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Articles 61 - 90 of 7543
Full-Text Articles in Medical Specialties
Social Correlates Of Trauma And Posttraumatic Stress Disorder: The Importance Of Context, Lukoye Atwoli, Linnet Ongeri
Social Correlates Of Trauma And Posttraumatic Stress Disorder: The Importance Of Context, Lukoye Atwoli, Linnet Ongeri
Internal Medicine, East Africa
Understanding trauma and posttraumatic stress disorder (PTSD) requires a contextual perspective that considers historical legacies, social environments, and cultural realities. This paper draws on empirical evidence from Kenya and Uganda to demonstrate the limitations of applying trauma frameworks developed in high-income countries to African contexts. Findings from the Orphaned and Separated Children’s Assessment Related to Their Health and Well-Being (OSCAR) study challenge assumptions about care environments. The study reveals higher PTSD rates among orphans in family-based settings compared to institutional care, and highlights the protective roles of religion and social support. The Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study provides …
Assessing The Association Between Musculoskeletal Injury And Mental Health In Rugby Players-A Cross-Sectional Study, Mordicai Atinga, Jasmit Shah, Sarah Karanja, Mark Lumbasi, Miriam Ndungu, Sarah Kiburi, James Ondiege, Njalalle Baraza
Assessing The Association Between Musculoskeletal Injury And Mental Health In Rugby Players-A Cross-Sectional Study, Mordicai Atinga, Jasmit Shah, Sarah Karanja, Mark Lumbasi, Miriam Ndungu, Sarah Kiburi, James Ondiege, Njalalle Baraza
Internal Medicine, East Africa
Background: Musculoskeletal injuries are common among athletes and can negatively affect both physical and psychological wellbeing. Beyond physical disability, injuries have been linked to poor mental health, loss of athletic identity, and increased substance use. In low- and middle-income countries (LMICs), where awareness and management of mental health remain limited, the psychological burden of sports injuries may be underrecognized. Rugby, a physically demanding contact sport, has one of the highest rates of injury, but little is known about how such injuries influence mental health and related outcomes in African contexts. This study explored the relationship between musculoskeletal injuries and health …
Prevalence Of Plasmodium Ovale And Plasmodium Malariae Mixed Infections And Associated Mortality In Children With Severe Falciparum Malaria, Giselle Lima-Cooper, Dibyadyuti Datta, Caitlin Bond, Kagan Mellencamp, Ruth Namazzi, Mahesh Gupta, Andrea Conroy, Robert Opoka, Chandy John
Prevalence Of Plasmodium Ovale And Plasmodium Malariae Mixed Infections And Associated Mortality In Children With Severe Falciparum Malaria, Giselle Lima-Cooper, Dibyadyuti Datta, Caitlin Bond, Kagan Mellencamp, Ruth Namazzi, Mahesh Gupta, Andrea Conroy, Robert Opoka, Chandy John
Paediatrics and Child Health, East Africa
The prevalence and clinical significance of mixed Plasmodium infections in children with severe Plasmodium falciparum (P. falciparum) malaria are not well characterized. In a cohort of 440 Ugandan children hospitalized with severe malaria who were diagnosed with Plasmodium species via microscopy, nested polymerase chain reaction (nPCR) testing was used to detect P. falciparum, Plasmodium ovale (P. ovale), Plasmodium malariae (P. malariae), and Plasmodium vivax (P. vivax) infections and assess their association with adverse clinical outcomes during hospitalization. Using nPCR testing, the Plasmodium 18S small-subunit ribosomal RNA gene was detected in 440 children. Plasmodium falciparum mono-infection was identified in 329 (74.8%) …
The 2025 Accra Declaration On Upskilling And Cost- Effective Cardiac Surgery In Africa, Charles Yankah, Jonathan Nwiloh, Carlos Mestres, Abdelmalek Bouzid, Tom Mwambu, Andrew Duncan, Mohamed Debieche, Samuel Omokhodion, Uvie Onakpoya, Matthias Angres
The 2025 Accra Declaration On Upskilling And Cost- Effective Cardiac Surgery In Africa, Charles Yankah, Jonathan Nwiloh, Carlos Mestres, Abdelmalek Bouzid, Tom Mwambu, Andrew Duncan, Mohamed Debieche, Samuel Omokhodion, Uvie Onakpoya, Matthias Angres
