Medicine and Health Sciences Commons^™

Factors Influencing Abortion Care-Seeking Outside Of Formal Healthcare Settings: Lived Experiences From Rwandan Young Women, Jean Pierre Ndayisenga, Assumpta Yamuragiye, Abe Oudshoorn, Godfrey Katende, Aimable Nkurunziza, Olive Tengera, Jean Bosco Henri Hitayezu, Justine Bagirisano, Jeanne D’ Arc Ayinkamiye, Gilbert Uwitonze

School of Nursing & Midwifery, East Africa

Background: Informal abortions, commonly known as unsafe abortions, refer to all induced abortions that occur outside of formal healthcare settings conducted without the assistance of a licensed, trained healthcare provider. Despite the legalization of safe induced abortion care services, informal abortions continue to be among the major causes of maternal mortality and morbidity among young women in Rwanda living in rural areas with limited or no access to safe abortion care services. The purpose of this qualitative study was to gain an in-depth understanding of the lived experience of seeking informal abortions from the perspective of young women in …

Academic Partnerships In Transforming Nursing And Midwifery Education In Africa: A Systematic Scoping Review Protocol, Claudine Muraraneza, Donatilla Mukamana, Godfrey Katende, Oliva Bazirete, Liz Wolvaardt

School of Nursing & Midwifery, East Africa

Background. In recent decades, the literature on global partnerships in nursing and midwifery education, to enhance the quality of education and produce competent graduates in the labor market, is on the rise in Africa. However, there is a gap regarding the best practices and barriers in the African context. This systematic scoping review aims to map the evidence of academic partnerships in transforming nursing and midwifery education in Africa.

Methods. The review will be guided by Arksey and O’Malley’s methodology framework through five stages: (1) Identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, …

Inspire : Vol 7 Issue 10, Department Of Medicine

INSPIRE – Department of Medicine Archives

• Message from the Chair
• Medicine at National and International Forums
• Asian Oceanian Myology Center
• Dr. Shahab Abid's at Gastro Summit
• BDLA Conference
• Cardiovascular Innovation Foundation Conference 2024
• Dr Javaid Khan once again!
• Epilepsy Mini-Fellowship
• PIMA Central convention
• Nazar Ali Waljee Staff Award
• Empowering Dermatology Postgraduates
• Fire Drill | Department of Medicine
• Dr Noreen Nasir | Sharing her FDA journey | NUH Singapore
• Featured Fellow: Sana Qamar
• Poem
• Upcoming Events

Breast Cancer Molecular Subtype Classification According To Immunohistochemistry Markers And Its Association With Pathological Characteristics Among Women Attending Tertiary Hospitals In Tanzania, Allyzain Ismail, Sajida Panjwani, Neelam Ismail, Caroline Ngimba, Innocent Mosha, Philip Adebayo, Ally Mwanga, Ali Zehri, Aidan Njau, Ali Athar

Family Medicine, East Africa

Background: Breast cancer immunohistochemistry is a biological characteristic of the tumour which has a role to diagnose molecular subtype, prognosticate and guide treatment and is categorised into 4 subtypes. Data in Tanzania was lacking and was based off data extrapolated from studies in Western Africa thus hypothesizing that women of African ancestry predominately develop Triple Negative Breast Cancer (TNBC).

Methods: A retrospective cross-sectional study was carried out at two tertiary referral hospitals on participants who were recruited from the cancer registries from 2015 to 2022. Prevalence of each molecular subtype was determined and association between molecular subtype to demographic and …

Pharmacy Newsletter : October 2024, Pharmacy Department

Department of Pharmacy Archives

• Pharmacy Newsletter provides information regarding the decisions of P&TC, current concepts in drug therapy, warnings and cautions issued by various regulatory agencies, drug interactions, ADRs, and matters related to drug usage.
• AKUH Clinical Pharmacy Accolades
• Treatment & Management Guidelines for Rodenticide Poisonings
• Drug & Poison Information Center
• Levetiracetam & Clobazam linked to Drug Reaction with Eosinophilia & Systemic Symptoms (DRESS)
• AKUH Antimicrobial Stewardship Committee (ASP)
• World Pharmacists Day 2024 at AKUH | “Pharmacists: Meeting global health needs”
• Clinical Pharmacists in Multidisciplinary Rounds

