHD Newsletters

• Research Highlights
• Key Publications
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• ‘Choice’ Programme - Technical Advisory Group
• Welcome New Team Members
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Improvement Of Community Health Worker Counseling Skills Through Early Childhood Development (Ecd) Videos, Supervision And Mentorship: A Mixed Methods Pre-Post Evaluation From Tanzania, Josephine Pascal Ferla, Michelle M. Gill, Teopista Komba, Amina Abubakar, Pieter Remes, Ola Jahanpour, Gretchen Antelman

Institute for Human Development, East Africa

Background: Community health workers (CHWs) play significant roles in improving health practices in under- resourced communities. This study evaluated an early childhood development (ECD) project in Tanzania assessing the effect of mobile video use, supervision and mentorship to improve quality of CHW counseling skills.

Methods: CHWs participating in the Malezi Project in Tabora Region were enrolled in a mixed methods pre-post evaluation. CHWs previously trained in UNICEF’s Care for Child Development package were further trained in counselling caregivers on nurturing care and father engagement using videos. Health providers were trained to provide ECD-focused supervision/mentorship of CHWs in facilities and …

Navigating Life With Hiv As An Older Adult On The Kenyan Coast: Perceived Health Challenges Seen Through The Biopsychosocial Model, Patrick Mwangala, Ryan G. Wagner, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Objectives: This study explores the perceptions of adults living with HIV aged ≥50 years (recognized as older adults living with HIV—OALWH), primary caregivers and healthcare providers on the health challenges of ageing with HIV at Kilifi, a low literacy setting on the coast of Kenya.

Methods: We utilized the biopsychosocial model to explore views from 34 OALWH and 22 stakeholders on the physical, mental, and psychosocial health challenges of ageing with HIV in Kilifi in 2019. Data were drawn from semi-structured in-depth interviews, which were audio-recorded and transcribed. A framework approach was used to synthesize the data.

Results: Symptoms of …

Neurobehavioral And Biochemical Effects Of Choline Chloride Administration In Rats, Lubna Anis, Irfan Sajid, Shoaib Ahmad, Saida Haider

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Choline is an essential nutrient related to vitamin B complex activity. It can be received through different food sources. It is an important component of acetylcholine which is involved in different brain functions. The present study is designed to assess the behavioral effects of choline chloride in animal models.

Methods:This case-control study was performed in the Department of Biochemistry, Federal Urdu University, Karachi for eight months from May 2022 to December 2022. Twenty-four adult male albino Wister rats were divided into four groups, one control and three test groups. Choline chloride dissolved in saline was given …

The Effects Of Height-For-Age And Hiv On Cognitive Development Of School-Aged Children In Nairobi, Kenya: A Structural Equation Modelling Analysis, Rachel Maina, Jia He, Amina Abubakar, Miguel Perez-Garcia, Manasi Kumar, Jelte M. Wicherts

Brain and Mind Institute

Background: Empirical evidence indicates that both HIV infection and stunting impede cognitive functions of school-going children. However, there is less evidence on how these two risk factors amplify each other’s negative effects. This study aimed to examine the direct effects of stunting on cognitive outcomes and the extent to which stunting (partially) mediates the effects of HIV, age, and gender on cognitive outcomes.

Methodology: We applied structural equation modelling to cross-sectional data from 328 children living with HIV and 260 children living without HIV aged 6–14 years from Nairobi, Kenya to test the mediating effect of stunting and predictive …

The Factors Associated With Caesarean Section At A Rural Hospital In Southwestern Uganda: A Cross-Sectional Study, Lilian Nuwabaine, Mathius Amperiize, Patience Annet Nakalega

School of Nursing & Midwifery, East Africa

Background

Globally, the overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. No studies have been carried out to account for the high rates of CS at Kisiizi Hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in southwestern Uganda.