General Surgery, East Africa
The Pan-African Society for Cardiothoracic Surgery (PASCaTS) organized the 1st Pan-African Cardiothoracic Surgery Summit on 21 to 24 February 2025 in Accra, Ghana. The summit brought together leading specialists from across Africa, China, Europe, South America and the USA to address the growing burden of cardiovascular disease, to share their vision for the fight against cardiovascular disease, to raise standards in the diagnosis, treatment and recovery of patients thereby improving procedural safety and clinical outcomes in Africa. The experts agreed on the need for cost effectiveness in cardiac surgery, simulation skills training, an African regional cardiothoracic surgery database, African heart …
Impaired Fetal Brain Growth And Neurodevelopmental Deficits At 2 Years: Deep Phenotyping Of Maternal–Fetal Pathophysiology, José Villar, Maria Carvalho, Robert Gunier, Rose Mcgready, Yolotzin Valdespino, Kim Lagerborg, Fernando Barros, Agustin Conde-Agudelo, Shane Norris, R. Ochieng
Impaired Fetal Brain Growth And Neurodevelopmental Deficits At 2 Years: Deep Phenotyping Of Maternal–Fetal Pathophysiology, José Villar, Maria Carvalho, Robert Gunier, Rose Mcgready, Yolotzin Valdespino, Kim Lagerborg, Fernando Barros, Agustin Conde-Agudelo, Shane Norris, R. Ochieng
Obstetrics and Gynaecology, East Africa
Background Impaired fetal cranial growth trajectories, diverging before 20 weeks' gestation, are associated with growth, vision, and neurodevelopment deficits at age 2 years. We aimed to understand the maternal–fetal pathophysiological processes underlying childhood developmental deficiencies.
Methods: Between 2012 and 2019, the INTERBIO-21st Fetal Study enrolled 3598 pregnant women who initiated antenatal care before 14 weeks' gestation. We prospectively measured fetal cranial and linear growth and brain volume, and we monitored the infants' health, growth, and development from birth to age 2 years to identify growth and development phenotypes. We grouped the observed cranial growth into five distinct phenotypes: median growth …
Feasibility And Safety Of Intrapartum Foetal Pulse Oximetry Using A Disposable Scalp Probe: A Cross-Sectional Study, Felix Oindi, Mukaindo Mwaniki, Sikolia Wanyonyi, Marleen Temmerman
Feasibility And Safety Of Intrapartum Foetal Pulse Oximetry Using A Disposable Scalp Probe: A Cross-Sectional Study, Felix Oindi, Mukaindo Mwaniki, Sikolia Wanyonyi, Marleen Temmerman
Obstetrics and Gynaecology, East Africa
Background Assessment of foetal wellbeing during labour is critical for reducing adverse perinatal outcomes. While pulse oximetry is widely used in adult and paediatric medicine, its application in intrapartum foetal monitoring remains limited. This study aimed to evaluate the feasibility and safety of a foetal pulse oximeter device (OxiReed™, formerly First Touch™) for obtaining intrapartum foetal oxygen saturation (SpO₂) measurements.
Methods A cross-sectional study was conducted at a tertiary referral hospital involving 110 women in the first or second stage of labour. Eligible participants had singleton pregnancies at ≥ 34 weeks’ gestation, vertex presentation, and ruptured membranes. A disposable foetal …
Co-Designing An Adolescent Perinatal Mental Health Intervention In Kenya And Mozambique: The Inspire Project, Tatiana Salisbury, Fernando Chissale, Margrette Hanselmann, Evaline Langat, Sarah Kinja, Violet Naanyu, Mark Nyalumbe, Mellan Lilumbi, Lucy Nyaga, Marleen Temmerman
Co-Designing An Adolescent Perinatal Mental Health Intervention In Kenya And Mozambique: The Inspire Project, Tatiana Salisbury, Fernando Chissale, Margrette Hanselmann, Evaline Langat, Sarah Kinja, Violet Naanyu, Mark Nyalumbe, Mellan Lilumbi, Lucy Nyaga, Marleen Temmerman
Centre of Excellence in Women and Child Health
Background Interventions to support adolescent perinatal mental health are limited and largely developed for delivery in high-income countries. This study aimed to co-design an intervention to improve mental health outcomes among pregnant and post-partum adolescent girls in Mozambique and Kenya.
