Publications by authors named "V Bandika"
Article Synopsis
- Acute febrile illness (AFI) is frequently misattributed to malaria in Sub-Saharan Africa, but a variety of pathogens can cause fever, emphasizing the need for better understanding and management of AFI.
- A study across four sites in Kenya from June 2017 to March 2019 enrolled over 3,200 AFI cases, primarily among children under 5, finding that 4.3% resulted in hospital fatalities and that many cases had undetermined causes.
- Identification of pathogens revealed malaria (Plasmodium) as the most common, while HIV and chikungunya were also detected; the results highlight the importance of improved diagnostics to address both malaria and non-malarial fever causes effectively.
Purpose: The life-saving role of oxygen therapy in African children with severe pneumonia is not yet established.
Methods: The open-label fractional-factorial COAST trial randomised eligible Ugandan and Kenyan children aged > 28 days with severe pneumonia and severe hypoxaemia stratum (SpO < 80%) to high-flow nasal therapy (HFNT) or low-flow oxygen (LFO: standard care) and hypoxaemia stratum (SpO 80-91%) to HFNT or LFO (liberal strategies) or permissive hypoxaemia (ratio 1:1:2). Children with cyanotic heart disease, chronic lung disease or > 3 h receipt of oxygen were excluded.
Article Synopsis
- * In a randomized double-blind study involving 843 hospitalized children in Kenya and Malawi, the median time to clinical stabilization was similar between mF75 and F75 groups, and there were no significant differences in in-hospital mortality or diarrheal episodes.
- * The trial did not find a significant advantage of the modified formula over the standard one for reducing complications or improving recovery time, highlighting the complexity of treating severe malnutrition in children. *
Infants and young children with severe acute malnutrition (SAM) are treated with empiric broad-spectrum antimicrobials. Parenteral ceftriaxone is currently a second-line agent for invasive infection. Oral metronidazole principally targets small intestinal bacterial overgrowth.
View Article and Find Full Text PDFIn Africa, the clinical syndrome of pneumonia remains the leading cause of morbidity and mortality in children in the post-neonatal period. This represents a significant burden on in-patient services. The targeted use of oxygen and simple, non-invasive methods of respiratory support may be a highly cost-effective means of improving outcome, but the optimal oxygen saturation threshold that results in benefit and the best strategy for delivery are yet to be tested in adequately powered randomised controlled trials.
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