Methods

This was a cross-sectional study of 321 immediate postnatal women in a rural hospital in southwestern Uganda. A structured …

Determinants Of First‐Ever Stroke Severity In West Africans: Evidence From The Siren Study, Oladimeji Adebayo, Onoja Akpa, Osahon J. Asowata, Adekunle Fakunle, Fred S. Sarfo, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Philip Adebayo

Internal Medicine, East Africa

Background: Baseline stroke severity is probably partly responsible for poor stroke outcomes in sub-Saharan Africa. However, there is a paucity of information on determinants of stroke severity among indigenous Africans. We sought to identify the factors associated with stroke severity among West Africans in the SIREN (Stroke Investigative Research and Educational Networks) study.

Methods and Results: Stroke was diagnosed clinically and confirmed with brain neuroimaging. Severe stroke was defined as a Stroke Levity Scale score of ≤5. A multivariate logistic regression model was constructed to identify factors associated with stroke severity at 95% CI and a nominal cutoff of 5% …

Enhancing The Education Of Paediatric Nurses: A Positive Step Towards Achieving Sustainable Development Goals, Aimable Nkurunziza, Godfrey Katende, Philomene Uwimana, Patricia J. Moreland

School of Nursing & Midwifery, East Africa

Aim: The aim of this discursive paper was to describe and expound on how paediatric nurses will be able to address the needs of children and adolescents through the lens of selected Sustainable Development Goals (SDGs) in Rwanda.

Design: A discursive analysis of SDGs relating to the roles of paediatric nurses in the context of Rwanda.

Methods: A discursive method using SDGs as a guiding framework is used in this paper. We drew on our own experiences and supported them with the available literature.

Results: A collection of contextually relevant examples of how paediatric nurses will …

School-Based Study To Assess The Nutritional Status (Bmi Based) Of Adolescents Of Gojra City Of District Toba Tek Singh, Punjab, Pakistan, Shagufta Perveen, Rozina Karmaliani, Rubina Barolia, Rozina Mistry

School of Nursing & Midwifery

Adolescence is the make-or-break stage of life. Major physical, mental, and psychological growth takes place at this age. Adequate and balanced nutrition is a vital requirement to support this phase. Adolescents living in developing and low-income countries are more likely to face nutritional challenges. Poor nutritional status during adolescence is an important determinant of health outcomes.
Objective: To analyze the nutritional status (BMI based) of school-going adolescents in Gojra city, Punjab, Pakistan.
Methods: A school-based cross-sectional survey was carried out covering 635 (6-8 grade) school-going adolescents (boys and girls) from public schools in Gojra city. Data were collected through anthropometric …

Neonatal Reference Intervals For Thyroid Stimulating Hormone And Free Thyroxine Assayed On A Siemens Atellica® Im Analyzer: A Cross Sectional Study, Geoffrey Omuse, David Kawalya, Patrick Mugaine, Assumpta Chege, Daniel Maina

Pathology, East Africa

Background Deriving population specific reference intervals (RIs) or at the very least verifying any RI before adoption is good laboratory practice. Siemens has provided RIs for thyroid stimulating hormone (TSH) and free thyroxine (FT4) determined on their Atellica® IM analyzer for all age groups except the neonatal age group which provides a challenge for laboratories that intend to use it to screen for congenital hypothyroidism (CH) and other thyroid disorders in neonates. We set out to determine RIs for TSH and FT4 using data obtained from neonates undergoing routine screening for CH at the Aga Khan University Hospital, Nairobi, Kenya. …

Using Social Practice Theory In Measuring Perceived Stigma Among Female Sex Workers In Mombasa, Kenya, Joseph Newton Guni, Stanley Wechuli Wanjala, Griffins Manguro, Caroline Gichuki, Megan Sc Lim, Minh D. Pham, Stanley Luchters, James Orwa

Institute for Human Development, East Africa

Background Perceived stigma is a complex societal phenomenon that is harboured especially by female sex workers because of the interplay of a myriad of factors. As such, a precise measure of the contribution of different social practices and characteristics is necessary for both understanding and intervening in matters related to perceived stigma. We developed a Perceived Stigma Index that measures the factors that greatly contribute to the stigma among sex workers in Kenya, and thereby inform a framework for future interventions.