Methods 159 adolescent girls (aged 15–19 years) and young women (aged 20–24 years) with experience of a pregnancy during adolescence, their partners and family members, service providers and community influencers were recruited in Kilifi County, Kenya and Moatize District, Mozambique. Those who consented took part in individual interviews, focus group discussions, observations, and workshops to identify key priorities for supporting …
The Influence Of Older Age On Rbc Transfusion Decisions In Icu Patients, Caroline Schaap, Jorinde Raasveld, Florian Reizine, Boillot Corentin, Jimmy Schenk, Sanne De Bruin, Merijn Reuland, Claudia Van Den Oord,, Andrew Flint, Marcus Lance
The Influence Of Older Age On Rbc Transfusion Decisions In Icu Patients, Caroline Schaap, Jorinde Raasveld, Florian Reizine, Boillot Corentin, Jimmy Schenk, Sanne De Bruin, Merijn Reuland, Claudia Van Den Oord,, Andrew Flint, Marcus Lance
Anaesthesiology, East Africa
Objectives: RBC transfusions are common in the ICU. Recent studies suggest that a restrictive transfusion policy is noninferior or superior to a liberal policy. However, few studies focus on the influence of age in transfusion. In elderly ICU patients, reduced physiologic reserves may shift the perceived risk-benefit balance of transfusion, potentially leading to different transfusion practices. This study examines whether transfusion practices in ICU patients differ across patient age.
Design: This is a substudy of the International Point Prevalence Study of ICU Transfusion Practices (InPUT), a global, multicenter, prospective observational cohort study.
Setting: ICUs from 233 centers …
Associations Of Cortisol With Alzheimer's Disease Fluid And Neuroimaging Biomarkers: A Systematic Review, Jasper Holleman, Sima Toopchiani, Oliver Robinson, Ingemar Kåreholt, Miia Kivipelto, Lefkos Middleton, Alina Solomon, Chinedu Momoh, Shireen Sindi
Associations Of Cortisol With Alzheimer's Disease Fluid And Neuroimaging Biomarkers: A Systematic Review, Jasper Holleman, Sima Toopchiani, Oliver Robinson, Ingemar Kåreholt, Miia Kivipelto, Lefkos Middleton, Alina Solomon, Chinedu Momoh, Shireen Sindi
Brain and Mind Institute
Background Chronic stress triggers the dysregulation of hypothalamic–pituitary–adrenal (HPA) axis which is characterized by altered diurnal cortisol patterns and increased basal cortisol levels. This dysregulation has been found in Alzheimer’s Disease (AD), but its link with AD-related biomarkers remains underexplored. This systematic review aims to synthesize the current knowledge regarding the association between cortisol and biomarkers related to AD.
Methods Keywords and phrases related to cortisol and AD-related biomarkers were used to search the MEDLINE database via PubMed and OVID interfaces up to January 2024. Studies focused on the association between cortisol levels and genetic, neuroimaging, and fluid biomarkers related …
Disseminated Tuberculosis Presenting With A Nodo-Colonic Fistula In A Newly Diagnosed Hiv-Positive Patient: A Case Report From Tanzania, Samina Somji, Salim Surani, Joshua Ngimbwa, Tevin Kahwa, Frank Swai, Fatema Tayabali, Bishoy Rofaeil
Disseminated Tuberculosis Presenting With A Nodo-Colonic Fistula In A Newly Diagnosed Hiv-Positive Patient: A Case Report From Tanzania, Samina Somji, Salim Surani, Joshua Ngimbwa, Tevin Kahwa, Frank Swai, Fatema Tayabali, Bishoy Rofaeil
Population Health, East Africa
We present the case of a 35-year-old male with no known comorbidities who presented with chronic gastrointestinal (GI) and constitutional symptoms and was empirically treated with several antibiotics during multiple clinic visits at different health facilities. The laboratory test sent included a stool GeneXpert, which was positive for Mycobacterium tuberculosis (MTB). CT imaging revealed multiple necrotic abdominal and retroperitoneal lymph nodes, hypoenhancing splenic lesions, a nodo-colonic fistula between the necrotic retroperitoneal lymph nodes and the adjacent colon, and a mild left-sided pleural effusion. Colonoscopy demonstrated caseating discharge from the fistulous tract 40 cm from the anal verge, and histology showed …
Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong
Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong
Centre of Excellence in Women and Child Health
No abstract provided.