2024 Eacts/Eactaic Guidelines On Patient Blood Management In Adult Cardiac Surgery In Collaboration With Ebcp, Filip Casselman, Marcus Lance, Aamer Ahmed, Alice Ascari, Juan Blanco-Morillo, Daniel Bolliger, Maroua Eid, Gabor Erdoes, Renard Gerhardus Haumann

Anaesthesiology, East Africa

Clinical practice guidelines consolidate and evaluate all pertinent evidence available at their time of formulation on a specific topic, the goal being to assist physicians in determining the most effective management strategies for patients with a particular condition. These guidelines assess the impact on patient outcomes and weigh the risk–benefit ratio of various diagnostic or therapeutic approaches. Although not a replacement for textbooks, they provide supplementary information on topics relevant to current clinical practice, becoming an essential tool to support physicians' decision making in daily practice. Nonetheless, it is crucial to understand that these recommendations are intended to guide but …

Low Prevalence Of Soil Transmitted Helminth Infection In Ugandan Children Hospitalized With Severe Malaria, Drew Capone, Nuzrath Jahan, Ruth Namazzi, Robert Opoka, Chandy John

Paediatrics and Child Health, East Africa

Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014-2017 and asymptomatic community children from the same household or neighborhood and enrolled at the same time, all 6 months to 48 months of age. We investigated if intestinal helminth infection modified risk of severe malaria. We extracted nucleic acids from stool …

Supporting African Communities To Increase Resilience And Mental Health Of Kids With Developmental Disabilities And Their Caregivers Using The World Health Organization’S Caregiver Skills Training Programme (Spark Trial): Study Protocol For A Cluster Randomised Clinical Controlled Trial, Melissa Nortey, Vibian Angweny, Beatrice Mkubwa, Rosa Hoekstra, Andrew Healey, Rahel Birhane, Nadine Seward, Temesgen Azmeraw, Fikite Girma

Institute for Human Development, East Africa

Background: Most children with developmental disabilities (DD) live in low- and middle-income countries, but access to services is limited, impacting their ability to thrive. Pilot study findings of the World Health Organization’s Caregiver Skills Training (WHO CST) intervention, which equips caregivers with strategies to facilitate learning and adaptive behaviours in children with DD, are promising but evidence from an appropriately powered trial delivered by non-specialist facilitators is lacking. This study will investigate the effectiveness and the resource impacts and costs and consequences of the WHO CST intervention in four sites in rural and urban Kenya and Ethiopia.

Methods: …

The Grenada Learning And Memory Scale: Psychometric Features And Normative Data In Caribbean Preschool Children, Karen Blackmon, Roberta Evans, Lauren Mohammed, Kemi Burgen, Erin Ingraham, Bianca Punch, Rashida Isaac, Toni Murray, Jesma Noel, Cora Belmar-Roberts

Brain and Mind Institute

Objective: Neuropsychological assessment of preschool children is essential for early detection of delays and referral for intervention prior to school entry. This is especially pertinent in low- and middle-income countries (LMICs), which are disproportionately impacted by micronutrient deficiencies and teratogenic exposures. The Grenada Learning and Memory Scale (GLAMS) was created for use in limited resource settings and includes a shopping list and face-name association test. Here, we present psychometric and normative data for the GLAMS in a Grenadian preschool sample.

