Medicine and Health Sciences Commons^™

Reducing The Burden Of Diabetes Mellitus: Is It Achievable?, Rafay Iqbal, Raheel Ahmad, Aisha Ambreen

Department of Family Medicine

Diabetes mellitus is rapidly on the rise globally, particularly in low- and middle-income countries. Pakistan has emerged with the highest prevalence of diabetes by percentage according to recent estimates. Evidence is available for different strategies to reduce this burden. Screening high-risk individuals can reduce burden of undiagnosed diabetes and improve outcomes. Although prediabetes can progress to type 2 diabetes, it has the potential to regress to normoglycaemia as well. Interventions like lifestyle modifications and metformin in high-risk individuals can reduce the risk of progression to diabetes. Furthermore, there is a potential to reverse diabetes in some individuals in the early …

Development Of An Online Teaching Platform To Improve Access To Postgraduate Pathology Training In Sub-Saharan Africa, Richard Byers, Anita Byers, Chibamba Mumba, Angela Mutuku, Jennifer Singer-Rupp, Michael Wilson, Kenneth Fleming, Shahin Sayed

Pathology, East Africa

Background: Resource barriers to the provision of accessible training in cancer diagnosis in lower- and middle-income countries (LMICs) limit the potential of African health systems. Long-term provision via teaching visits from senior pathologists and trainee foreign placements is unsustainable due to the prohibitive costs of travel and subsistence. Emerging eLearning methods would allow pathologists to be trained by experts in a cheaper, more efficient, and more scalable way.

Purpose: This study aimed to develop an online teaching platform, starting with hematopathology, for trainee pathologists in sub-Saharan Africa, initially in Nairobi, Kenya, and Lusaka, Zambia.

Methods: Course materials …

Maternal And Neonatal Outcome In Pregnant Women Undergone Induction Of Labor At Muhimbili National Hospital, Dar Es Salaam, Tanzania, Shweta Jaiswal, Willbroad Kyejo, Charles Kilewo

Family Medicine, East Africa

Introduction

Labor induction is a common obstetric intervention aimed at initiating labor when spontaneous onset is delayed or deemed necessary for maternal or fetal well-being. Despite its widespread use, the practice’s impact on maternal and neonatal outcomes remains a subject of ongoing research and debate. This study aims to evaluate the maternal and neonatal outcomes associated with labor induction in a tertiary hospital setting in Tanzania.

Methodology

A descriptive analytical cross-sectional study was conducted over a seven-month period from January 2021 to July 2021 at Muhimbili National Hospital in Dar es Salaam, Tanzania. A total of 120 pregnant women who …

Long-Term Healthcare Utilisation, Costs And Quality Of Life After Invasive Group B Streptococcus Disease: A Cohort Study In Five Low-Income And Middle-Income Countries, Farah Seedat, Simon Procter, Ziyaad Dangor, Shannon Leahy, Sridhar Santhanam, Hima John, Quique Bassat, Celine Aerts, Amina Abubakar, Carophine Nasambu

Institute for Human Development, East Africa

Introduction There are no published data on the long-term impact of invasive group B Streptococcus disease (iGBS) on economic costs or health-related quality of life (HRQoL) in low-income and middle-income countries. We assessed the impact of iGBS on healthcare utilisation, costs and HRQoL in Argentina, India, Kenya, Mozambique and South Africa.

Methods Inpatient and outpatient visits, out-of-pocket (OOP) healthcare payments in the 12 months before study enrolment, and health-state utility of children and caregivers (using the EuroQol 5-Dimensions-3-Level) were collected from iGBS survivors and an unexposed cohort matched on site, age at recruitment and sex. We used logistic or Poisson …

Cost-Effectiveness Analysis Of Alternative Screening Strategies For The Detection Of Cervical Cancer Among Women In Rural Areas Of Western Kenya, Christopher Lobin, Elkanah Omenge, Edwin Were, Kapten Muthoka, Kavita Singh, Manuela De Allegri, Konrad Obermann, Magnus Doeberitz, Hermann Bussmann