Pseudo-Bartter Syndrome In A Pancreatic Insufficient Infant With Cftr, Dnah9, Lyst And G6pd Variants, Diana Marangu‐Boore, Doris Kinuthia, Janet Maranga, Peter Ngwatu, Joel Lessan, Rita Boateng
Pseudo-Bartter Syndrome In A Pancreatic Insufficient Infant With Cftr, Dnah9, Lyst And G6pd Variants, Diana Marangu‐Boore, Doris Kinuthia, Janet Maranga, Peter Ngwatu, Joel Lessan, Rita Boateng
Pathology, East Africa
No abstract provided.
World Health Organization Classification Of Tumours Of The Breast 6th Edition 2026, Cecily Quinn, Puay Tan, Kimberly Allison, Edi Brogi, Sunil Lakhani, Stuart Schnitt, Stephen Fox, Shabnam Jaffer, Aysegul Sahin, Shahin Sayed
World Health Organization Classification Of Tumours Of The Breast 6th Edition 2026, Cecily Quinn, Puay Tan, Kimberly Allison, Edi Brogi, Sunil Lakhani, Stuart Schnitt, Stephen Fox, Shabnam Jaffer, Aysegul Sahin, Shahin Sayed
Pathology, East Africa
The 6th edition of the WHO Classification of Breast Tumours introduces both major and minor changes based on recent advances in our understanding of breast biology, developments in diagnostic modalities, identification of specific molecular targets and new treatment regimens necessitating modifications to pathology reporting and tumour biomarker categorisation. This review summarises the main changes that strive towards a classification of global relevance. In invasive carcinoma, predictive factors increasingly inform modern breast cancer treatment. The 6th edition provides an update on HER2 reporting categories following the DESTINY-Breast 04 and 06 trials. Terminologies used to classify invasive tumours are clarified, with the …
Building Qualitative Research Capacity In The Global Health Workforce And Developing A Community Of Practice In Parts Of Sub-Saharan Africa: A Case Study, Jack Lumsdon, Catherine Dotchin, Albert Akpalu, Benedict Calys-Tagoe, Dilraj Sokhi, Momodou Cham, Njideka Okubadejo, Richard Morton, Violet Naanyu, Richard Walker
Building Qualitative Research Capacity In The Global Health Workforce And Developing A Community Of Practice In Parts Of Sub-Saharan Africa: A Case Study, Jack Lumsdon, Catherine Dotchin, Albert Akpalu, Benedict Calys-Tagoe, Dilraj Sokhi, Momodou Cham, Njideka Okubadejo, Richard Morton, Violet Naanyu, Richard Walker
Internal Medicine, East Africa
Background Qualitative research offers unique insights into the lived experience of individuals with chronic conditions which can tie directly into public health priorities and identifying the need for additional support. More participatory approaches and qualitative data surrounding chronic diseases are needed in sub-Saharan Africa (SSA). Valuable “insider” insights are often missing as the conceptualisation of research often overlooks the value of such interactions. For successful and meaningful global health research, it is imperative to involve in-country experts and strengthen the capacity of research teams with qualitative skills.
Methods To address this, two hybrid qualitative research skills workshops were conducted in …
Renal Adverse Effects Of Antiangiogenic Agents In A Tertiary Hospital In Kenya, Joan Wambugu, Joyce Bwombengi, Jasmit Shah, Manel Haj Mansour
Renal Adverse Effects Of Antiangiogenic Agents In A Tertiary Hospital In Kenya, Joan Wambugu, Joyce Bwombengi, Jasmit Shah, Manel Haj Mansour
Internal Medicine, East Africa
Introduction Anti-angiogenic therapies, including vascular endothelial growth factor (VEGF) inhibitors and tyrosine kinase inhibitors (TKIs), have transformed cancer management by targeting tumor vasculature and suppressing metastasis. However, these agents can induce renal toxicities such as hypertension, proteinuria, and acute kidney injury (AKI), which may affect treatment continuity and outcomes. Data from sub-Saharan Africa on these adverse effects remains scarce.
