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Full-Text Articles in Medicine and Health Sciences

Case Series On Prosthetic Valve Thromboses Treated With Intravenous Thrombolysis At A Tertiary Teaching Hospital In Nairobi – Kenya, John Odhiambo, Salim Abdallah, Mzee Ngunga Mar 2025

Case Series On Prosthetic Valve Thromboses Treated With Intravenous Thrombolysis At A Tertiary Teaching Hospital In Nairobi – Kenya, John Odhiambo, Salim Abdallah, Mzee Ngunga

Internal Medicine, East Africa

Valvular heart disease is a significant global health issue, particularly in developing countries where Rheumatic Heart Disease (RHD) is the leading cause. Valve replacement surgeries have increased, with mechanical prostheses favored for their durability. However, thromboembolism remains a critical complication post-surgery, with prosthetic valve thrombosis rates of 0.03% for bioprosthetic valves and between 0.5% to 8% for mechanical valves in the aortic and mitral position. This report details two cases of heart failure following valve replacement due to rheumatic heart disease. The first case involves a 42-year-old female who developed prosthetic valve thrombosis after discontinuing warfarin for menorrhagia postmechanical mitral …


Community Engagement Approaches And Lessons Learned: A Case Study Of The Precise Pregnancy Cohort Study In Kenya, Onesmus Wanje, Angela Koech, Maggie Woo Kinshella, Grace Mwashigadi, Alice Kombo, Grace Maitha, Nathan Barreh, Hiten D. Mistry, Marianne Vidler, Rachel Craik Mar 2025

Community Engagement Approaches And Lessons Learned: A Case Study Of The Precise Pregnancy Cohort Study In Kenya, Onesmus Wanje, Angela Koech, Maggie Woo Kinshella, Grace Mwashigadi, Alice Kombo, Grace Maitha, Nathan Barreh, Hiten D. Mistry, Marianne Vidler, Rachel Craik

Centre of Excellence in Women and Child Health

Community engagement (CE) has been recommended as an important ethical consideration for health research to enhance informed consent and exchange knowledge between researchers and community members. The purpose of this paper is to describe how CE was developed and delivered for the PRECISE prospective pregnancy cohort study in Kenya. PRECISE enrolled pregnant women in antenatal care, followed them up to the postpartum period, and collected data and biological samples to enable the study of placental disorders in sub-Saharan Africa. Initially CE was aimed at informing the community about the study, establishing communitywide acceptance of the research and addressing concerns about …


Decolonizing Global Health Research: Experiences From The Women In Health And Their Economic, Equity And Livelihood Statuses During Emergency Preparedness And Response (Wheeler) Study, Ahmed Adam, Lisa Lazarus, Bernadette Kina, Robert Lorway, Bilali Mazoya, Michaela Mantel, Marleen Temmerman, Lisa Avery, Evaline Chepchirchir Langat Mar 2025

Decolonizing Global Health Research: Experiences From The Women In Health And Their Economic, Equity And Livelihood Statuses During Emergency Preparedness And Response (Wheeler) Study, Ahmed Adam, Lisa Lazarus, Bernadette Kina, Robert Lorway, Bilali Mazoya, Michaela Mantel, Marleen Temmerman, Lisa Avery, Evaline Chepchirchir Langat

Centre of Excellence in Women and Child Health

Decolonizing global health research involves rethinking power structures and research collaboration to prioritize the voices and experiences of communities that have been historically marginalized. Cross-sectoral and cross-regional partnerships based on reciprocity, trust, and transparency can be facilitated by decolonized research frameworks. To address global health issues in a way that is inclusive, context-specific, and genuinely advantageous to all parties involved, especially communities most impacted by health disparities, the ethics behind this change is imperative. We applied a decolonizing health research approach to the Women in Health and their Economic, Equity, and Livelihood Statuses During Emergency Preparedness and Response (WHEELER) study …


Supraclavicular Nodal Metastasis At Primary Staging Of Prostate Cancer Using 18f-Psma-1007 Pet/Ct, Samuel Gitau, Jasmit Shah, William Olwit, Saeed Samnakay, Manel Haj Mansour, Khalid Makhdomi Mar 2025

Supraclavicular Nodal Metastasis At Primary Staging Of Prostate Cancer Using 18f-Psma-1007 Pet/Ct, Samuel Gitau, Jasmit Shah, William Olwit, Saeed Samnakay, Manel Haj Mansour, Khalid Makhdomi

Brain and Mind Institute

Background: The most common sites of metastasis in prostate cancer are bone, pelvic and retroperitoneal lymph nodes, liver and lungs. This study aimed to evaluate the prevalence of supraclavicular nodal metastasis in newly diagnosed prostate cancer using 18F-PSMA-1007 PET/CT which has hitherto been understudied.