Obstetrics and Gynaecology, East Africa

While the incidence of cervical cancer has dropped in high-income countries due to organized cytology-based screening programs, it remains the leading cause of cancer death among women in Eastern Africa. Therefore, the World Health Organization(WHO) now urges providers to transition from widely prevalent but low-performance visual inspection with acetic acid (VIA) screening to primary human papillomavirus(HPV) DNA testing. Due to high HPV prevalence, effective triage tests are needed to identify those lesions likely to progress and so avoid over-treatment. To identify the optimal cost-effective strategy, we compared the VIA screen-and-treat approach to primary HPV DNA testing with p16/Ki67 dual-stain cytology …

Evaluation Of The Feasibility Of A Midwifery Educator Continuous Professional Development (Cpd) Programme In Kenya And Nigeria: A Mixed Methods Study, Duncan Shikuku, Hauwa Mohammed, Lydia Mwanzia, Alice Ladur, Peter Nandikove, Eunice Ndirangu, Alphonce Uyara, Catherine Waigwe, Lucy Nyaga, Issak Bashir

School of Nursing & Midwifery, East Africa

Background Midwifery education is under-invested in developing countries with limited opportunities for midwifery educators to improve/maintain their core professional competencies. To improve the quality of midwifery education and capacity for educators to update their competencies, a blended midwifery educator-specific continuous professional development (CPD) programme was designed with key stakeholders. This study evaluated the feasibility of this programme in Kenya and Nigeria.

Methods This was a mixed methods intervention study using a concurrent nested design. 120 randomly selected midwifery educators from 81 pre-service training institutions were recruited. Educators completed four self-directed online learning (SDL) modules and three-day practical training of the …

Male Infertility: A Retrospective Review Of Laboratory Charts At A Tertiary Teaching Hospital In Nairobi City County, Festus Mulakoli, Doris Machaki, Abednego Ongeso, Maureen Akolo, Ruth Wagathu

School of Nursing & Midwifery, East Africa

Background: Globally, approximately 50 million couples experience one form of infertility, and 10 million cases of subfertility have been reported in sub-Saharan Africa. Infertility is characterized by a lack of clinical conception among couples who live together for more than one year with regular coitus, without the use of contraception. Factors related to fertility vary by sex and geographical region. These factors include age, lifestyle, infectious diseases, and genetic disorders. In African culture, children are considered a simple inheritance and a measure of masculinity, so efforts are needed to address the growing problem of male infertility in this context. …

The 2022 Symposium On Dementia And Brain Aging In Low- And Middle-Income Countries: Highlights On Research, Diagnosis, Care, And Impact, Raj Kalaria, Gladys Maestre, Simin Mahinrad, Daisy Acosta, Rufus Akinyemi, Suvarna Alladi, Ricardo Allegri, Faheem Arshad, Wambui Karanja, Chinedu Momoh

Brain and Mind Institute

Two of every three persons living with dementia reside in low- and middle-incomecountries (LMICs). The projected increase in global dementia rates is expected toaffect LMICs disproportionately. However, the majority of global dementia care costsoccur in high-income countries (HICs), with dementia research predominantly focus-ing on HICs. This imbalance necessitates LMIC-focused research to ensure thatcharacterization of dementia accurately reflects the involvement and specificities ofdiverse populations. Development of effective preventive, diagnostic, and therapeu-tic approaches for dementia in LMICs requires targeted, personalized, and harmonizedefforts. Our article represents timely discussions at the 2022 Symposium on Demen-tia and Brain Aging in LMICs that identified the foremost …

A Systematic Review Of Mental Health Of Women In Fragile And Humanitarian Settings Of The Eastern Mediterranean Region, Fauziah Rabbani, Aysha Zahidie, Amna Siddiqui, Sanam Shah, Zul Merali, Khalid Saeed, Mohamed Afifi

Brain and Mind Institute

Background: The increasing emergencies and humanitarian challenges have worsened the mental health condition of women in the Eastern Mediterranean Region.

Aim: To assess the prevalence, determinants and interventions to address mental health among women in fragile and humanitarian settings in the Eastern Mediterranean Region.

Methods: Using the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, we reviewed 59 peer-reviewed published studies (PubMed, IMEMR) and grey literature (WHO/IRIS) from January 2001 to February 2023, focusing on women's mental health in the Eastern Mediterranean Region. We then conducted a descriptive analysis of the sociodemographic characteristics.