Methods: Typically developing children between 36 and 72 months of age, primarily English speaking, were recruited from public preschools in …

Considerations For Widespread Implementation Of Blood-Based Biomarkers Of Alzheimer's Disease, Michelle Mielke, Matthew Anderson, Wesson Ashford, Andreas Jeromin, Pei-Jung Lin, Allyson Rosen, Jamie Tyrone, Lawren Vandevrede, Deanna Willis, Zul Merali

Brain and Mind Institute

Diagnosing Alzheimer's disease (AD) poses significant challenges to health care, often resulting in delayed or inadequate patient care. The clinical integration of blood-based biomarkers (BBMs) for AD holds promise in enabling early detection of pathology and timely intervention. However, several critical considerations, such as the lack of consistent guidelines for assessing cognition, limited understanding of BBM test characteristics, insufficient evidence on BBM performance across diverse populations, and the ethical management of test results, must be addressed for widespread clinical implementation of BBMs in the United States. The Global CEO Initiative on Alzheimer's Disease BBM Workgroup convened to address these challenges …

Peer Counseling For Perinatal Depression In Low- And Middle-Income Countries: A Scoping Review, Alexander Cuncannon, Kailyn Seitz, Aneel Signh, Aliyah Dosani

Brain and Mind Institute

Perinatal depression is associated with adverse maternal, newborn and child health outcomes. Treatment gaps and sociocultural factors contribute to its disproportionate burden in low- and middle-income countries (LMICs). Task-sharing approaches, such as peer counseling, have been developed to improve access to mental health services. We conducted a scoping review to map the current literature on peer counseling for perinatal women experiencing depression in LMICs. We searched CINAHL, MEDLINE, APA PsycINFO, Global Health and EMBASE for literature with no date limits. We included 73 records in our analysis, with most being systematic reviews and meta-analyses, randomized controlled trials and qualitative studies. …

Recommendations For Clinical Implementation Of Blood-Based Biomarkers For Alzheimer's Disease, Michelle Mielke, Matthew Anderson, Wesson Ashford, Andreas Jeromin, Pei-Jung Lin, Allyson Rosen, Jamie Tyrone, Lawren Vandevrede, Deanna Willis, Zul Merali, Chinedu Momoh

Brain and Mind Institute

Blood-based biomarkers (BBM) for Alzheimer's disease (AD) are being increasingly used in clinical practice to support an AD diagnosis. In contrast to traditional diagnostic modalities, such as amyloid positron emission tomography and cerebrospinal fluid biomarkers, BBMs offer a more accessible and lower cost alternative for AD biomarker testing. Their unique scalability addresses the anticipated surge in demand for biomarker testing with the emergence of disease-modifying treatments (DMTs) that require confirmation of amyloid pathology. To facilitate the uptake of BBMs in clinical practice, The Global CEO Initiative on Alzheimer's Disease convened a BBM Workgroup to provide recommendations for two clinical implementational …

Healthcare Worker Practices For Hpv Vaccine Recommendation: A Systematic Review And Meta-Analysis, Damola Bakare, Elisa Gobbo, Kofoworola Akinsola, Ayobami Bakare, Julius Salako, Claudia Hanson, Sibylle Herzig Van Wees, Adegoke Falade, Carina King

Centre of Excellence in Women and Child Health

Healthcare workers (HCWs) are trusted sources of information for vaccination and their attitude toward vaccination is thus critical. We aimed to synthesize existing literature on healthcare workers’ HPV vaccine confidence and their practices of recommending this vaccine. We conducted a systematic literature review and meta-analysis, with the search conducted last in March 2024. For the inclusion criteria, the studies needed to include healthcare worker practices or behaviors on recommending the HPV vaccination. Seventy-three articles were included. The proportions of HCWs recommending varied considerably by region and gender of the recipient, but there was no statistically significant difference in income level …

A Qualitative Study Exploring Graduated Medical Residents’ Research Experiences, Barriers To Publication And Strategies To Improve Publication Rates From Medical Residents, Dorothy Kamya, Brigette Macharia, Wangari Siika, Caroline Mbuba

Anaesthesiology, East Africa

Background: In Kenya, postgraduate medical residents must complete a research dissertation for their Master of Medicine studies. However, the subsequent publication rate is lower than in higher-income settings, limiting the availability of population-specific data. This study explored residents’ experiences with research, reasons for the low publication rate, and strategies to improve publication rates.

