Pediatrics Commons^™

Neonatal Admissions And Mortality: A Statistical Adjustment Approach Using Birthweight-Specific Curves To Address Bias Due To Underreporting In 65 Hospitals In Four African Countries, Lucas Malla, Siu Wong, Samuel Ngwala, Evelyn Zimba, Msandeni Chiume, Norman Lufesi, Kondwani Kawaza, Honorati Masanja, Josephine Shabani, William Macharia

Paediatrics and Child Health, East Africa

Background Underreporting of neonatal admissions and deaths – particularly among <  1000 g newborns – compromises the plausibility of in-patient neonatal mortality rate (iNMR) estimates. This limits progress tracking, since 2.3 million neonatal deaths occur annually, and 65 countries are projected to miss the Sustainable Development Goal (SDG) 3.2 target of fewer than 12 deaths per 1000 live births by 2030. Reliable iNMR estimates are essential for national and hospital-level monitoring. This study assessed birthweight-specific adjustment curves developed using simulated data, and extended the approach to routine data from 172,809 neonatal admissions across four African countries in the NEST360 network.

Methods Simulated data were generated using birthweight intervals of 500 g from 500 to 5000 g, with 1000 values per category representing 1000 hospitals. Admissions were drawn from a negative binomial distribution and mortality rates from a beta distribution based on published birthweight-specific iNMRs. Adjustment functions were developed using data from 500 hospitals without underreporting and tested on 500 with induced underreporting. This approach was then extended to real data from 65 NEST360 partnering hospitals. The adjustment functions were derived from 26 hospitals with plausible reporting (iNMR ≥ 700 per …

Hydroxyurea Interferes With Point-Of-Care Creatinine Testing In Children With Sickle Cell Anemia, Ruth Namazzi, Robert Opoka, Charles Ssuuna, Michael Goings, Kathryn Mcelhinney, Dibyadyuti Datta, Russell Ware, Chandy John, Andrea Conroy

Paediatrics and Child Health, East Africa

Objective To evaluate the performance of the point-of-care i-STAT device for creatinine measurement in Ugandan children with sickle cell anemia (SCA), and to determine the clinical impact of hydroxyurea-associated assay interference.

Results description This secondary analysis was nested within a randomized clinical trial involving 248 Ugandan children with SCA. The mean age at enrollment was 32 months, and 115/248 (46.2%) initiated hydroxyurea during 12 months of follow-up as part of routine clinical care. At enrollment, creatinine values measured by i-STAT and reference laboratory testing were clinically comparable. At follow-up, children receiving hydroxyurea had significantly higher creatinine values measured by iSTAT …

Household Air Pollution Is Associated With Disease Severity In Ugandan Children Hospitalized With Hypoxemic Pneumonia, Ayla Ahmed, Sehaj Sandhu, Sophie Namasopo, Juliet Nabwire, Qaasim Mian, Andrea Conroy, Jackson Amone, Charles Olaro, Robert Opoka, Michael Hawkes

Paediatrics and Child Health, East Africa

Background Household air pollution (HAP) due to biomass fuel use is a risk factor for childhood pneumonia, a leading cause of under-five mortality globally. This study examined the relationship between HAP and disease severity in Ugandan children hospitalized with hypoxemic pneumonia.

Methods We conducted a retrospective case-control study across 20 Ugandan hospitals. PM2.5 exposure was estimated using caregiver-reported fuel use, cooking duration, kitchen structure, and ventilation. Pneumonia severity was assessed clinically, and associations were analyzed using non-parametric tests.

Results We included 735 children (median age 9 months, 42% female) hospitalized with hypoxemic pneumonia. Most households used firewood (84%) or charcoal …

Transcranial Doppler Ultrasound Velocity Measurements In Children With Sickle Cell Disease In Kenya, Catherine Mwalimu, Oscar Odhiambo, Elaine Mashisia, Teresa Mwanja, Allan Ade, Maria De Vita, Katherine Oyieke, Pauline Samia, Fenella Kirkham, Samson Gwer

Paediatrics and Child Health, East Africa

Background Sickle cell disease (SCD) is the most common inherited haemoglobinopathy and poses a high public health burden in Sub-Saharan Africa. Children with sickle cell anaemia are at a highrisk of ischemic stroke, and transcranial Doppler (TCD) ultrasonography helps identify those at highest risk for primary stroke prevention.

Objective To determine the prevalence of abnormal cerebral blood flow velocity (CBFV) in children with SCD and describe CBFV in children without SCD.