Results: Among …

Psychiatric Morbidity Among Patients On Treatment For Tuberculosis At A Tertiary Referral Hospital In Western Kenya, Robina Momanyi, Edith Kwobah, Philip Owiti, Henry Nyamogoba, Lukoye Atwoli

Internal Medicine, East Africa

Background Mental disorders account for nine percent of the overall global burden of disease and are among the top ten leading causes of disability. Mental illness and tuberculosis share risk factors including poverty, overcrowding, stigma, poor nutrition, substance use and retro-viral disease co-infection. Presence of mental illness in tuberculosis delays health-seeking, affects drug adherence, increases cost of treatment, prolongs disease duration, lowers quality of life, and increases mortality. Early diagnosis, linkage, and treatment of psychiatric morbidity among patients with tuberculosis would improve outcomes for both. This study thus aimed to determine the prevalence and factors associated with psychiatric morbidity among …

A Mixed-Methods Study To Investigate Feasibility And Acceptability Of An Early Warning Score For Preterm Infants In Neonatal Units In Kenya: Results Of The News-K Study, Eleanor Mitchell, Jalemba Aluvaala, Lucy Bradshaw, Jane Daniels, Caren Emadau, Bernadine Muthumbi, Helen Nabwera, Ednah Ojee, Jacqueline Opira, Phoebe Pallotti

Centre of Excellence in Women and Child Health

Preterm birth (< 37 weeks gestation) complications are the leading cause of neonatal mortality. Early-warning scores (EWS) are charts where vital signs (e.g., temperature, heart rate, respiratory rate) are recorded, triggering action. To evaluate whether a neonatal EWS improves clinical outcomes in low-middle income countries, a randomised trial is needed. Determining whether the use of a neonatal EWS is feasible and acceptable in newborn units, is a prerequisite to conducting a trial. We implemented a neonatal EWS in three newborn units in Kenya. Staff were asked to record infants’ vital signs on the EWS during the study, triggering additional interventions as per existing local guidelines. No other aspects of care were altered. Feasibility criteria were pre-specified. We also interviewed health professionals (n = 28) and parents/family members (n = 42) to hear their opinions of the EWS. Data were collected on 465 preterm and/or low birthweight (< 2.5 kg) infants. In addition to qualitative study participants, 45 health professionals in participating hospitals also completed an online survey to share their views on the EWS. 94% of infants had the EWS completed at least once during their newborn unit admission. EWS completion was highest on the day of admission (93%). Completion rates were similar across shifts. 15% of vital signs triggered escalation to a more senior member of staff. Health professionals reported liking the EWS, though recognised the biggest barrier to implementation was poor staffing. Newborn unit infant to staff ratios varied between 10 and 53 staff per 1 infant, depending upon time of shift and staff type. A randomised trial of neonatal EWS in Kenya is possible and acceptable, though adaptations are required to the form before implementation.

Stillbirth Mortality By Robson Ten-Group Classification System: A Cross-Sectional Registry Of 80 663 Births From 16 Hospital In Sub-Saharan Africa, Claudia Hanson, Kristi Annerstedt, Maria Alsina, Muzdalfat Abeid, Hussein Kidanto, Helle Alvesson, Andrea Pembe, Peter Waiswa, Jean-Paul Dossou, Effie Chipeta

Centre of Excellence in Women and Child Health

Objective To assess stillbirth mortality by Robson ten-group classification and the usefulness of this approach for understanding trends.

Design Cross-sectional study.

Setting Prospectively collected perinatal e-registry data from 16 hospitals in Benin, Malawi, Tanzania and Uganda.

Population All women aged 13–49 years who gave birth to a live or stillborn baby weighting >1000 g between July 2021 and December 2022.

Methods We compared stillbirth risk by Robson ten-group classification, and across countries, and calculated proportional contributions to mortality.

Main outcome measures Stillbirth mortality, defined as antepartum and intrapartum stillbirths.

Results We included 80 663 babies born to 78 085 women; …

Sexual Satisfaction, An Indicator Of Sexual Health And Well-Being? Insights From Sti/Hiv Prevention Research In European Men Who Have Sex With Men, Karel Blondeel, Massimo Mirandola, Lorenzo Gios, Cinta Folch, Christiana Noestlinger, Maddalena Cordioli, Petra Sutter, Marleen Temmerman, Igor Toskin

Centre of Excellence in Women and Child Health

Introduction Although sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general.