Methods: 18F-PSMA-1007 PET/CT examinations performed at our institution between June 2020 and June 2022 for primary staging of prostate cancer were reviewed to identify supraclavicular nodal metastasis from prostate cancer. Data variables included age, stage of disease, PSA level, Gleason score and ISUP/WHO grade group and how these compare with the presence of supraclavicular …


Molecular Profile Of Non-Small Cell Lung Cancer In A Predominantly Black African Population In Kenya: A Single Institution Review, Sitna Mwanzi, Shahin Sayed, Swati Das, Jonathan Wawire, Jasmit Shah, Asim Jamal Shaikh Mar 2025

Molecular Profile Of Non-Small Cell Lung Cancer In A Predominantly Black African Population In Kenya: A Single Institution Review, Sitna Mwanzi, Shahin Sayed, Swati Das, Jonathan Wawire, Jasmit Shah, Asim Jamal Shaikh

Haematology and Oncology, East Africa

Targeted therapies for patients with non-small cell lung cancer (NSCLC) have significantly improved the outcomes for patients with oncogenic driver mutations. Testing for epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) rearrangement, c-ros oncogene 1 (ROS1) rearrangement and programmed death ligand 1 (PDL 1) testing are now highly recommended for all patients with NSCLC. There are clear geographical differences in the rate of driver mutations with higher EGFR mutation rates in the Asian population in comparison to the Caucasian population. Little is known about the rate of oncogenic driver mutations in predominantly Black African populations like those living …


Global Burden Of Metabolic Dysfunction-Associated Steatosis Liver Disease, 2010 To2021, Gong Feng, Giovanni Targher, Christopher D. Byrne, Yusuf Yilmaz, Vincent Wai-Sun Wong, Cosmas Rinaldi Adithya Lesmana, Leon A. Adams, Jerome Boursier, George Papatheodoridis, Christopher Opio Mar 2025

Global Burden Of Metabolic Dysfunction-Associated Steatosis Liver Disease, 2010 To2021, Gong Feng, Giovanni Targher, Christopher D. Byrne, Yusuf Yilmaz, Vincent Wai-Sun Wong, Cosmas Rinaldi Adithya Lesmana, Leon A. Adams, Jerome Boursier, George Papatheodoridis, Christopher Opio

Internal Medicine, East Africa

Background & Aims :This study used the Global Burden of Disease data (2010–2021) to analyze the rates and trends of point prevalence, annual incidence, and years lived with disability (YLDs) for metabolic dysfunction-associated steatotic liver disease (MASLD) in 204 countries.

Methods :Total numbers and age-standardized rates per 100,000 population for MASLD prevalence, annual incidence, and YLDs were compared across regions and countries by age, sex, and sociodemographic index (SDI). Smoothing spline models were used to evaluate the relationship between the burden of MASLD and SDI. Estimates were reported with uncertainty intervals (UI).

Results: Globally, in 2021, the age-standardized rates per …


Social Media In Advancing Equity And Collaboration In Rheumatology: The Cordiality Review, Ihsane Hmamouchi, Nelly Ziade, Adewale Adebajo, Latika Gupta, Puja Mehta, Angela Migowa, Elena Nikiphorou, Noelle A. Rolle, Didem Saygin, Namrata Singh Mar 2025

Social Media In Advancing Equity And Collaboration In Rheumatology: The Cordiality Review, Ihsane Hmamouchi, Nelly Ziade, Adewale Adebajo, Latika Gupta, Puja Mehta, Angela Migowa, Elena Nikiphorou, Noelle A. Rolle, Didem Saygin, Namrata Singh

Pathology, East Africa

Social media has transformed communication in academia and medicine, offering stakeholders innovative avenues for knowledge exchange and collaboration. The CORDIALITY review (soCial media fOR aDvancing equIty And coLlaboration In rheumaTologY) examines the impact of social media on education and information dissemination, patient education and empowerment, networking and mentorship, and research collaboration within rheumatology, when effectively used. In this narrative review, we consider the opportunities as well as the challenges related to each of these facets of social media use. With a focus on inequities faced globally, we give particular consideration to disparities by gender as they relate to the rheumatology …