Methods We conducted a two-component study comprising a retrospective review and a cross-sectional assessment. TCD measurements from 143 children with confirmed SCD aged 2–16 years were reviewed. In a …

Cost Of Health Systems Strengthening For Small And Sick Newborn Care In Four Sub-Saharan African Countries Implemented With Nest360: Incremental Cost Analyses, Alice Tarus, Meghan Kumar, Rebecca Penzias, Rosemary Kamuyu, James Cross, Mbozu Sipalo, Edith Gicheha, Christine Bohne, George Okello, William Macharia

Paediatrics and Child Health, East Africa

Background

Methods

Rare Diseases In Children—Knowledge, Experiences And Challenges Faced By Pediatricians In Tanzania, Mariam Noorani, Mohamedraza Ebrahim, Francis Furia

Paediatrics and Child Health, East Africa

Diagnosing and treating rare diseases in children is a major challenge for pediatricians globally. There is a lack of adequate knowledge of these conditions and diagnostic testing is not easily accessible, which frequently results in delays in care. The knowledge, experiences and challenges faced by pediatricians in Tanzania are not known. This study used a nationwide cross-sectional online survey to describe the knowledge of pediatricians in Tanzania on rare diseases, their experiences, and the challenges they face in treating these children. The survey tool was shared on the Pediatric Association of Tanzania WhatsApp group where most pediatricians are registered. 168 …

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%) …

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 …

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

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 …

International Normative Charts For Twin Weight, Length, And Head Circumference At Birth, By Gestational Age And Sex: The Twin Neonatal Cross-Sectional Study Of The Intergrowth-21st Project, Francesca Giuliani, Sonia Deantoni, Enrico Bertino, Yasmin A. Jaffer, Manorama Purwar, Fernando C. Barros, Leila Cheikh Ismail, Wu Qingqing, Ilaria Stura, Maria Carvalho

Obstetrics and Gynaecology, East Africa

Assessing the size of twins at birth using charts developed for singletons may over diagnose small for gestational age in this sub-population. The study aimed to produce international, twin-specific, newborn size normative charts by gestational age and sex. This longitudinal observational study in eight geographically diverse settings prospectively collected data between May 2009 and August 2013 from healthy pregnant women and their newborn twins. The participants were enrolled as part of the INTERGROWTH-21st study, and recruited based on World Health Organization recommendations for evaluation of anthropometric measures. All the women met, in addition to the underlying population characteristics of low …

Hydroxyurea Pharmacokinetics In Children With Sickle Cell Anemia Across Different Global Populations, Alexandra Power-Hays, Kathryn Mcelhinney, Thomas Williams, George Mochamah, Peter Olupot-Olupot, George Paasi, Marvin Reid, Angela Rankine-Mullings, Robert Opoka, John Chandy

Paediatrics and Child Health, East Africa

Hydroxyurea provides effective disease-modifying treatment for people with sickle cell anemia (SCA), especially when escalated to maximum tolerated dose (MTD), but has wide interpatient dosing variability due to pharmacokinetic (PK) differences. Whether hydroxyurea PK parameters differ among children with SCA in different global regions is unknown. We compared hydroxyurea PK parameters among children with SCA from five clinical trials: HUSTLE (USA, NCT00305175), TREAT (USA, NCT02286154), NOHARM (Uganda, NCT01976416), REACH (Uganda and Kenya, NCT01966731), and EXTEND (Jamaica, NCT02556099). Key hydroxyurea PK parameters were determined using HdxSim™, a validated hydroxyurea PK-software program. The results were compared across regions by one way analysis …

Investigating Neonatal Sepsis: Anti-Infectives, Diagnostics And Guidelines Used In Health Systems Across Sub-Saharan Africa – The Insights Study, Jack Louis Stanley, David Hettle, Rachel Poffley, Larisse Bolton, Emelyne Gres, Isabel Coelho, Raana Hussain, Gildas Boris Hedible, Gwendoline Lilly Chimhini, Valeriane Leroy

Paediatrics and Child Health, East Africa

Background Sepsis is a leading cause of neonatal mortality in sub-Saharan Africa (SSA), where microbiological diagnostic capacity and antibiotic access are limited. High antimicrobial resistance (AMR) rates limit the effectiveness of current treatment guidelines, with concern that available antibiotics are rarely adequate treatment for neonatal sepsis in the region.