Methods: In-depth interviews were conducted with 9 faculty members and non-academic support staff, as well as 18 Master of Medicine graduates who had successfully completed their research projects, to investigate their experiences with conducting, supervising, and publishing research. The interview data was analysed using inductive …

Corrigendum: Sars-Cov-2 Seroprevalence In Pregnant Women In Kilifi, Kenya From March 2020 To March 2022, Angela Koech, Geoffrey Omuse, Joseph Mutunga, Moses Mukhanya, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Rachel Craik, Alex Mugo, Marleen Temmerman

Pathology, East Africa

Background: Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.

Methods: We obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, …

Burden Of Disease Attributable To High Body Mass Index: An Analysis Of Data From The Global Burden Of Disease Study 2021, Xiao-Dong Zhou, Qin-Fen Chen, Wah Yang, Mauricio Zuluaga, Giovanni Targher, Christopher Byrne, Luca Valentu, Fei Luo, Christos Katsouras, Christopher Opio

Internal Medicine, East Africa

Background: Obesity represents a major global health challenge with important clinical implications. Despite its recognized importance, the global disease burden attributable to high body mass index (BMI) remains less well understood.

Methods: We systematically analyzed global deaths and disability-adjusted life years (DALYs) attributable to high BMI using the methodology and analytical approaches of the Global Burden of Disease Study (GBD) 2021. High BMI was defined as a BMI over 25 kg/m2 for individuals aged ≥20 years. The Socio-Demographic Index (SDI) was used as a composite measure to assess the level of socio-economic development across different regions. Subgroup analyses considered age, …

Vaccine Decision-Making Among Pregnant Women: A Protocol For A Cross-Sectional Mixed-Method Study In Brazil, Ghana, Kenya And Pakistan, Jessica Schue, Prachi Singh, Berhaun Fesshaye, Emily Miller, Shanelle Quinn, Ruth Karron, Renato Souza, Maria Laura Costa, Ferdinand Okwaro, Marleen Temmerman

Centre of Excellence in Women and Child Health

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited …

A Scoping Review Of Substance Use Brief Interventions In Africa, Florence Jaguga, Sarah Kiburi, Eunice Temet, Matthew Aalsma, Mary Ott, Rachel Maina, Cyprian Mostert, Lukoye Atwoli, Juddy Wachira, Gilliane Kosgei

Internal Medicine, East Africa

Background: The burden of substance use in Africa is substantial. Brief interventions (BIs) are a recommended public health strategy for the prevention and early intervention for substance use problems. The objective of this scoping review was to map the literature on substance use BIs in Africa, identify gaps, and provide directions for future research.

Methods: The scoping review was guided by the Arksey O’Malley Framework and the PRISMA-Scoping review (PRISMA-ScR) guidelines. A search of five bibliographic databases (PubMed, PsychINFO, Web of Science, Cumulative Index of Nursing and Allied Professionals (CINAHL) and Cochrane Library) was conducted from inception until 1st November …

The Case For Eliminating Excessive Worry As A Requirement For Generalized Anxiety Disorder: A Cross-National Investigation, Ayelet Meron Ruscio, Madeleine Rassaby, Murray Stein, Dan Stein, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Lukoye Atwoli, Guilherme Borges, Evelyn Bromet

Internal Medicine, East Africa

Background: Around the world, people living in objectively difficult circumstances who experience symptoms of generalized anxiety disorder (GAD) do not qualify for a diagnosis because their worry is not ‘excessive’ relative to the context. We carried out the first largescale, cross-national study to explore the implications of removing this excessiveness requirement.

Methods: Data come from the World Health Organization World Mental Health Survey Initiative. A total of 133 614 adults from 12 surveys in Low- or Middle-Income Countries (LMICs) and 16 surveys in High-Income Countries (HICs) were assessed with the Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-5 …

Accuracy Of Nine-Item Patient Health Questionnaire Against Psychiatric Diagnosis For Depression Among People With Hiv, Marcela Yotebieng, Natalia Zotova, Charlotte Bernard, Suzanne Goodrich, Ajeh Rogers Awoh, Dana Watnick, Dominique Mahambu Nsonde, Elodie Flore Tchiengang Moungang, Moussa Seydi, Lukoye Atwoli

Internal Medicine, East Africa

Objective: The aim of this study was to assess the performance of the nine-item Patient Health Questionnaire (PHQ-9) against psychiatrist diagnosis in people with HIV (PWH).