Current Management Of Skin Conditions In Kenya: Exploring Teledermatology Preferences And Perspectives Among Providers, Jennifer Fernandez, Hashim Kaderbhai, Jennifer Adams, Mary B. Adam, Rodney Adam Mar 2025

Current Management Of Skin Conditions In Kenya: Exploring Teledermatology Preferences And Perspectives Among Providers, Jennifer Fernandez, Hashim Kaderbhai, Jennifer Adams, Mary B. Adam, Rodney Adam

Internal Medicine, East Africa

Background: Teledermatology programs may help expand access to care for skin conditions in areas that are underserved by dermatologists such as sub-Saharan Africa, but their success requires input from participating providers.

Objective: This study assesses teledermatology preferences among healthcare providers in Kenya.

Methods: An anonymous cross-sectional survey of nondermatology providers was conducted in Kenya from January to March 2024 at Aga Khan University Hospital-Nairobi and Kijabe Hospital.

Results: Among the 38 providers, 81.6% were physicians. Patient population was primarily Fitzpatrick skin types V and VI. Almost all (97.4%) regularly encountered patients with skin disorders, yet only …


Global Burden Of Major Chronic Liver Diseases In 2021, Gong Feng, Yusuf Yilmaz, Luca Valenti, Wai Kay Seto, Calvin Q. Pan, Nahum Méndez Sánchez, Feng Ye, Silvia Sookoian, Giovanni Targher, Christopher Opio Mar 2025

Global Burden Of Major Chronic Liver Diseases In 2021, Gong Feng, Yusuf Yilmaz, Luca Valenti, Wai Kay Seto, Calvin Q. Pan, Nahum Méndez Sánchez, Feng Ye, Silvia Sookoian, Giovanni Targher, Christopher Opio

Internal Medicine, East Africa

Background: This study utilised the Global Burden of Disease data (2010–2021) to analyse the rates and trends in point preva-lence, annual incidence and years lived with disability (YLDs) for major chronic liver diseases, such as hepatitis B, hepatitis C,metabolic dysfunction-associated liver disease, cirrhosis and other chronic liver diseases.

Methods: Age-standardised rates per 100,000 population for prevalence, annual incidence and YLDs were compared acrossregions and countries, as well as the socio-demographic index (SDI). Trends were expressed as percentage changes (PC) andestimates were reported with uncertainty intervals (UI).

Results: Globally, in 2021, the age-standardised rates per 100,000 population for the …


Management Of Pulmonary Arterial Hypertension: Current Strategies And Future Prospects, Munish Sharma, Vivek Paudyal, Saifullah Khalid Syed, Rubi Thapa, Nadeem Kassam, Salim Surani Mar 2025

Management Of Pulmonary Arterial Hypertension: Current Strategies And Future Prospects, Munish Sharma, Vivek Paudyal, Saifullah Khalid Syed, Rubi Thapa, Nadeem Kassam, Salim Surani

Internal Medicine, East Africa

Primary pulmonary hypertension (PPH), now known as pulmonary arterial hypertension (PAH), has induced significant treatment breakthroughs in the past decade. Treatment has focused on improving patient survival and quality of life, and delaying disease progression. Current therapies are categorized based on targeting different pathways known to contribute to PAH, including endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5 inhibitors), prostacyclin analogs, soluble guanylate cyclase stimulators, and activin signaling inhibitors such as Sotatercept. The latest addition to treatment options is soluble guanylate cyclase stimulators, such as Riociguat, which directly stimulates the nitric oxide pathway, facilitating vasodilation. Looking to the future, advancements in …


Experiences Among Parents Caring For Children With Juvenile Idiopathic Arthritis At A Tertiary Referral Hospital In Kenya, Hassan Silim, Susan Wamithi, Roselyter Riang’A, Angela Migowa Mar 2025

Experiences Among Parents Caring For Children With Juvenile Idiopathic Arthritis At A Tertiary Referral Hospital In Kenya, Hassan Silim, Susan Wamithi, Roselyter Riang’A, Angela Migowa

Paediatrics and Child Health, East Africa

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. Despite the availability of effective treatment strategies such as disease-modifying antirheumatic drugs (DMARDs), JIA is reported to have a negative impact on the quality of life of the patients and their caregivers. Ascertaining the perceptions of the parents will help facilitate more effective management strategies and improve outcomes for these patients. This study aimed to ascertain parental experiences and perceptions of caring for children with juvenile idiopathic arthritis (JIA).