Methods A cross-sectional online survey was electronically distributed in English, French and Portuguese to neonatal clinicians across SSA between April and June 2025. Questions focused on the management of neonatal sepsis including diagnostic, antibiotic and guideline use. Responses were analysed descriptively and presented as percentages of the total number of responses. …

A Cost-Consequence Analysis Of The Children’S Administration Oxygenation Strategies Trial (Coast) In Severe Pneumonia, Orlagh U. Carroll, Richard Grieve, Sarah Kiguli, Peter Olupot-Olupot, Robert Opoka, Charles Engoru, Florence Alaroker, Abner Tagoola, Mainga Hamaluba, Eva Nabawanuka

Paediatrics and Child Health, East Africa

Oxygen supplementation is a recommended treatment for children with severe pneumonia or hypoxaemia. The open, fractional-factorial Children’s Oxygen Administration Strategies Trial (COAST) recruited Kenyan and Ugandan children with severe pneumonia and hypoxaemia. Participants in the severe hypoxaemia stratum (SpO₂ <  80%) were randomised to high-flow nasal therapy (HFNT) or low-flow oxygen (LFO), and in the hypoxaemia stratum (SpO₂ 80–91%) to HFNT, LFO or permissive hypoxaemia (ratio 1:1:2). The trial stopped early and there is ongoing uncertainty about the clinical benefits of the alternative strategies. There is a lack of evidence about the relative costs, of alternative oxygen delivery for critically-ill children in low- and middle- income countries. We used data from COAST to conduct a cost-consequence analysis …

Infantile Epileptic Spasms Syndrome: Clinical Profile And Outcomes At A Tertiary Hospital In Kenya, Peninah Mwangi, Katherine Oyieke, Sam Gwer, Pauline Samia

Paediatrics and Child Health, East Africa

Background: Infantile epileptic spasms syndrome (IESS) is characterised by onset of epileptic spasms between 3 and 12 months, with or without typical hypsarrhythmia, and developmental stagnation or regression. There are limited data on the clinical profile and treatment outcomes of IESS in sub-Saharan Africa.

Objective: To describe the clinical profile and treatment outcomes of infants diagnosed with and managed for IESS at Aga Khan University Hospital, Nairobi.

Methods: Records of children aged 3–24 months diagnosed with IESS between January 2012 and December 2021 were identified from the hospital information system using the terms “infantile spasm”, “epileptic spasms”, …

Altered Natural Killer Cell Function In Children With Severe Malaria, Grace Turyasingura, Kagan A. Mellencamp, Ruth Namazzi, Robert Opoka, Chandy C. John, Geoffrey T. Hart

Paediatrics and Child Health, East Africa

Memory-like natural killer (NK) cells with enhanced antibody-dependent cellular cytotoxicity (ADCC) have correlated with protection from uncomplicated malaria in prior studies. However, the role of NK cells in severe malaria (SM) has not been characterized. In Ugandan sites with moderate and low malaria transmission, we evaluated NK cell (CD56bright, CD56dim, CD56neg) phenotype and ADCC function by flow cytometry in children < 5 years of age with SM (n = 21) and control community children (CC, n = 19). Children with SM had similar total NK cell counts to CC. Children with SM had a higher proportion of LILRB1+ NK cells than CC. The level of malaria transmission …

Spectrum Of Neurodevelopmental Disorders In Children Attending A Developmental Clinic In Dar Es Salaam, Tanzania, Aleya Zulfikar Remtulla, Sumayyah Nasiruddin Saudin, Orujul Hassan, Mariam Noorani

Paediatrics and Child Health, East Africa

Background: Neurodevelopmental disorders (NDDs) in children present significant challenges for healthcare systems globally. In Tanzania, children with NDDs and their families face significant challenges due to late diagnosis, lack of standardized screening tools, widespread stigma and cultural beliefs that deter health-seeking behaviours. Awareness about NDDs is low, and financial constraints further complicate access to necessary medical interventions. The country suffers from a severe shortage of specialized healthcare providers, and general healthcare providers often lack adequate training. Additionally, limited specialized facilities, high treatment costs and insufficient healthcare policies dedicated to NDDs make it difficult to manage these conditions effectively. Understanding the …

Optimal Anthropometric Discharge Criteria From Treatment Of Wasting: Meta-Analysis Of Individual Patient Data From 34 Studies, Lilia Bliznashka, Sandhya Chaudhary, Susan Rattigan, Sheila Isanaka, Ruth Adah, Tahmeed Ahmed, Nur Alam, Rodrigue Alitanou, Paluku Bahwere, Helen Nabwera

Paediatrics and Child Health, East Africa

Background: Community-based treatment of acute malnutrition saves lives, but recovered children remain at risk of relapse post-discharge. Strategies to reduce this risk may include modification of anthropometric discharge criteria.