Methods This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Nairobi, oncology clinic. Medical records of adult patients receiving anti-angiogenic therapy between January 2020 and December 2024 were reviewed. Demographic data, comorbidities, treatment regimens, renal parameters, and …
Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o
Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o
Obstetrics and Gynaecology, East Africa
Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …
Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o
Availability Of Cancer Screening Across Hiv Treatment Sites In The Iedea Consortium, Rachael Pellegrino, Bryan Shepherd, Sanjay Pujari, Valeria Fink, Gad Murenzi, Miriam Nakalembe, Sally Coburn, Eliane Rohner, Antoine Jaquet, Elkanah Orang'o
Obstetrics and Gynaecology, East Africa
Cancer remains a leading cause of morbidity and mortality in people with HIV, and the importance of cancer screening increasesas this population ages. In 2017, 2020, and 2023, cross-sectional surveys were conducted at HIV care sites across 5 continentswithin the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We described cancer screening avail-ability in 2023 and over time for cervical and anal cancer screening using generalized estimating equations with a logit linkfunction to account for site clustering, rurality, and country income. Of the 220 sites in the 2023 survey, 61% (134/220) reportedcervical cancer screening by cytology or human papillomavirus (HPV) …
A Review Of Yellow Fever: Epidemiology, Pathogenesis, Clinical Manifestations, Treatment, Prevention, And Prognosis, Farah Ebrahim, Samina Somji, Reena Shah, Salim Surani
A Review Of Yellow Fever: Epidemiology, Pathogenesis, Clinical Manifestations, Treatment, Prevention, And Prognosis, Farah Ebrahim, Samina Somji, Reena Shah, Salim Surani
Internal Medicine, East Africa
Yellow fever is a mosquito-borne viral illness caused by the yellow fever virus (YFV), a member of the Flaviviridae family. Despite the availability of an effective live-attenuated vaccine, the disease remains endemic in regions of Africa and South America. Transmission occurs primarily via an infected mosquito called Aedes aegypti, with distinct urban, sylvatic, and intermediate transmission cycles. Clinically, infection ranges from mild febrile illness to severe disease, which is characterized by jaundice, hemorrhage, and multiorgan failure. Pathogenesis involves viral replication in hepatocytes, immune-mediated injury, and dysregulated inflammatory responses, leading to characteristic hepatic mid-zone necrosis. Diagnosis relies on molecular detection …
Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong
Beyond Parallel Programmes: A Roadmap For Operational Integration Of Family Planning And Nutrition In Low- And Middle-Income Countries, Marleen Temmerman, Samuel Ojong
Centre of Excellence in Women and Child Health
No abstract provided.
Daily Outdoor Pm2.5 Exposure Characterization And Road Edge Effect During A 2022 - 2023 Monitoring Campaign In Gambia, Kenya And Mozambique, Terence Mushore, Handsome Nyoni, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Anotida Chapunza, Stanley Luchters, Matthew Chersich, Marleen Temmerman, Angela Koech
Daily Outdoor Pm2.5 Exposure Characterization And Road Edge Effect During A 2022 - 2023 Monitoring Campaign In Gambia, Kenya And Mozambique, Terence Mushore, Handsome Nyoni, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Anotida Chapunza, Stanley Luchters, Matthew Chersich, Marleen Temmerman, Angela Koech
Centre of Excellence in Women and Child Health
Air pollution is a major contributor to mortality and adverse health outcomes, particularly in pregnant women and children, with vehicular emissions as a key source. This study aimed to characterize long-term exposure to fine particulate matter (PM2.5), evaluate potential health risks, and quantify the contribution of road transport and proximity to roads in The Gambia, Kenya, and Mozambique. Multi-temporal personal exposure data were interpolated into continuous spatial surfaces and aggregated into daily averages, which were then compared with World Health Organization (WHO) guidelines to assess potential health impacts. Multi-distance buffers at 10 m intervals up to 1000m from major roads …
The 'Golden Hour': A Geospatial Analysis Of Travel Time To Public Emergency Departments In Kenya, Tushara Surapaneni, Nancy Kinyua, Benjamin Wachira
The 'Golden Hour': A Geospatial Analysis Of Travel Time To Public Emergency Departments In Kenya, Tushara Surapaneni, Nancy Kinyua, Benjamin Wachira
Emergency Medicine, East Africa
Introduction In Kenya and many other low- and middle-income countries, prehospital care systems are underdeveloped or entirely non-existent, leaving emergency departments (EDs) as the primary point of care for medical emergencies. The aim of this cross-sectional observational study was to use a geographic information system (GIS) to comprehensively analyse access to public EDs in Kenya within 1-hour and 2-hour travel times.