Design: Cross-sectional analysis of data collected between January 2018 and July 2022 across five sites in Cameroon, Cote d’Ivoire, Kenya, Senegal, and the Republic of Congo. Participants were ≥18 years and receiving HIV care at the participating site. PHQ-9 was administered by study staff followed by a psychiatrist's evaluation within 3 days.

Results: Overall, 778 participants with complete data were included: 297 (38.2%) in Cameroon, 132 (17.0%) in Congo, 148 (19.0%) in Cote d’Ivoire, …

Content And Design Of Respectful Maternity Care Training Packages For Health Workers In Sub-Saharan Africa: Scoping Review, Judith Yargawa, Marina Daniele, Kelly Pickerill, Marianne Vidler, Angela Koech, Hawanatu Jah, Grace Mwashigadi, Mukaindo Mwaniki, Peter Von Dadelszen, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background Training health workers might facilitate respectful maternity care (RMC); however, the content and design of RMC training remain unclear.

Objective To explore the content and design of RMC training packages for health workers in sub-Saharan Africa.

Search Strategy MEDLINE, EMBASE, CINAHL Complete, Web of Science Core Collections, SCOPUS, and grey literature sources (including websites of RMC-focused key organizations and Ministries of Health) were searched for journal papers, reports, and training guides from January 2006 up to August 2022.

Selection Criteria There were no restrictions on study designs, language, or health-worker cadre. Two reviewers independently screened results.

Data Collection and …

Psychological Distress Among Ethnically Diverse Participants From Eastern And Southern Africa, Kester Tindi, Allan Kalungi, Eugene Kinyanda, Bizu Gelaye, Alicia Martin, Ronald Galiwango, Wilber Ssembajjwe, Fred Kirumira, Adele Pretorius, Lukoye Atwoli

Internal Medicine, East Africa

Importance: Psychological distress is characterized by anxiety and depressive symptoms. Although prior research has investigated the occurrence and factors associated with psychological distress in low- and middle-income countries, including those in Africa, these studies’ findings are not very generalizable and have focused on different kinds of population groups.

Objective: To investigate the prevalence and characteristics (sociodemographic, psychosocial, and clinical) associated with psychological distress among African participants.

Design, setting and participants: This case-control study analyzed data of participants in the Neuropsychiatric Genetics in African Populations-Psychosis (NeuroGAP-Psychosis) study, which recruited from general outpatient clinics in Eastern (Uganda, Kenya, and Ethiopia) and Southern …

The Dengue Vaccine Initiative: A Bibliometric Analysis Of Research Publications, Festus Mulakoli, Abednego Ongeso, Horatius Musembi

School of Nursing & Midwifery, East Africa

Dengue fever has become a significant public health problem in tropical and subtropical regions and affects millions of people annually. Approximately 390 million people worldwide are estimated to be infected with dengue every year, of which 96 million develop dengue fever. Recently, there has been a noticeable increase in dengue cases, primarily in areas with tropical and subtropical climates. Vaccines have been developed to prevent or reduce the severity of the disease. This study reviews the number of publications on dengue vaccines and related topics worldwide. We aimed to evaluate the research output and create a narrative on global vaccine …

Determinants Of Quality Antenatal Care Use In Kenya: Insights From The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Angella Namulem, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Earnest Amwiine, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Provision of quality antenatal care (ANC) is important to reduce maternal and newborn fatalities worldwide. However, the use of quality ANC by women of reproductive age and associated factors remain unclear in many developing countries. Therefore, this study aimed to determine factors associated with receiving quality ANC in Kenya among women of reproductive age. We analyzed secondary data from the 2022 Kenya Demographic Health Survey, which included 11,863 women. Participants were selected using two-stage stratified sampling. Univariate and multivariable logistic regression analyses were used to analyze the data. Of the 11,863 participating women, 61.2% (95% confidence interval (CI): 59.7%–62.6%) received …