Objectives: This study aims to compare the diagnostic accuracy of anthropometric indices to reduce post-discharge relapse risk.

Methods: We searched PubMed from inception to June 2022. We included studies that enrolled children aged 0–59 mo successfully treated for severe or moderate acute malnutrition (SAM or MAM), assessed anthropometry at discharge, and had ≥1 follow-up assessment ≤6 mo post-discharge. Pooled sensitivity and specificity for anthropometric indices at discharge over multiple cutoffs were …

Factors Associated With Stillbirth In Four Selected Hospital Maternity Units: An Unmatched Case-Control Study In Eswatini, Phetsile Thwala, Abednego Ongeso, Rose Maina, Benard Mutwiri

School of Nursing & Midwifery, East Africa

Background: Stillbirth is a substantially under-recognized adverse pregnancy outcome that predominantly occurs in low-middle-income countries. In 2019, Eswatini’s stillbirth rate was 13.2 per 1,000 births, higher than global targets. However, there is limited research on stillbirths in Eswatini. This study analyzed factors associated with stillbirths among women giving birth in four selected hospitals.

Methods: A multi-center unmatched case-control study was conducted using secondary data sources from July 1 to December 31, 2021. Birth records of 268 stillbirths (cases) and 1,151 live births (controls) were selected using consecutive and systematic random sampling, respectively. A piloted data extraction tool was used to …

Gut Bacterial Dysbiosis In Pediatric Severe Malaria Associates With Post-Discharge Mortality, Olivia Bednarski, Sawyer Lehman, David Mzinza, Caroline Kazinga, Ruth Namazzi, Robert Opoka, Jie Ren, Tuan Tran, Terrie Taylor, Karl Seydel

Paediatrics and Child Health, East Africa

Gut microbiota have been implicated in severe malaria in murine models, but their contribution to the pathogenesis of severe malaria in children is unknown. Here we show through analysis of gut bacteria in stool samples from two separate African studies enrolling children with severe malaria, and children from local communities, that children with severe malaria have gut bacteria dysbiosis. Among children with severe malaria, there is increased abundance of Enterobacteriaceae that associates with multiple clinical complications of severe malaria. Moreover, increased abundance of Escherichia coli was a predictor of post-discharge mortality. Metagenome analysis identify elevated metabolic pathways and genes supporting …

Neonatal Unit Human Resources: Coverage For Six Cadres And Trends For Staff-To-Baby Ratios In 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca Penzias, Eric Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Josephine Shabani, Vincent Ochieng, Ekran Rashid, William Macharia

Paediatrics and Child Health, East Africa

Background: Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker wellbeing. There are limited data and no cur‑ rent World Health Organization (WHO) standards for staftobaby ratios in neonatal units in low and middleincome countries (LMICs) to inform policy, planning, and investment.

Methods: In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and governmentled quality improvement (QI) processes were implemented. Stafng data were col‑ lated from baseline HFA (Sept 2019–March 2021) …

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris Papageorghiou, María Restrepo-Méndez, Rose Mcgready, Fernando Barros, Francois Nosten, Shama Munim, R. Ochieng, Rachel Craik, Hellen Barsosio, James Berkley

Paediatrics and Child Health, East Africa

BACKGROUND: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.

OBJECTIVE: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.

STUDY …

The Children's Hospitals In Africa Mapping Project (Champ) Survey: Facilities, Equipment, Supplies, Infrastructure, And Capacity To Respond To Emergencies, Vinayak Bhardwaj, Lawrence Stanberry, Philip Larussa, Wilmot James, Maitry Mahida, Aimable Kanyamuhunga, Atnafu Tekleab, Augustine Omoigberale, Crispen Ngwenya, Pauline Samia

Paediatrics and Child Health, East Africa

The Children’s Hospitals in Africa Mapping Project (CHAMP) survey was developed and implemented to assess the capabilities of some of the best resourced sub-Saharan African hospitals serving children. The aim was to evaluate hospital facilities, infrastructure, equipment, supplies, services, staffing, and readiness to care for children amid public health emergencies. This report analysed a subset of survey questions that characterised the hospitals and assessed facilities, equipment, supplies, infrastructure and capacity to respond to emergencies and outbreaks. Twenty-four sites were recruited. Twenty hospitals from 15 countries completed the survey from 2018 to 2019. This portion of the CHAMP study identified issues …

Implementation Of The Multicountry Who Covid-19 Pregnancy Cohort Study: Challenges And Lessons Learned During The Pandemic, Maria Costa, Renato Souza, Jose Cecatti, Sami Gottlieb, Marie Delnord, Soe Soe Thwin, Ndema Habib, Marleen Temmerman, Ingrid Gichere, Beth Maina

Obstetrics and Gynaecology, East Africa

Introduction A generic research protocol was developed for a prospective cohort study to allow systematic, harmonized data collection of the impact of SARS-CoV-2 infection and vaccination during pregnancy on maternal, obstetric, and neonatal outcomes across different settings. This article describes the study conception, development, implementation, challenges, and key lessons learned within study sites across the world.