Methods Using open-source GIS software, population, land cover, elevation and road network data were analysed to create maps of 1-hour and 2-hour travel time catchment areas around public EDs in Kenya. Travel time analysis was calculated using AccessMod with …
Ten-Year Pathology-Based Cancer Registry At A Tertiary Referral Hospital In Kenya (2015–2024): Distribution Of Cancers And Completeness Of Pathology Reporting, Brian Ayara, Samuel Mukono, Rodney Adam, Shahin Sayed
Ten-Year Pathology-Based Cancer Registry At A Tertiary Referral Hospital In Kenya (2015–2024): Distribution Of Cancers And Completeness Of Pathology Reporting, Brian Ayara, Samuel Mukono, Rodney Adam, Shahin Sayed
Pathology, East Africa
Background Population-based cancer registries remain limited in low- and middle-income countries (LMICs). In Kenya, their coverage is below the 20% threshold recommended by the International Agency for Research on Cancer. Pathology-based registries can provide complementary data in such contexts. This study describes the distribution of cancers diagnosed at a tertiary referral hospital in Nairobi over ten years, and evaluates the completeness of pathology reporting for selected cancers using College of American Pathologists (CAP) protocols.
Methods We conducted a retrospective review of all histologically confirmed cancers at the Aga Khan University Hospital, Nairobi, from 2015 to 2024. Data were extracted from …
A Physician Survey On Research And Implementation Priorities For Caffeine Citrate Use In Newborn Care In Sub-Saharan Africa, Olufunke Bolaji, Osayame Ekhaguere, Franck Houndjahoue, Nicholas Embleton, Helen Nabwera
A Physician Survey On Research And Implementation Priorities For Caffeine Citrate Use In Newborn Care In Sub-Saharan Africa, Olufunke Bolaji, Osayame Ekhaguere, Franck Houndjahoue, Nicholas Embleton, Helen Nabwera
Centre of Excellence in Women and Child Health
Background:Evidence on caffeine citrate (CC) for apnoeaof prematurity (AOP) originate from high-income countries. This study aimed to develop consensus on research design for evidence in sub-Saharan Africa (SSA).
Methods:We surveyed physicians in newborn units across SSA to assess their opinions on CC research and their preferred study designs.
Participants rated four study designs:a) an observational before-and-after study; a randomized controlled trial (RCT) of b) caffeine versus placebo; c) caffeine versus aminophylline; d) a traditional or stepped wedge cluster trial. They assessed each design using a Likert scale for evidence, feasibility, and ethics considerations.
Results:Ninety-two newborn physicians …
Benefits, Challenges, And The Way Forward: Medical Specialists' Perception On Family Physician Integration In Healthcare System In Tanzania, Juvenalius Anselm, Roselyter Riang’A, Neelam Ismail, Davis Rubagumya, Jesca Munishi, Sumayyah Saudin, Lynn Moshi, Willbroad Kyejo, Nancy Matillya
Benefits, Challenges, And The Way Forward: Medical Specialists' Perception On Family Physician Integration In Healthcare System In Tanzania, Juvenalius Anselm, Roselyter Riang’A, Neelam Ismail, Davis Rubagumya, Jesca Munishi, Sumayyah Saudin, Lynn Moshi, Willbroad Kyejo, Nancy Matillya
Family Medicine, East Africa
Background Family medicine provides comprehensive care by integrating biomedical, behavioral, and social sciences. While established in some sub-Saharan countries, it remains new and unintegrated in Tanzania’s public health system. Its integration is vital for healthcare reform to enhance patient care and system quality.This study aimed to understand the perceptions of medical specialists regarding the integration of family physicians into the Tanzanian healthcare system.