Methods Social Practice Theory was adopted in the development of the Perceived Stigma Index in which three social domains …

Psychometric Evaluation Of The Computerized Battery For Neuropsychological Evaluation Of Children (Benci) Among School Aged Children In The Context Of Hiv In An Urban Kenyan Setting, Rachel Maina, He Jia, Amina Abubakar, Miguel Perez-Garcia, Manasi Kumar, Jelte M. Wicherts

Brain and Mind Institute

Introduction Culturally validated neurocognitive measures for children in Low‐ and Middle‐Income Countries are important in the timely and correct identification of neurocognitive impairments. Such measures can inform develop‐ ment of interventions for children exposed to additional vulnerabilities like HIV infection. The Battery for Neuropsy‐ chological Evaluation of Children (BENCI) is an openly available, computerized neuropsychological battery specifically developed to evaluate neurocognitive impairment. This study adapted the BENCI and evaluated its reliability and validity in Kenya.

Methodology The BENCI was adapted using translation and back‐translation from Spanish to English. The psy‐ chometric properties were evaluated in a case–control study of 328 …

Soil Water Use Efficiency Under Integrated Soil Management Practices In The Drylands Of Kenya, Nathan O. Oduor, Monicah Mucheru-Muna, Jayne Njeri Mugwe, Isaya Sijali, George Nyabuga, Daniel Njiru Mugendi

Graduate School of Media and Communications

Soil moisture scarcity and soil fertility decline in the drylands contribute to declining crop productivity. The possible synergistic effects of integrating soil & water conservation, and soil fertility management practices on soil moisture, and hence water use efficiency (WUE) in the drylands of Tharaka-Nithi County in Kenya was assessed. The experiment was laid in a three by three split plot arrangement, with four replications, for four cropping seasons. Minimum tillagewith mulch, tied ridges, and conventional tillage formed the main plot factors. The sub-plot factors included animal manure plus fertilizer at 120, 60, and 30 N kg ha−1. There was significant …

Barriers And Facilitators To Anti-Retroviral Therapy Adherence Among Adolescents Aged 10 To 19 Years Living With Hiv In Sub-Saharan Africa: A Mixed-Methods Systematic Review And Meta-Analysis, Londiwe D. Hlophe, Jacques L. Tamuzi, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Background: Human Immunodeficiency Virus (HIV) significantly affects adolescents globally, with the sub-Saharan Africa (SSA) reporting a high burden of the disease. HIV testing, treatment, and retention to care are low among adolescents. We conducted a mixed-method systematic review to assess anti-retroviral therapy (ART) adherence; barriers and facilitators to ART adherence and ART outcomes among adolescents living with HIV and on ART in sub-Saharan Africa.

Methods: We conducted searches in four scientific databases for studies conducted between 2010 and March 2022 to identify relevant primary studies. Studies were screened against inclusion criteria and assessed for quality, and data was …

Prevalence, Incidence And Chronicity Of Child Abuse Among Orphaned, Separated, And Street-Connected Children And Adolescents In Western Kenya: What Is The Impact Of Care Environment?, Samuel Ayaya, Allison Delong, Lonnie Embleton, David Ayuku, Edwin Sang, Joseph Hogan, Allan Kamanda, Lukoye Atwoli, Dominic Makori, Mary A. Ott, Caroline Ombok, Paula Braitstein

Internal Medicine, East Africa

Background: The effect of different types of care environment on orphaned and separated children and adolescents’ (OSCA) experiences of abuse in sub-Saharan Africa is uncertain.

Objective: Our two primary objectives were 1) to compare recent child abuse (physical, emotional, and sexual) between OSCA living in institutional environments and those in family-based care; and 2) to understand how recent child abuse among street-connected children and youth compared to these other vulnerable youth populations.