Methods The Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013–2014 among men who have sex with men. Sexual satisfaction was explored using one single item: ‘How satisfied are …

Global Landscape Of The Attack Of Predatory Journals In Oncology, Khalid El Bairi, Dario Trapani, Sara Nidhamalddin, Shah Khan, Arman Chowdhury, Csongor Lengyel, Sadaqat Hussain, Baker Habeeb, Angelica Petrillo, Miriam Mutebi

General Surgery, East Africa

Purpose Open-access publishing expanded opportunities to give visibility to research results but was accompanied by the proliferation of predatory journals (PJos) that offer expedited publishing but potentially compromise the integrity of research and peer review. To our knowledge, to date, there is no comprehensive global study on the impact of PJos in the field of oncology.

Materials and Methods A 29 question-based cross-sectional survey was developed to explore knowledge and practices of predatory publishing and analyzed using descriptive statistics and binary logistic regression.

Results Four hundred and twenty-six complete responses to the survey were reported. Almost half of the responders …

Establishing Kidney Transplantation In A Low-Income Country: A Case In Tanzania, Francis F. Furia, Jaqueline G. Shoo, Paschal Ruggajo, Jonathan W. Jonathan W. Mngumi, Valentine Valentine, Mahmoud A. Muhiddin, Kim Kim, Isaack Mlatie, Moses Mulungu, Namala Mkopi

Internal Medicine, East Africa

Background

Sub-Saharan African countries, including Tanzania, have a high burden of chronic kidney diseases (CKDs) and limited capacity for the provision of services. Tanzania and other countries in the region have made signifcant improvements in the provision of services for patients with CKD, including hemodialysis. Few countries are ofering kidney transplantation services, which is the defnitive treatment for patients with CKD and kidney failure. This study was conducted to review the steps taken by Muhimbili National Hospital (MNH) to establish a kidney transplantation service in Tanzania.

Methods

This study was based on the review of the activities that were undertaken …

A Randomized Controlled Study Of The Effects Of Targeted Health Education On Uptake Of Contraceptives Among Women Of Reproductive Age In Nnewi City, South-East Nigeria, Yanmeer Tyotswam, Rosebella Iseme-Ondiek, Eliphas Makunyi

Population Health, East Africa

Objective: There is a need for contraception uptake among people to enable them to fulfil their right to determine the timing, number and spacing of their children. In regions with poor contraceptive prevalence rates, lack of effective education has been largely implicated, and Nigeria falls among such regions. Thus, the present study is designed to examine the impact of an educational intervention on uptake of contraceptives among women aged 18–49 years seeking care at the Nnamdi Azikiwe University Teaching Hospital Nnewi.

Methods: Being an interventional study to underscore the effect of targeted health education on uptake of contraceptives, …

Factors Associated With Anaemia Among Pregnant Women In Rwanda: An Analysis Of The Rwanda Demographic And Health Survey Of 2020, Lilian Nuwabaine, Joseph Kawuki, Livingstone Kamoga, Quraish Sserwanja, Ghislaine Gatasi, Linet M Mutisya, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background: Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda.

Methods: Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26).

Results: Of the 435 pregnant …

Beyond The Classroom Walls: Stakeholder Experiences With Remote Instruction In Post Rn Baccalaureate Nursing Program During The Covid-19 Pandemic: A Qualitative Inquiry, Laila Akber Cassum, Arusa Mansoor, Saima Sachwani, Zeenar Salim, Ridah Feroz, Shanaz Cassum

School of Nursing & Midwifery

The COVID-19 pandemic led to the closure of educational campuses and the suspension of conventional classroom teaching globally and locally, and many switched overnight to an online modality. The change was experienced differently by varied audiences, given the availability of resources. The study aimed to examine stakeholders' experiences of emergency remote instructions in the Post-RN Baccalaureate Nursing Program during the COVID-19 pandemic. A qualitative descriptive exploratory design with a purposive sampling technique was used at a private nursing university in Karachi, Pakistan. Focus group discussions with students and faculty were conducted separately, while in-depth interviews with key informants were held …