Inspire : Vol 7 Issue 9, Department Of Medicine

INSPIRE – Department of Medicine Archives

• Message from the Chair
• Medicine at National and International Forums
• Epilepsy Mini fellowship in Doha | Neurology Faculty
• Asia Pacific Digestive Week (APDW) 2024 | Bali
• PSIM & AKU
• Spotlight on Samina Akhtar: Attendee at Lugano Summer School 2024
• Featured Fellow: Sawera Hanif | Instructor
• What Academics are reading?
• Upcoming Events

Assessing Nurse Educators' Competencies For Adopting Blended Learning In The Skills Labs In Uganda's Public Nursing Schools, Eva Kakonge Nampiima, Mathias M Bwanika Ulumba, Musisi Badru, Grace Nakate

School of Nursing & Midwifery, East Africa

Blended learning has become an integral part of nursing education, offering a blend of online and face-to-face instruction that enhances learning experiences, particularly within skills labs. However, the effectiveness of blended learning largely depends on the competencies of nurse educators in utilizing digital tools and methodologies. This study assessed the competencies of nurse educators in Uganda's public nursing schools concerning blended learning adoption. Data was collected from 40 randomly selected nursing educators in 4 public nursing schools in Uganda. The findings indicate significant inadequacies: only 25% are proficient with Learning Management Systems (LMS) like Moodle, 20% can effectively use platforms …

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guideline Update – Xi – Milk Supplement/Replacement Formulas For Infants And Toddlers With Cma – Systematic Review, Antonio Bognanni, Ramon Firmino, Stefania Arasi, Derek Chu, Alexandro Chu, Siw Waffenschmidt, Arnav Agarwal, Piotr Dziechciarz, Andrea Horvath, Rose Kamenwa

Paediatrics and Child Health, East Africa

Background: Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes. The addition of …

The Psychometric Properties Of The Swahili Version Of The Primary Care Post Traumatic Stress Disorder Screen For Dsm-5 Among Adults In Kenya, Patrick Nzivo Mwangala, Joseph Newton Guni, Paul Mwangi, Millicent Makandi, Anita Kerubo, Rachel Odhiambo, Amina Abubakar

Institute for Educational Development, East Africa

Background: The psychometric properties of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are undocumented in Kenya and sub-Saharan Africa (SSA) at large. This study aimed to evaluate the psychometric properties of the Swahili version of the tool, S-PC-PTSD-5, in a community sample of adults 18 years and older drawn from Nairobi, Mombasa and Kwale counties in Kenya.

Methods: Analysis of cross-sectional data from 1431 adults from the community was conducted, examining the reliability, factorial structure, measurement invariance, and convergent and divergent validity of the interviewer-administered S-PC-PTSD-5.

Results: Out of 1431 adults who completed the S-PC-PTSD-5, 666 (46.5%) reported experiencing …

Neurological Symptoms And Cause Of Death Among Young Children In Low- And Middle-Income Countries, Sara Ajanovic, Zachary Madewell, Shams El Arifeen, Emily Gurley, Mohammad Zahid Hossain, Kazi Munisul Islam, Afruna Rahman, Nega Assefa, Lola Madrid, R Gunturu

Pathology, East Africa

Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies.

Objective: To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival.

Design, Setting, and Participants: This cross-sectional …

Can Written Prompts Help Medical Residents To Accurately Monitor Their Own Communication Skills And Those Of Others?, F. O. De Meijer, N. Nyamu, A. H. De Bruin

Family Medicine, East Africa

In healthcare, effective communication in complex situations such as end of life conversations is critical for delivering high quality care. Whether residents learn from communication training with actors depends on whether they are able to select appropriate information or ‘predictive cues’ from that learning situation that accurately reflect their or their peers’ performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predictive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties were randomly assigned to …