Participants and setting: This project followed a cohort of OSCA in Uasin Gishu County, Kenya (2009–2019). This analysis includes 2393 participants aged 18 years and below, 1017 from …

Quality & Patient Safety Gazette : Volume 2, Issue 2 - 2023, The Aga Khan University Hospital, Karachi

Quality and Patient Safety Archives

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Making Morbidity Multiple: History, Legacies, And Possibilities For Global Health, Justin Dixon, Emily Mendenhall, Edna Bosire, Felix Limbani, Rashida A. Ferrand, Clare I R. Chandler

Brain and Mind Institute

Multimorbidity has been framed as a pressing global health challenge that exposes the limits of systems organised around single diseases. This article seeks to expand and strengthen current thinking around multimorbidity by analysing its construction within the field of global health. We suggest that the significance of multimorbidity lies not only in challenging divisions between disease categories but also in what it reveals about the culture and history of transnational biomedicine. Drawing on social research from sub-Saharan Africa to ground our arguments, we begin by describing the historical processes through which morbidity was made divisible in biomedicine and how the …

Machine Learning For Accurate Estimation Of Fetal Gestational Age Based On Ultrasound Images, Lok Hin Lee, Elizabeth Bradburn, Rachel Craik, Mohammad Yaqub, Shane A. Norris, Leila Cheikh Ismail, Eric O. Ohuma, Fernando C. Barros, Maria Carvalho, Shama Munim, Zulfiqar Ahmed Bhutta

Obstetrics and Gynaecology, East Africa

Accurate estimation of gestational age is an essential component of good obstetric care and informs clinical decision-making throughout pregnancy. As the date of the last menstrual period is often unknown or uncertain, ultrasound measurement of fetal size is currently the best method for estimating gestational age. The calculation assumes an average fetal size at each gestational age. The method is accurate in the first trimester, but less so in the second and third trimesters as growth deviates from the average and variation in fetal size increases. Consequently, fetal ultrasound late in pregnancy has a wide margin of error of at …

Spontaneous Large Volume Hemothorax Managed With A Small-Bore Chest Tube, Moiz Salahuddin, Samia Ayub

Department of Medicine

A 67-year-old male with metastatic lung cancer presented with acute shortness of breath and increasing oxygen requirements. He had a decreasing hemoglobin for which he required red blood cell transfusions. His chest x-ray showed near complete white-out of the left lung. Bedside ultrasound (Handheld Sonostar C4PL) showed a large pleural effusion with swirling echogenic material suggestive of plankton sign. The pleural effusion was aspirated and showed frank blood, after which a small-bore chest tube (SBCT) was inserted. A total of 3200ml of blood was drained with the SBCT. There was complete clearance of the pleural space, and no further blood …

A Study To Investigate The Uptake Of Digital Technology In Ruben Fm Radio Station, Nahashon Shisia Wasilwa

Master of Arts in Digital Journalism

Having realized the potential of digital technologies, radio stations in Kenya have embraced technology to improve “interactivity with their listeners”. However, the extent to which digital technologies are used at radio stations and existing challenges and opportunities in uptake is yet to be established. The research's primary goal was to investigate technology uptake in Ruben FM radio stations. Specifically, the study sought to examine the extent of use of the existing digital technologies in Ruben FM radio station, explore other digital technology opportunities for uptake in Ruben FM radio station and establish challenges facing digital technology uptake in Ruben FM …

Ruben Fm And Its Involvement In Socio-Economic Challenges Of Mukuru Kwa Ruben Slums Of Nairobi, Henix Obuchunju