Wcn24-931 Aki Phenotypes In Ugandan Children Hospitalized With Hypoxemia And Malaria, Andrea Conroy, Anthony Batte, Rodney Ogwang, Sophie Namasopo, Robert Opoka, Michael Hawkes

Paediatrics and Child Health, East Africa

Introduction: Acute kidney injury (AKI) is a frequent life-threatening complication in hospitalized children. Emerging data suggest AKI is a heterogeneous condition that varies based on the underlying cause and is composed of distinct phenotypes. The objective of this study was to define AKI phenotypes using proposed classification systems in Ugandan children hospitalized with hypoxemia and to evaluate differences in phenotypes by malaria infection.

Methods: Between 2019 and 2021, 2402 Ugandan children <5 years of age hospitalized with hypoxemia were enrolled in a cluster randomized trial of solar powered oxygen delivery across 20 districts in Uganda. At enrollment, urine NGAL was measured using a point-of-care lateral flow test with a positive test defined as a level ≥150ng/mL. Malaria was assessed using a threeband rapid diagnostic test. In an extended sub-study, 491 children had creatinine measured to define AKI. AKI was defined using a single creatinine measure at enrolment and phenotypically characterized using two acute dialysis quality initiative (ADQI) proposed AKI phenotypes. The AKI biomarker definition incorporated urine NGAL into the KDIGO definition[group 1, no AKI; group 2, subclinical AKI (biomarker positive); group 3, AKI; group 4, biomarker positive AKI]. The ADQI sepsis AKI phenotype groups stage 1 AKI as sepsis phenotype (SP)-1 irrespective of biomarker status and differentiates severe AKI (stage 2/3) based on biomarker positivity where severe AKI that is biomarker negative is (SP2) and severe biomarker positive AKI is SP3.

Results: Overall, 491 children were included in the extended study with AKI defined and uNGAL measured. The median age was 1.3 years (interquartile range, 0.7 to 2.3) and 53.8% …

Neurocognitive Impairment In Ugandan Children With Sickle Cell Anaemia Compared To Sibling Controls: A Cross-Sectional Study, Paul Bangirana, Amelia Boehme, Annet Birabwa, Robert Opoka, Deogratias Munube, Ezekiel Mupere, Phillip Kasirye, Grace Muwanguzi, Maxencia Musiimenta, George Ru

Paediatrics and Child Health, East Africa

Introduction: The neurocognitive functions in Ugandan children aged 1–12 years with sickle cell anemia (SCA) were compared to their non-SCA siblings to identify risk factors for disease-associated impairment.

Methods: This cross-sectional study of the neurocognitive functions in children with SCA (N = 242) and non-SCA siblings (N = 127) used age- and linguistically appropriate standardized tests of cognition, executive function, and attention for children ages 1–4 and 5–12. Test scores were converted to locally derived age-normalized z-scores. The SCA group underwent a standardized stroke examination for prior stroke and transcranial Doppler ultrasound to determine stroke risk by arterial …

Future Directions For Emergency Medical Services Development In Low- And Middle-Income Countries., Peter G. Delaney, Jon Moussally, Benjamin Wachira

Emergency Medicine, East Africa

The lack of prehospital care access in low- and middle-income countries is one of the greatest unmet needs and, therefore, one of the most urgent priorities in global health. Establishing emergency medical services in low- and middle-income countries poses significant challenges and complexities, requiring solutions tailored to prevailing conditions, informed by needs assessments, and adapted to meet local demands in a culturally appropriate and sustainable manner. In areas without existing emergency medical services, patients must rely on informal networks of untrained bystanders and community members to provide first aid and transport to definitive care. Since 2005, training lay first responders …

Incidental Actinomycosis In A 44-Year-Old Female During Total Abdominal Hysterectomy For Abnormal Uterine Bleeding: A Case Report, Willbroad Kyejo, Ally Zain Ismail, Abduel Kitua, Gregory Ntiyakunze, Munawar Kaguta, Ally Mwawnga