Methods: This was a single-center facility-based qualitative study. An in-depth interview guide was used to collect …


Inspire : Vol 8 Issue 2, Department Of Medicine Feb 2025

Inspire : Vol 8 Issue 2, Department Of Medicine

INSPIRE – Department of Medicine Archives

  • Message from the Chair
  • MRCP PACES Mock Exams at AKU
  • The Third Annual Fogarty AKUPI NCD Research Certification Course
  • AKU Dermatology at National Forums
  • Outstanding Women in Medicine Lecture Series
  • Dr. Javaid Khan | Carrying the Torch for Tobacco Control
  • Dr Om Parkash | Working on AI in GI!
  • Dr Masood Karim wins a competitive visiting fellowship
  • AWARDS -- MBBS '88 Student and Trainee Initiated Research (STIR)- ROUND#5 AND Dr. Aleem Qureshi and Kulsum Aleem Fund - ROUND#4
  • Neurology | Brain Blitz competition!
  • Breaking Barriers | First Female FCPS in Sindh in Interventional Cardiology
  • Poem | Sea Fever
  • Featured Faculty …


Neonatal Care In Low- And Middle-Income Countries: A Fresh Look, Ola D. Saugstad, Joy E. Lawn, Peter Waiswa, Zulfiqar Ahmed Bhutta Feb 2025

Neonatal Care In Low- And Middle-Income Countries: A Fresh Look, Ola D. Saugstad, Joy E. Lawn, Peter Waiswa, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

No abstract provided.


Spectrum Of Venous Thromboembolism In Adult Patients With Ulcerative Colitis In Pakistan: A Single Center Retrospective Study, Masood Muhammad Karim, , Hafsa Shaikh, Faisal Wasim Ismail Feb 2025

Spectrum Of Venous Thromboembolism In Adult Patients With Ulcerative Colitis In Pakistan: A Single Center Retrospective Study, Masood Muhammad Karim, , Hafsa Shaikh, Faisal Wasim Ismail

Department of Medicine

Background: Patients with inflammatory bowel disease are at a 2-8-fold higher risk of developing venous thromboembolism (VTE) as compared to the general population. Although the exact pathogenesis is unclear, the literature suggests that increased risk of thromboembolic events in such patients occurs as a result of increased coagulation factors, inflammatory cytokines, and reduction in anticoagulants leading to a prothrombotic state.
Aim: To assess the prevalence, risk factors, management, and outcome of ulcerative colitis (UC) patients who develop VTE.
Methods: This was a retrospective chart review done in The Gastroenterology Department of The Aga Khan University Hospital. Data was collected from …


Global Guideline For The Diagnosis And Management Of Candidiasis: An Initiative Of The Ecmm In Cooperation With Isham And Asm, Oliver A. Cornely, Rosanne Sprute, Matteo Bassetti, Sharon C-A Chen, Andreas H. Groll, Oliver Kurzai, Cornelia Lass Flörl, Luis Ostrosky Zeichner, Riina Rautemaa Richardson, Gunturu Revathi Feb 2025

Global Guideline For The Diagnosis And Management Of Candidiasis: An Initiative Of The Ecmm In Cooperation With Isham And Asm, Oliver A. Cornely, Rosanne Sprute, Matteo Bassetti, Sharon C-A Chen, Andreas H. Groll, Oliver Kurzai, Cornelia Lass Flörl, Luis Ostrosky Zeichner, Riina Rautemaa Richardson, Gunturu Revathi

Pathology, East Africa

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal …


Healthcare Informatics February 2025, Aga Khan University Feb 2025

Healthcare Informatics February 2025, Aga Khan University

Department of Chief Medical Information Officer (CMIO) Archives

  • Message from the Physician Director
  • Update by Workgroup Leads
  • AKUH-Karachi, OneHealth Activities
  • Business and Innovation Award
  • Academics - Research - Scholarship
  • Upcoming Events


Prevalence And Correlates Of Depressive And Anxiety Symptoms Among Pregnant Women From An Urban Informal Settlement In Nairobi, Kenya: A Community-Based Cross-Sectional Study, Stephen Mulupi, Amina Abubakar, Moses Nyongesa, Vibian Angweny, Margaret Kabue, Paul Mwangi, Rachel Odhiambo, Joyce Marangu, Eunice Njoroge, Mercy Mokaya, Emmanuel Obulemire, Eunice Ombech, Kofi Marfo Feb 2025