Methods A descriptive qualitative study was conducted through in-depth interviews with ten medical specialists from Aga Khan Hospital and Muhimbili National Hospital in Dar es Salaam. Thematic analysis was employed in this study.
Results Integration of family …
Mental Wellbeing Of Family Caregivers Of People Living With Mental Illness In Kenya: Who Cares? A Cross-Sectional Study, Norah Obungu, Fleur Meijer, Stanley Luchters
Mental Wellbeing Of Family Caregivers Of People Living With Mental Illness In Kenya: Who Cares? A Cross-Sectional Study, Norah Obungu, Fleur Meijer, Stanley Luchters
Family Medicine, East Africa
Background Although about 60% of patients with chronic mental health disorders in sub-Saharan Africa live with their relatives, burden amongst family caregivers has not been studied much. The aim of this study was to evaluate the prevalence and factors associated with caregiver burden among family caregivers of patients with chronic mental illness attending two psychiatric care facilities in Nairobi, Kenya.
Methods A cross-sectional study was conducted among 284 systematically sampled participants who completed a socio-demographic questionnaire and the Zarit Burden Interview. Moderate to severe burden was defined as a ZBI score > 41. Independent associations were examined using bivariable and multivariable …
Early Insights From A Multi-Centre National Stroke Surveillance Initiative In Tanzania, Sarah Shali Matuja, Azan Nyundo, Emmanuel Assey, Joel Bwelemo, Marieke Dekker, Sarah Urasa, Emanuel Makarius, Peter Kishimbo, Philip Adebayo, Paschal Ruggajo
Early Insights From A Multi-Centre National Stroke Surveillance Initiative In Tanzania, Sarah Shali Matuja, Azan Nyundo, Emmanuel Assey, Joel Bwelemo, Marieke Dekker, Sarah Urasa, Emanuel Makarius, Peter Kishimbo, Philip Adebayo, Paschal Ruggajo
Internal Medicine, East Africa
Background: Stroke is a leading cause of death and disability globally, with sub-Saharan Africa, bearing the greatest burden. Tanzania has only one active stroke registry, limiting evidence-based care and policy development. We aimed to expand the registry into a multi-centre study across eight major tertiary hospitals to generate baseline data for a national stroke registry.
Methods: From January to August 2024, we analysed de-identified data from adults (≥18 years) admitted with a World Health Organisation defined stroke. Data collected included demographics, risk factors, imaging, and in-hospital mortality. Logistic regression identified predictors of mortality.
Results: A total of 1000 patients were …
Bayesian Machine Learning Enables Discovery Of Risk Factors For Hepatosplenic Multimorbidity Related To Schistosomiasis, Yin-Cong Zhi, Victor Anguajibi, John Oryema, Betty Nabatte, Christopher Opio, Narcis Kabatereine, Goylette Chami
Bayesian Machine Learning Enables Discovery Of Risk Factors For Hepatosplenic Multimorbidity Related To Schistosomiasis, Yin-Cong Zhi, Victor Anguajibi, John Oryema, Betty Nabatte, Christopher Opio, Narcis Kabatereine, Goylette Chami
Internal Medicine, East Africa
One in 25 deaths worldwide is related to liver disease, and often with multiple hepatosplenic conditions. Yet, little is understood of the risk factors for hepatosplenic multimorbidity, especially in the context of chronic infections. We present a novel Bayesian multitask learning framework to jointly model 45 hepatosplenic conditions assessed using point-of-care B-mode ultrasound for 3155 individuals aged 5-91 years within the SchistoTrack cohort across rural Uganda, where chronic intestinal schistosomiasis is endemic. We identify distinct and shared biomedical, socioeconomic, and spatial risk factors for individual conditions and hepatosplenic multimorbidity, and introduce methods for measuring condition dependencies as risk factors. Notably, …