Family Medicine, East Africa

Actinomycosis, a rare chronic bacterial infection caused by Actinomyces species, presents diagnostic challenges due to diverse clinical presentations. This report presents a case of peritoneal actinomycosis incidentally discovered during a total abdominal hysterectomy in a 44-year-old female with refractory abnormal uterine bleeding and a history of long-term intrauterine contraceptive device use. The patient presented with persistent abnormal uterine bleeding despite conservative management. Intraoperative findings during total abdominal hysterectomy revealed peritoneal involvement, prompting histopathological evaluation confirming actinomycosis. This case highlights diagnostic complexities associated with actinomycosis, emphasizing the significance of histopathological confirmation. Postoperative management with antibiotics demonstrated favorable outcomes, supporting their efficacy …

A Scoping Review Of The Literature On The Application And Usefulness Of The Problem Management Plus (Pm+) Intervention Around The World, Patrick Nzivo Mwangala, Anita Kerubo, Moses Nyongesa, Amina Abubakar

Institute for Human Development, East Africa

Background: Given the high rates of common mental disorders and limited resources, task-shifting psychosocial interventions are needed to provide adequate care. One such intervention developed by the World Health Organization is Problem Management Plus (PM+).

Aims: This review maps the evidence regarding the extent of application and usefulness of the PM+ intervention, i.e. adaptability, feasibility, effectiveness and scalability, since it was introduced in 2016.

Method: We conducted a scoping review of seven literature databases and grey literature from January 2015 to February 2024, to identify peer-reviewed and grey literature on PM+ around the world.

Results: Out of 6739 potential records, …

Time To Full Enteral Feeds In Hospitalised Preterm And Very Low Birth Weight Infants In Nigeria And Kenya, Zainab Imam, Helen Nabwera, Olukemi Tongo, Pauline Andang’O, Isa Abdulkadir, Chinyere Ezeaka, Beatrice Ezenwa, Iretiola Fajolu, Martha Mwangome, Dominic Umoru

Paediatrics and Child Health, East Africa

Background: Preterm (born < 37 weeks’ gestation) and very low birthweight (VLBW; <1.5kg) infants are at the greatest risk of morbidity and mortality within the first 28 days of life. Establishing full enteral feeds is a vital aspect of their clinical care. Evidence predominantly from high income countries shows that early and rapid advancement of feeds is safe and reduces length of hospital stay and adverse health outcomes. However, there are limited data on feeding practices and factors that influence the attainment of full enteral feeds among these vulnera- ble infants in sub-Saharan Africa.

Aim: To identify factors that influence the time to full enteral feeds, defined as tolerance of 120ml/ kg/day, in hospitalised preterm and VLBW infants in neonatal units in two sub-Saharan Afri- can countries.

Methods: Demographic and clinical variables were collected for newborns admitted to 7 neonatal units in Nigeria and Kenya over 6-months. Multiple linear regression analysis was conducted to identify factors independently associated with time to full enteral feeds.

Results: Of the 2280 newborn infants admitted, 484 were preterm and VLBW. Overall, 222/484 (45.8%) infants died with over half of the deaths (136/222; 61.7%) occurring before …

Kawasaki Disease In Kenya And Review Of The African Literature, Angela Migowa, Catherine Njeri, Edwin Were, Thomas Ngwiri, L Colmegna

Paediatrics and Child Health, East Africa

Background: Kawasaki disease has been described across the globe, although publications from Africa are limited. To our knowledge, there are no publications on Kawasaki disease from Kenya, which triggered this report.

Methods: A retrospective cross-sectional study was undertaken to identify in-patients with a discharge diagnosis of Kawasaki disease, over 2 different 5-year periods, at two pediatric hospitals in Nairobi, Kenya. We reviewed the medical records of all patients and report their clinical findings, diagnostic workup and treatment. In addition, we undertook a detailed review of the literature.

Results: Twenty-three patients with Kawasaki disease were identified, of those 12 (52.2%) had …

A Rare Case Of Biliary Atresia With Biliary Ascites On A (Hepatobiliary Iminodiacetic Acid) Hida Scan, Poonamjeet Loyal, Khalid Makhdomi, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Biliary atresia is one of the most challenging conditions in pediatric surgery even when it is the only finding. Here we present a rare case of biliary atresia complicated with biliary ascites due to ductal perforation identified on a hepatobiliary iminodiacetic acid (HIDA) scan.