Methods The protocol was implemented in 43 facilities in 10 countries during the pandemic, involving consecutive recruitment of over 16,000 pregnant or postpartum women. We evaluated selection of study sites, ethical approvals, staff recruitment and training, recruitment and follow-up, and incorporation of new elements …

Neonatal Unit Human Resources: Coverage For Six Cadres And Trends For Staff-To-Baby Ratios In 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca Penzias, Eric Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Vincent Ochieng, Ekran Rashid, William Macharia

Paediatrics and Child Health, East Africa

Background Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker well-being. There are limited data and no current World Health Organization (WHO) standards for staff-to-baby ratios in neonatal units in low- and middle-income countries (LMICs) to inform policy, planning, and investment.

Methods In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and government-led quality improvement (QI) processes were implemented. Staffing data were collated from baseline HFA (Sept 2019–March 2021) and mid-2023 …

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Ménde, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Background: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.
Objective: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.
Study design: Prospective …

Growth Measurements In Ugandan Children With Sickle Cell Anaemia From A Hydroxyurea (Hydroxycarbamide) Treatment Trial Relative To Unaffected Sibling Controls, Dennis Kalibbala, Vincent Mboizi, Grace Nambatya, Susan Murungi, Joan Ashaba, Catherine Nabaggala, Lynnth Turyagyenda, Deogratias Munube, Phillip Kasirye, Robert Opoka

Paediatrics and Child Health, East Africa

No abstract provided.

Incidence Of Peripheral Intravenous Cannula Complications And Associated Factors Among Paediatric Patients At A Tertiary-Care Referral Hospital, Vanessa Minsari Ogega

Master of Medicine in Paediatrics and Child Health

Introduction: Peripheral intravenous catheters (PIVCs) are widely used in clinical practice and are a major source of procedure-related pain in children. Their use is associated with complications including occlusion, dislodgement, infiltration, extravasation, phlebitis, and, rarely, bloodstream infections.

Objectives: To determine the incidence and risk factors associated with PIVC complications among paediatric patients aged 1 day to 18 years at Aga Khan University Hospital, Nairobi. The study also assessed the average survival time of PIVCs.

Methods: A prospective cohort study was conducted on 320 PIVCs among 192 children admitted between August and October 2024. Data collected included patient demographics, clinical characteristics, …

Perception And Experiences With Telemedicine Among Caregivers Of Children Requiring Outpatient Chronic Care, Maureen Wambui Kigara

Master of Medicine in Paediatrics and Child Health

Introduction Telemedicine is an expanding healthcare modality with potential to enhance access to paediatric specialist care, reduce healthcare costs, and minimize school and work disruptions. However, little is known about caregiver perceptions and experiences with telemedicine in low- and middle-income countries, especially in the context of chronic paediatric care.

Objectives This study explored how caregivers of children with chronic health conditions perceive and experience telemedicine, and what factors influence its adoption. The findings aim to inform the design of patient-centered paediatric telemedicine services.

Methodology A cross-sectional qualitative study was conducted at the Paediatric Specialist Clinics of Aga Khan University Hospital. …

Economic Evaluation Of Caregiver Interventions For Children With Developmental Disabilities: A Scoping Review, Angela Kairu, Edwin Dzoro, Vibian Angweny, Charles Newton, Charlotte Hanlon, Rosa Hoekstra, Amina Abubakar, Edwine Barasa

Institute for Human Development, East Africa

Globally, families with children with developmental disabilities (DDs) experience challenges, including social isolation, stigma, and poverty, especially in low-income settings in Africa. Most children with DDs in Africa remain unidentified and receive no formal support. Caregiver interventions focusing on education and training for the carers/parents have been shown to be adaptable and low intensity in implementation, although the economic evidence is limited. This review aimed to describe the evidence and methodological aspects of economic evaluations for caregiver interventions for DDs. The Arksey and O’Malley framework was applied. Seven electronic databases, grey literature and cited references were systematically searched to identify …