Publications by authors named "Grace Nalwa"

Article Synopsis
  • Preterm and very low birthweight (VLBW) infants face high health risks in their early days, with full enteral feeding being crucial for their care, especially in sub-Saharan Africa where data on feeding practices is limited.
  • This study analyzed demographic and clinical data from 484 preterm and VLBW infants across 7 neonatal units in Nigeria and Kenya to assess factors affecting the time to achieve full enteral feeds.
  • Results indicated a significant percentage of mortality before feeding, revealing that earlier first feeds and gestational age greatly influenced the time to reach full enteral feeds, suggesting that implementing standardized feeding guidelines could improve outcomes in these infants.
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Objectives: Neonatal sepsis, a major cause of death amongst infants in sub-Saharan Africa, is often gut derived. Gut colonisation by Enterobacteriaceae producing extended spectrum beta-lactamase (ESBL) or carbapenemase enzymes can lead to antimicrobial-resistant (AMR) or untreatable infections. We sought to explore the rates of colonisation by ESBL or carbapenemase producers in two neonatal units (NNUs) in West and East Africa.

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Objectives: Accurate and timely diagnosis of common neonatal conditions is crucial for reducing neonatal deaths. In low/middle-income countries with limited resources, there is sparse information on how neonatal diagnoses are made. The aim of this study was to describe the diagnostic criteria used for common conditions in neonatal units (NNUs) in Nigeria and Kenya.

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Background: Optimizing nutrition in very preterm (28-32 weeks gestation) and very low birth weight (VLBW; 1,000 g to <1,500 g) infants has potential to improve their survival, growth, and long-term health outcomes.

Aim: To assess feeding practices in Nigeria and Kenya for very preterm and VLBW newborn infants.

Methods: This was a cross-sectional study where convenience sampling was used.

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Background: Under-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates.

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Objective: To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria.

Study Design: In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period.

Results: 2280 newborns were admitted.

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Objective: To examine the availability of paediatricians in Kenya and plans for their development.

Design: Review of policies and data from multiple sources combined with local expert insight.

Setting: Kenya with a focus on the public, non-tertiary care sector as an example of a low-income and middle-income country aiming to improve the survival and long-term health of newborns, children and adolescents.

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Background: Globally, there were 2.7 million neonatal deaths in 2015. Significant mortality reduction could be achieved by improving care in low- and middle-income countries (LMIC), where the majority of deaths occur.

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