Prevalence And Correlates Of Depressive And Anxiety Symptoms Among Pregnant Women From An Urban Informal Settlement In Nairobi, Kenya: A Community-Based Cross-Sectional Study, Stephen Mulupi, Amina Abubakar, Moses Nyongesa, Vibian Angweny, Margaret Kabue, Paul Mwangi, Rachel Odhiambo, Joyce Marangu, Eunice Njoroge, Mercy Mokaya, Emmanuel Obulemire, Eunice Ombech, Kofi Marfo

Institute for Human Development, East Africa

Purpose: Previous research, largely from the Global North, reports high rates of common mental health disorders among women in the antenatal period, but there is paucity of such data in contexts like Kenya. This study investigated the prevalence and correlates of depressive and anxiety symptoms among pregnant women in an urban informal settlement in Kenya’s capital – Nairobi.

Method: An analysis of baseline cross-sectional data from a pilot cluster randomized trial of an integrated early childhood development programme. Participants were pregnant women in their third pregnancy trimester (N = 249), residing in an urban informal settlement in Nairobi County. Mental …


Exploring Adolescents' Mental Health In Kampala, Uganda In The Context Of Covid-19: A Mixed Methods Study, Gideon Mbithi, Ahmed Sarki, Adam Mabrouk, Rachel Odhiambo, Mary Namuguzi, Joseph Atukwatse, Margaret Kabue, Stephen Mulupi, Amina Abubakar Feb 2025

Exploring Adolescents' Mental Health In Kampala, Uganda In The Context Of Covid-19: A Mixed Methods Study, Gideon Mbithi, Ahmed Sarki, Adam Mabrouk, Rachel Odhiambo, Mary Namuguzi, Joseph Atukwatse, Margaret Kabue, Stephen Mulupi, Amina Abubakar

Institute for Human Development, East Africa

Background: Urban areas, particularly in developing nations like Uganda, face heightened risks due to poverty, unemployment, and environmental challenges, intensifying the vulnerability of urban youth to poor mental health. This study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 pandemic in Kampala City, Uganda.

Methods: We conducted a cross-sectional survey of 500 adolescents aged 13–19 years residing within the five divisions of Kampala City, Uganda. We utilized standardized psychological assessment tools including the Patient Health Questionnaire, Generalized Anxiety Scale, …


Air Pollution Exposures In Early Life And Brain Development In Children (Abc): Protocol For A Pregnancy Cohort Study, Sarah Benki-Nugent, Faridah H. Were, Anne M Riederer, Michael Gatari, Cj Karr, Edmund Yw Seto, Beatrice C. Mutai, Susan Wamithi, Brent R. Collett, John Kinuthia Feb 2025

Air Pollution Exposures In Early Life And Brain Development In Children (Abc): Protocol For A Pregnancy Cohort Study, Sarah Benki-Nugent, Faridah H. Were, Anne M Riederer, Michael Gatari, Cj Karr, Edmund Yw Seto, Beatrice C. Mutai, Susan Wamithi, Brent R. Collett, John Kinuthia

Paediatrics and Child Health, East Africa

Introduction Air pollution is linked with poor neurodevelopment in high-income countries. Comparable data are scant for low-income countries, where exposures are higher. Longitudinal pregnancy cohort studies are optimal for individual exposure assessment during critical windows of brain development and examination of neurodevelopment. This study aims to determine the association between prenatal ambient air pollutant exposure and neurodevelopment in children aged 12, 24 and 36 months through a collaborative, capacity-enriching research partnership.

Methods and analysis This observational cohort study is based in Nairobi, Kenya. Eligibility criteria are singleton pregnancy, no severe pregnancy complications and maternal age 18 to 40 years. At …


Delphi-Driven Consensus Definition For Mesenchymal Stromal Cells And Clinical Reporting Guidelines For Mesenchymal Stromal Cell-Based Therapeutics, Laurent Renesme, Kelly D. Cobey, Manoj M. Lalu, Tania M. Bubela, Raghavan Chinnadurai, John De Vos, Rod Dunbar, Dean Fergusson, Daniel Freund, Jacques Galipeau Feb 2025

Delphi-Driven Consensus Definition For Mesenchymal Stromal Cells And Clinical Reporting Guidelines For Mesenchymal Stromal Cell-Based Therapeutics, Laurent Renesme, Kelly D. Cobey, Manoj M. Lalu, Tania M. Bubela, Raghavan Chinnadurai, John De Vos, Rod Dunbar, Dean Fergusson, Daniel Freund, Jacques Galipeau