Master of Arts in Digital Journalism

vii ABSTRACT Slums are a reflection of underdeveloped and marginalisation. It is so yet the traditional watchdog genre of journalism and the commercial press are both as old as the slums themselves. Past studies show that community radios are struggling with feedback. As such they are yet to assess their value to the world. This study sought to assess the impact of the Mukuru kwa Ruben-based Ruben FM in addressing the socio- economic needs of its listeners; and whether it is advancing the tenets of Solutions Journalism practice. That is; coverage of solutions rather than the problems. The study relied …

Clinical Risk Factors Of Adverse Outcomes Among Women With Covid-19 In The Pregnancy And Postpartum Period: A Sequential, Prospective Meta-Analysis, Emily R. Smith, Erin Oakley, Gargi Wable Grandner, Gordon Rukundo, Fouzia Farooq, Kacey Ferguson, Sasha Baumann, Kristina Adams Waldorf, Yalda Afshar, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: This sequential, prospective meta-analysis (sPMA) sought to identify risk factors among pregnant and postpartum women with COVID-19 for adverse outcomes related to: disease severity, maternal morbidities, neonatal mortality and morbidity, adverse birth outcomes.

Data sources: We prospectively invited study investigators to join the sPMA via professional research networks beginning in March 2020.

Study eligibility criteria: Eligible studies included those recruiting at least 25 consecutive cases of COVID-19 in pregnancy within a defined catchment area.

Study appraisal and synthesis methods: We included individual patient data from 21 participating studies. Data quality was assessed, and harmonized variables for risk factors and …

Preparedness, Resilience And Unmet Needs Of Informal Caregivers Of Advanced Cancer Patients In A Regional Mission Hospital In Kenya: Qualitative Study, Too Wesley, Faith Lelei, Mary Adam, Pete Halestrap

School of Nursing & Midwifery, East Africa

Background: Cancer is the third highest cause of death in Kenya. Eighty percent of cancer cases arrive at advanced stages, when there is nothing that can be done to cure them, and palliative care is the best alternative. Although the majority of end-of-life care in Kenya is provided at home, little is known about the caregivers’ preparedness, resilience and continued unmet needs. The goal of this qualitative study was to explore caregivers’ perceived preparedness, resilience and continued unmet needs in their caregiving role to patients with advanced stages of cancer.

Methods: A purposive sampling method was used to identify and …

Patient-Level And System-Level Determinants Of Stroke Fatality Across 16 Large Hospitals In Ghana And Nigeria: A Prospective Cohort Study, Fred S. Sarfo, Onoja M. Akpa, Bruce Ovbiagele, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Lukman Owolabi, Godwin Ogbole, Philip Adebayo

Internal Medicine, East Africa

Background: Every minute, six indigenous Africans develop new strokes. Patient-level and system-level contributors to early stroke fatality in this region are yet to be delineated. We aimed to identify and quantify the contributions of patient-level and system-level determinants of inpatient stroke fatality across 16 hospitals in Ghana and Nigeria.

Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicentre study involving 16 sites in Ghana and Nigeria. Cases include adults (aged ≥18 years) with clinical and radiological evidence of an acute stroke. Data on stroke services and resources available at each study site were collected and analysed as …

Protocol For Validation Of The Global Scales For Early Development (Gsed) For Children Under 3 Years Of Age In Seven Countries, Vanessa Cavallera, Gillian Lancaster, Melissa Gladstone, Maureen M. Black, Gareth Mccray, Ambreen Nizar, Salahuddin Ahmed, Muhammad Imran Nisar, Farzana Begum, Fyezah Jehan

Department of Paediatrics and Child Health

Introduction: Children's early development is affected by caregiving experiences, with lifelong health and well-being implications. Governments and civil societies need population-based measures to monitor children's early development and ensure that children receive the care needed to thrive. To this end, the WHO developed the Global Scales for Early Development (GSED) to measure children's early development up to 3 years of age. The GSED includes three measures for population and programmatic level measurement: (1) short form (SF) (caregiver report), (2) long form (LF) (direct administration) and (3) psychosocial form (PF) (caregiver report). The primary aim of this protocol is to validate …