Disseminated Iatrogenic Upper Gastrointestinal Kaposi Sarcoma Following Prolonged Steroid Use In A Patients With Crohn's Disease: A Case Report, Glory Makupa, Furaha Serventi, Leila Mwakipunda, Godwin Nnko, Edwin Liwa, Salum Lidenge, Ayesiga Herman, Lilian Gasper, Amos Mwasamwaja, Beatrice Kombole
Disseminated Iatrogenic Upper Gastrointestinal Kaposi Sarcoma Following Prolonged Steroid Use In A Patients With Crohn's Disease: A Case Report, Glory Makupa, Furaha Serventi, Leila Mwakipunda, Godwin Nnko, Edwin Liwa, Salum Lidenge, Ayesiga Herman, Lilian Gasper, Amos Mwasamwaja, Beatrice Kombole
Internal Medicine, East Africa
Background Kaposi sarcoma is a malignant vascular neoplasm caused by human herpesvirus-8. It is mostly seen in immunocompromised individuals, particularly those with human immunodeficiency virus/acquired immunodeficiency syndrome or organ transplants. Cutaneous and mucosal Kaposi sarcoma manifestation is common; however, Kaposi sarcoma may involve the visceral organs. Iatrogenic or drug-induced Kaposi sarcoma may develop in immunocompromised patients undergoing immunosuppressive medication. It is quite uncommon for patients with inflammatory bowel diseases on immunosuppressive medication to develop intestinal Kaposi sarcoma. This case report describes the clinical presentation of steroid-induced disseminated upper gastrointestinal Kaposi sarcoma in a patient with underlying Crohn’s disease and examines …
Measurement Of Mucocutaneous Domain Activity In A Novel Treatment Response Measure For Systemic Lupus Erythematosus Clinical Trials, Kathryn Connelly, Eric Morand, Rachel Koelmeyer, Lavanya Rajagopala, Ambika Wakhlu, Yanjie Hao, Katie Liao, Darshini Ayton, Amita Aggarwal, Angela Migowa
Measurement Of Mucocutaneous Domain Activity In A Novel Treatment Response Measure For Systemic Lupus Erythematosus Clinical Trials, Kathryn Connelly, Eric Morand, Rachel Koelmeyer, Lavanya Rajagopala, Ambika Wakhlu, Yanjie Hao, Katie Liao, Darshini Ayton, Amita Aggarwal, Angela Migowa
Paediatrics and Child Health, East Africa
Objectives Previous work by an international taskforce delivered consensus to include rash, mucosal ulcers and alopecia in the mucocutaneous domain of a novel multi-domain clinical outcome measure for systemic lupus erythematosus (SLE) clinical trials, the Treatment Response Measure for SLE (TRM-SLE). (1) Here we report results of a consensus process to define a fit for purpose clinical outcome assessment and entry and response thresholds for assessment of mucocutaneous activity.
Methods A multi-step consensus process was completed by a 18-person working group comprising rheumatologists, dermatologists, and patients with lived experience of mucocutaneous SLE. The domain scope for rash, mucosal ulcers and …
Evaluation Of Pulse Oximetry Alarm Fatigue And The Impact Of Spo2 Thresholds On Clinical Workflow: A Prospective Observational Study In A Kenyan Neonatal Unit, Bazil Masabo, Augustine Waswa, Jesse Coleman, Morris Ogero, Grace Irimu, Dorothy Chomba, Millicent Parsimei, Cynthia Shitote, Ferdinand Okwaro, William Macharia
Evaluation Of Pulse Oximetry Alarm Fatigue And The Impact Of Spo2 Thresholds On Clinical Workflow: A Prospective Observational Study In A Kenyan Neonatal Unit, Bazil Masabo, Augustine Waswa, Jesse Coleman, Morris Ogero, Grace Irimu, Dorothy Chomba, Millicent Parsimei, Cynthia Shitote, Ferdinand Okwaro, William Macharia
Paediatrics and Child Health, East Africa
Introduction: Effective pulse oximetry monitoring in a newborn unit requires clinician action. However, if thresholds are not adapted to each neonate, frequent alarms cause alarm fatigue, which impacts the quality of patient monitoring, staff workload and clinical workflow.
Methods: We conducted an observational study from October 2021 to December 2022 in a Kenyan newborn unit which enrolled neonates through convenience sampling. Data were analysed in R using default thresholds of 85% to 96% for SpO2 and 90 to 200 bpm for PR.
Results: Among the 49 neonates enrolled, median hourly alarms per patient were 12 visual and …