Office of the Provost

Background aims: Despite promising results in pre-clinical studies, mesenchymal stromal cells (MSCs) face significant challenges in clinical translation. A scoping review by our group highlighted two key issues contributing to this gap: (i) lack of a clear and consensus definition for MSCs and (ii) under-reporting of critical parameters in MSC clinical studies. To address these issues, we conducted a modified Delphi study to establish and implement a consensus definition for MSCs and develop reporting guidelines for MSC clinical studies.
Methods: A steering committee of 22 international experts, including stakeholders from different MSC research fields, participated in the three Delphi rounds. …


Evaluating The Efficacy Of Diabetes Nurse-Led Health Coaching Intervention For Type 2 Diabetes At Aga Khan University Hospital, Nairobi: A Randomised Controlled Study, Jane Mugo Feb 2025

Evaluating The Efficacy Of Diabetes Nurse-Led Health Coaching Intervention For Type 2 Diabetes At Aga Khan University Hospital, Nairobi: A Randomised Controlled Study, Jane Mugo

MSc in Advanced Practice Nursing

Background: Type 2 Diabetes (T2DM) has placed a significant burden on both healthcare systems and individuals living with the disease. However, it is preventable through health promotion strategies. Healthy behavior changes, which improve disease outcomes, highlight the importance of supporting and sustaining self-efficacy in diabetes self-management.

Objective: This study aimed to test the effectiveness of a nurse-led health coaching program on diabetes control for individuals with T2DM with HbA1c >6.5% specifically on glycated haemoglobin (HbA1c) levels as compared with standard diabetes care only.

Methodology: The study adopted a randomized controlled trial (RCT) with two groups: an intervention group receiving the …


Knowledge, Attitude, And Practices Of Nurses Providing End-Of-Life Care At Aga Khan University Hospital, Nairobi County, Eunice Wanjiku Kariuki Feb 2025

Knowledge, Attitude, And Practices Of Nurses Providing End-Of-Life Care At Aga Khan University Hospital, Nairobi County, Eunice Wanjiku Kariuki

MSc in Advanced Practice Nursing

Introduction: End-of-life care is an essential aspect of healthcare, and nurses play a vital role in its provision. Due to the growing population, there has been an increase in the number of people in need of End-of-life care, and nurses must be adequately prepared to meet the complex and diverse needs of patients and their families. However, many studies suggest that many nurses feel unprepared to provide quality end-of-life care, and there is a need for further investigation of the factors that contribute to their preparedness.

Methods:The study was conducted at a level 6 teaching and referral hospital, in …


Cytomegalovirus Reactivation And Acute And Chronic Complications In Children With Cerebral Malaria: A Prospective Cohort Study, Jonathan A. A. Mayhew, Andrew J. Witten, Caitlin A. Bond, Robert Opoka, Paul Bangirana, Andrea L. Conroy, Nelmary Hernandez-Alvarado, Mark R. Schleiss, Chandy C. John C. John Feb 2025

Cytomegalovirus Reactivation And Acute And Chronic Complications In Children With Cerebral Malaria: A Prospective Cohort Study, Jonathan A. A. Mayhew, Andrew J. Witten, Caitlin A. Bond, Robert Opoka, Paul Bangirana, Andrea L. Conroy, Nelmary Hernandez-Alvarado, Mark R. Schleiss, Chandy C. John C. John

Paediatrics and Child Health, East Africa

Background: Virus co-infection or reactivation may modify the host response during cerebral malaria. Cytomegalovirus (CMV) DNAemia has been associated with increased morbidity and mortality in adults with sepsis; however, the impact of CMV DNAemia on adverse outcomes in children with cerebral malaria is unknown.: Clinical, physiological, and neurocognitive outcomes were compared in children aged 18 months to 12 years with cerebral malaria (N = 242) based on the presence or absence of CMV DNAemia 24 h after admission. The primary study outcome was subsequent in-hospital mortality. Secondary outcomes included the presence of acute kidney injury, neurocognitive impairment over a …


Evidence Based Quality Improvement For Prescribing Stewardship In Icu (Equips-Icu): Protocol For Type Iii Hybrid Implementation-Effectiveness Study, Duncan Wagstaff, John Amausi, Sumaiya Arfin, Diptesh Aryal, Mohd Basri Mat Nor, Joseph Bonney, Arjen Dondorp, David Dongelmans, Layoni Dullawe, Wangari Siika Feb 2025