Wcn24-2067 Regional Differences In Acute Kidney Injury In Ugandan Children Hospitalized For Hypoxemia, Anthony Batte, Rodney Ogwang, Robert Opoka, Sophie Namasopo, Michael Hawkes, Andrea Conroy

Paediatrics and Child Health, East Africa

Introduction: Acute kidney injury (AKI) is associated with increased mortality in hospitalized patients and incidence is highest in resource limited settings. The objective of this study was to assess sub-National regional differences in the incidence of AKI in children <5 years of age hospitalized with an acute febrile illness and hypoxemia.

Methods: This was a secondary analysis of a stepped wedge cluster randomized controlled trial, which enrolled children <5 years of age hospitalized with hypoxemia between 2019 and 2021. At least one measure of kidney function was available in 1452 children. A single creatinine was measured at enrolment in a sub-set of 495 children with serum stored and AKI defined using KDIGO criteria where baseline creatinine was estimated using the age-based Pottel equation assuming a normal glomerular filtration rate of 120mL/min per 1.73m2. Markers were divided into structural (uNGAL positive, proteinuria, hematuria) or functional (AKI, saliva urea nitrogen (SUN)) measures of kidney injury.

Results: 1452 children were included in this AKI sub-study (Figure 1). The mean age of participants was 1.49 years (standard deviation (SD), 1.21) and 55.7% were male (809/1452). Overall 2.6% of children died (38/1452). The majority of participants enrolled were from the West (31.3%) …

The Impact Of Silver-Impregnated External Ventricular Catheter On The Rate Of Catheter-Related Infection At The Aga Khan University Hospital, Nairobi, Monica Adongo Nyikal

Master of Medicine in General Surgery

Background: 

External Ventricular Drain insertion has been practised at the Aga Khan University Hospital for more than 15 years, with the initial use of plain catheters. Subsequently between 2016 and 2017 the use of Silver-impregnated external ventricular catheters was adopted in the hospital with the aim of reducing external ventricular catheter-related infections. There is a need to assess the effect of the Silver-impregnated external ventricular drain (EVD).

Objectives: 

The primary objective of the study was to determine the difference in the incidence of EVD related infections between the plain EVD and Silver-impregnated EVD at AKUHN in the duration between the …

Use Of Mobile Technology To Identify Behavioral Mechanisms Linked To Mental Health Outcomes In Kenya: Protocol For Development And Validation Of A Predictive Model, Willie Njoroge, Rachel Maina, Frank Elena, Lukoye Atwoli, Anthony Ngugi, Srijan Sen, Stephen Wong, Linda Khakali, Andrew Aballa, James Orwa, Moses Nyongesa, Jasmit Shah, Amina Abubakar, Zul Merali

Brain and Mind Institute

Objective:This study proposes to identify and validate weighted sensor stream signatures that predict near-term risk of a major depressive episode and future mood among healthcare workers in Kenya.

Approach: The study will deploy a mobile application (app) platform and use novel data science analytic approaches (Artificial Intelligence and Machine Learning) to identifying predictors of mental health disorders among 500 randomly sampled healthcare workers from five healthcare facilities in Nairobi, Kenya.

Expectation: This study will lay the basis for creating agile and scalable systems for rapid diagnostics that could inform precise interventions for mitigating depression and ensure a healthy, resilient …

Leveraging Ai And Machine Learning To Develop And Evaluate A Contextualized User-Friendly Cough Audio Classifier For Detecting Respiratory Diseases: Protocol For A Diagnostic Study In Rural Tanzania, Kahabi Isangula, Rogers John Haule

School of Nursing & Midwifery, East Africa

Background:

Respiratory diseases, including active tuberculosis (TB), asthma, and chronic obstructive pulmonary disease (COPD), constitute substantial global health challenges, necessitating timely and accurate diagnosis for effective treatment and management.

Objective:

This research seeks to develop and evaluate a noninvasive user-friendly artificial intelligence (AI)–powered cough audio classifier for detecting these respiratory conditions in rural Tanzania.

Methods:

This is a nonexperimental cross-sectional research with the primary objective of collection and analysis of cough sounds from patients with active TB, asthma, and COPD in outpatient clinics to generate and evaluate a noninvasive cough audio classifier. Specialized cough sound recording devices, designed to be …