Prevalence of acute kidney injury and its characteristics among neonates with suspected sepsis in a tertiary hospital in Kenya.

Introduction: Unique aspects of neonatal renal physiology enhance the occurrence of Acute Kidney Injury (AKI) as a complication of neonatal sepsis. The study sought to determine prevalence of AKI and its characteristics in neonates with suspected sepsis.

Methods: A cross-sectional study was conducted at Kenyatta National Hospital among neonates aged 0-28 days.

Prevalence of non-alcoholic fatty liver disease in overweight and obese children seeking ambulatory healthcare in Nairobi, Kenya.

Background: While linked to obesity and associated with an increased cardiovascular morbidity, non-alcoholic fatty liver disease (NAFLD) is an often-asymptomatic cause of chronic liver disease in children. Early detection provides opportunity for interventions to curb progression. Childhood obesity is on the rise in low/middle-income countries, but cause-specific mortality data associated with liver disease are scanty.

Antenatal Dexamethasone for Early Preterm Birth in Low-Resource Countries.

Background: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain.

Methods: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo.

Prevalence of rotavirus infection among children with acute diarrhoea after rotavirus vaccine introduction in Kenya, a hospital cross-sectional study.

Background: Rotavirus infection is the most common cause of acute gastroenteritis globally in children under 5 years of age and is responsible for approximately 5% of all child deaths yearly. Rotavirus vaccination is considered an effective public health strategy to prevent infection and reduce the severity of disease. Multi-centre country trials on rotavirus vaccines demonstrated efficacy rates of more than 85% in developed countries but only about 65% in developing nations.

Overnutrition: Does Complementary Feeding Play a Role?

Globally, obesity is considered an epidemic due to an increase in its prevalence and severity especially among young children and adolescents. This nutritional disorder is not limited to affluent countries as it is becoming increasingly prevalent in developing countries. Obesity is associated not only with cardiovascular, endocrine, gastrointestinal, orthopedic, and respiratory diseases, but also with psychological complications, implying a problem of far-reaching consequences for health and health services.

Caregiver oral rehydration solution fluid monitoring charts versus standard care for the management of some dehydration among Kenyan children: a randomized controlled trial.

Background: Diarrhoea is a major cause of child mortality. Although oral rehydration solution (ORS) is an efficacious intervention for correcting dehydration, inadequate monitoring may limit its effectiveness in routine settings. We evaluated the effect of using a caregiver-administered chart to monitor oral fluid therapy on hydration status among children with some dehydration.

Prevalence and factors associated with preterm birth at kenyatta national hospital.

Background: The World Health Organization estimates the prevalence of preterm birth to be 5-18% across 184 countries of the world. Statistics from countries with reliable data show that preterm birth is on the rise. About a third of neonatal deaths are directly attributed to prematurity and this has hindered the achievement of Millennium Development Goal-4 target.

Perspectives of host faculty and trainees on international visiting faculty to paediatric academic departments in East Africa.

Background: Investments in faculty exchanges to build physician workforce capacity are increasing. Little attention has been paid to the expectations of host institution faculty and trainees. This prospective qualitative research study explored faculty and resident perspectives about guest faculty in paediatric departments in East Africa, asking (1) What are the benefits and challenges of hosting guest faculty, (2) What factors influence the effectiveness of faculty visits and (3) How do host institutions prepare for faculty visits?

Methods: We recruited 36 faculty members and residents from among four paediatric departments in East Africa to participate in semistructured interviews which were audio recorded and transcribed.

Racecadotril for the treatment of severe acute watery diarrhoea in children admitted to a tertiary hospital in Kenya.

Background: Diarrhoea is the second most common cause of death in children under 5 years of age in Kenya. It is usually treated with oral rehydration, zinc and continued feeding. Racecadotril has been in use for over 2 decades; however, there is a paucity of data regarding its efficacy from Africa.

Evaluating the level of adherence to Ministry of Health guidelines in the management of severe acute malnutrition at Garissa Provincial General Hospital, Garissa, Kenya.

Introduction: Half of Kenya's high infant and under five mortality rates is due to malnutrition. Proper implementation of World Health Organization's (WHO) Evidence Based Guidelines (EBG) in management of severe acute malnutrition can reduce mortality rates to less than 5%. The objectives were to establish the level of adherence to WHO guideline and the proportion of children appropriately managed for severe acute malnutrition (steps 1-8) as per the WHO protocol in the management of severe acute malnutrition.

Mesalazine in the initial management of severely acutely malnourished children with environmental enteric dysfunction: a pilot randomized controlled trial.

Background: Environmental enteric dysfunction (EED) is an acquired syndrome of impaired gastrointestinal mucosal barrier function that is thought to play a key role in the pathogenesis of stunting in early life. It has been conceptualized as an adaptive response to excess environmental pathogen exposure. However, it is clinically similar to other inflammatory enteropathies, which result from both host and environmental triggers, and for which immunomodulation is a cornerstone of therapy.

Effectiveness of sequential v. standard triple therapy for treatment of Helicobacter pylori infection in children in Nairobi, Kenya.

Background: Once the diagnosis of Helicobacter pylori is confirmed, treatment requires at least two antibiotics and an acid inhibitor for a minimum of seven days. Unfortunately, treatment failures are being frequently reported. Treatment regimens that include sequential administration of antibiotics with acid inhibitors have been developed to try and increase the rate of eradication.

Who is to blame? Perspectives of caregivers on barriers to accessing healthcare for the under-fives in Butere District, Western Kenya.

Background: Kenya, like many developing nations, continues to experience high childhood mortality in spite of the many efforts put in place by governments and international bodies to curb it. This study sought to investigate the barriers to accessing healthcare services for children aged less than five years in Butere District, a rural district experiencing high rates of mortality and morbidity despite having relatively better conditions for child survival.

Methods: Exit interviews were conducted among caregivers seeking healthcare for their children in mid 2007 in all the 6 public health facilities.