Evidence Based Quality Improvement For Prescribing Stewardship In Icu (Equips-Icu): Protocol For Type Iii Hybrid Implementation-Effectiveness Study, Duncan Wagstaff, John Amausi, Sumaiya Arfin, Diptesh Aryal, Mohd Basri Mat Nor, Joseph Bonney, Arjen Dondorp, David Dongelmans, Layoni Dullawe, Wangari Siika

Anaesthesiology, East Africa

Approximately half of all antimicrobial prescriptions in intensive care units (ICUs) may be inappropriate, including those prescribed when not needed, in unnecessary combinations or for longer durations than needed. Inappropriate prescribing is costly, exposes patients to unnecessary side-effects and drives population-level antimicrobial resistance, the prevalence and consequences of which are greatest in low- and middle-income countries. However, the implementation of interventions to improve the appropriateness of antimicrobial prescribing has been variable and requires further study..


Outcomes Of Pregnant Icu Patients With Severe Covid-19 Pneumonia In Qatar During The Three Waves Of The Covid-19 Pandemic: A Retrospective Cohort Study, Layla J.M Kily, Sohel M.G Ahmed, Tamam A.K.M Alhusban, Mohammed J. Orompurath, Marcus Lance, Mogahed I.H Hussein, Salwa M. Abuyaqoub, Huda A. Saleh, Eynas Abdalla, Santhosh Gopalakrishnan Feb 2025

Outcomes Of Pregnant Icu Patients With Severe Covid-19 Pneumonia In Qatar During The Three Waves Of The Covid-19 Pandemic: A Retrospective Cohort Study, Layla J.M Kily, Sohel M.G Ahmed, Tamam A.K.M Alhusban, Mohammed J. Orompurath, Marcus Lance, Mogahed I.H Hussein, Salwa M. Abuyaqoub, Huda A. Saleh, Eynas Abdalla, Santhosh Gopalakrishnan

Anaesthesiology, East Africa

Introduction: Pregnant women are considered a high-risk group for COVID-19 infection/pneumonia as they are known to be more vulnerable to viral infections. They require close monitoring and appropriate timely intervention to minimize the impact on both the mother and the fetus. Although the more prevalent Omicron variant led to fewer severe infections and fewer intensive care unit (ICU) admissions globally during the third wave, the effect on pregnant women and pregnancy outcomes was unknown. The vaccination campaign was thoroughly established by the third wave of the pandemic in Qatar. This retrospective descriptive cohort study investigates the characteristics, hospital stay, interventions, …


The Case For An International Severity Of Illness Scoring System, Alexander Tracy, Jorge Ibrain Figueira Salluh, Eirik Alnes Buanes, Dave A. Dongelmans, Stefano Finazz, Bharath Kumar Tirupakuzhi Vijayaraghavan, Nazir Lone, David Pilcher, Matti Reinikainen, Wangari Siika Feb 2025

The Case For An International Severity Of Illness Scoring System, Alexander Tracy, Jorge Ibrain Figueira Salluh, Eirik Alnes Buanes, Dave A. Dongelmans, Stefano Finazz, Bharath Kumar Tirupakuzhi Vijayaraghavan, Nazir Lone, David Pilcher, Matti Reinikainen, Wangari Siika

Anaesthesiology, East Africa

Severity of illness scores in the critical care context have evolved to serve multiple functions. These scores enable risk-adjusted outcomes to be benchmarked for the assessment of intensive care unit (ICU) performance, inform resource allocation, and enable the characterization of disease severity. Numerous illness severity scores have been developed to optimize calibration at the national level, but few studies have examined the international application of such scores.()

The COVID-19 pandemic demonstrated the value of benchmarking outcomes across heterogeneous populations and across various health care systems. Severity of illness scores were widely used to describe trial populations, assess treatment effects and …


Implementation Of A Cascade Training Model To Enhance Emergency Care Capacity Of Healthcare Workers During The Covid-19 Outbreak In Uganda, Sulaiman Bugosera Wasukira, Carl Trevor Kambugu, Judith S. Nanyondo, Emmanuel Candia, Stephen Emmanuel Aporu, Cliff Asher Aliga Feb 2025

Implementation Of A Cascade Training Model To Enhance Emergency Care Capacity Of Healthcare Workers During The Covid-19 Outbreak In Uganda, Sulaiman Bugosera Wasukira, Carl Trevor Kambugu, Judith S. Nanyondo, Emmanuel Candia, Stephen Emmanuel Aporu, Cliff Asher Aliga

School of Nursing & Midwifery, East Africa

Introduction

The COVID-19 pandemic highlighted the gaps and the need to strengthen the emergency care system in Uganda. The Ugandan Ministry of Health implemented an emergency care capacity-building program during the COVID-19 pandemic response to improve COVID-19 case management in Uganda. We describe the curriculum development and rollout using a cascade model.

Methods

In June 2021, the World Health Organisation (WHO) Hospital Emergency Unit Assessment Tool (HEAT) was used to assess emergency units and document existing capacity gaps in regional referral hospitals and general hospitals. The WHO Basic Emergency Care curriculum was modified to a training curriculum for emergency care …


Support Needs For Registered Nurses To Bachelor Of Science In Nursing Students In Kenyan Universities, Gladys Mbuthia, Gisela H. Van Rensburg, Sheila Shaibu Feb 2025

Support Needs For Registered Nurses To Bachelor Of Science In Nursing Students In Kenyan Universities, Gladys Mbuthia, Gisela H. Van Rensburg, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Higher percentages of the registered nurses (RN) workforce with a bachelor's degree have been associated with better patient outcomes. RN with a diploma in nursing who are upgrading their qualifications to a bachelor's degree in nursing enter universities in Kenya as mature and part-time students. Studies have shown that mature and part-time students in universities have a higher attrition than their full-time peers. They are less likely to access extra support and personal development opportunities available at university, have a history of campus isolation, and fewer opportunities to engage with campus peers. The purpose of the study was to explore …


Procalcitonin-Guided Duration Of Antibiotic Treatment In Children Hospitalised With Confirmed Or Suspected Bacterial Infection In The Uk (Batch): A Pragmatic, Multicentre, Open-Label, Two-Arm, Individually Randomised, Controlled Trial, Cherry-Ann Waldron, Philip Pallmann, Simon Schoenbuchner, Debbie Harris, Lucy Brookes-Howell, Céu Mateus, Jolanta Bernatoniene, Katrina Cathie, Saul N. Faust, Helen Nabwera Feb 2025

Procalcitonin-Guided Duration Of Antibiotic Treatment In Children Hospitalised With Confirmed Or Suspected Bacterial Infection In The Uk (Batch): A Pragmatic, Multicentre, Open-Label, Two-Arm, Individually Randomised, Controlled Trial, Cherry-Ann Waldron, Philip Pallmann, Simon Schoenbuchner, Debbie Harris, Lucy Brookes-Howell, Céu Mateus, Jolanta Bernatoniene, Katrina Cathie, Saul N. Faust, Helen Nabwera

Centre of Excellence in Women and Child Health

Background Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker.

Methods The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales. Children aged 72 h to 18 years who were admitted to hospital and were being treated with intravenous antibiotics for suspected or confirmed bacterial infection …


Seroprevalence And Associated Factors For Hepatitis B And Hepatitis C Viral Infection Among Patients With Diabetes Mellitus In Northern Tanzania, Doreen T. Eliah, Nyasatu G. Chamba, Abid M. Sadiq, Amos Mwasamwaja, Faustini C. Kimondo, Cuthbert D. Matay, Eliada B. Nziku, Tumaini E. Mirai, Ibrahim Ali Ibrahim Muhina, Fuad H. Said Feb 2025

Seroprevalence And Associated Factors For Hepatitis B And Hepatitis C Viral Infection Among Patients With Diabetes Mellitus In Northern Tanzania, Doreen T. Eliah, Nyasatu G. Chamba, Abid M. Sadiq, Amos Mwasamwaja, Faustini C. Kimondo, Cuthbert D. Matay, Eliada B. Nziku, Tumaini E. Mirai, Ibrahim Ali Ibrahim Muhina, Fuad H. Said

Internal Medicine, East Africa

Background: The coexistence of viral hepatitis with diabetes mellitus (DM) significantly escalates the risk of severe outcomes. This study aimed to determine the seroprevalence and associated factors of hepatitis B (HBV) and hepatitis C (HCV) viral infections among DM patients in northern Tanzania.

Materials and methods: Conducted between February 2023 and May 2023, this hospital-based cross-sectional study enrolled 189 patients with DM from the Diabetic Clinic of Kilimanjaro Christian Medical Centre. A structured questionnaire captured relevant clinical information, and plasma blood sample was assessed for hepatitis B surface antigen and anti-hepatitis C antibody seropositivity. Data analysis employed SPSS v26, and …