Design Research to Embed mHealth into a Community-Led Blood Pressure Management System in Uganda: Protocol for a Mixed Methods Study.

Background: Uncontrolled hypertension is a leading risk factor for cardiovascular diseases. In Uganda, such diseases account for approximately 10% of all deaths, with 1 in 5 adults having hypertension (>90% of the hypertensive cases are uncontrolled). Although basic health care in the country is available free of cost at government facilities, regularly accessing medication to control hypertension is difficult because supply chain challenges impede availability.

Uptake and effectiveness of a mobile application for real-time reporting and quality assurance of decentralized SARS-CoV-2 testing in Uganda.

Background: Effective management of the COVID-19 pandemic required rapid expansion of diagnosis. The introduction of antigen tests presented an opportunity to decentralize testing, but raised challenges with ensuring accurate and timely reporting of testing data, which is essential to guide the response. Digital solutions can help address this challenge and provide more efficient means of monitoring and quality assurance.

Effect of ten-valent pneumococcal conjugate vaccine on invasive pneumococcal disease and nasopharyngeal carriage in Kenya: a longitudinal surveillance study.

Background: Ten-valent pneumococcal conjugate vaccine (PCV10), delivered at 6, 10, and 14 weeks of age was introduced in Kenya in January, 2011, accompanied by a catch-up campaign in Kilifi County for children aged younger than 5 years. Coverage with at least two PCV10 doses in children aged 2-11 months was 80% in 2011 and 84% in 2016; coverage with at least one dose in children aged 12-59 months was 66% in 2011 and 87% in 2016. We aimed to assess PCV10 effect against nasopharyngeal carriage and invasive pneumococcal disease (IPD) in children and adults in Kilifi County.

Coverage and timeliness of vaccination and the validity of routine estimates: Insights from a vaccine registry in Kenya.

Background: The benefits of childhood vaccines are critically dependent on vaccination coverage. We used a vaccine registry (as gold standard) in Kenya to quantify errors in routine coverage methods (surveys and administrative reports), to estimate the magnitude of survivor bias, contrast coverage with timeliness and use both measures to estimate population immunity.

Methods: Vaccination records of children in the Kilifi Health and Demographic Surveillance System (KHDSS), Kenya were combined with births, deaths, migration and residence data from 2010 to 17.

Does audit and feedback improve the adoption of recommended practices? Evidence from a longitudinal observational study of an emerging clinical network in Kenya.

Background: Audit and feedback (A&F) is widely used in healthcare but there are few examples of how to deploy it at scale in low-income countries. Establishing the Clinical Information Network (CIN) in Kenya provided an opportunity to examine the effect of A&F delivered as part of a wider set of activities to promote paediatric guideline adherence.

Methods: We analysed data collected from medical records on discharge for children aged 2-59 months from 14 Kenyan hospitals in the CIN.

Risk of Injection-Site Abscess among Infants Receiving a Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate Vaccine in Kenya.

There is a theoretical risk of adverse events following immunization with a preservative-free, 2-dose vial formulation of 10-valent-pneumococcal conjugate vaccine (PCV10). We set out to measure this risk. Four population-based surveillance sites in Kenya (total annual birth cohort of 11,500 infants) were used to conduct a 2-year post-introduction vaccine safety study of PCV10.

Tuberculosis treatment outcomes among hospital workers at a public teaching and national referral hospital in Kenya.

Setting: Kenyatta National Hospital (KNH), Nairobi, Ken-ya, a large referral and teaching hospital.

Objective: 1) To document tuberculosis (TB) case notification rates and trends; 2) to describe demographic, clinical and workplace characteristics and treatment outcomes; and 3) to examine associations between demographic and clinical characteristics, HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome) treatment and anti-tuberculosis treatment outcomes among hospital workers with TB at KNH during the period 2006-2011.

Design: A retrospective cohort study involving a review of medical records.

Attracting and retaining health workers in rural areas: investigating nurses' views on rural posts and policy interventions.

Background: Kenya has bold plans for scaling up priority interventions nationwide, but faces major human resource challenges, with a lack of skilled workers especially in the most disadvantaged rural areas.

Methods: We investigated reasons for poor recruitment and retention in rural areas and potential policy interventions through quantitative and qualitative data collection with nursing trainees. We interviewed 345 trainees from four purposively selected Medical Training Colleges (MTCs) (166 pre-service and 179 upgrading trainees with prior work experience).

Are hospitals prepared to support newborn survival? - An evaluation of eight first-referral level hospitals in Kenya.

Objective: To assess the availability of resources that support the provision of basic neonatal care in eight first-referral level (district) hospitals in Kenya.

Methods: We selected two hospitals each from four of Kenya's eight provinces with the aim of representing the diversity of this part of the health system in Kenya. We created a checklist of 53 indicator items necessary for providing essential basic care to newborns and assessed their availability at each of the eight hospitals by direct observation, and then compared our observations with the opinions of health workers providing care to newborns on recent availability for some items, using a self-administered structured questionnaire.

Chilaiditi's sign possibly associated with malposition of chest tube placement.

Although diaphragmatic paralysis is a rare recognized complication of chest tube malposition, Chilaiditi's sign occurring as a result of this complication has never been reported in literature to the best of our knowledge. We describe one such case, which had an interesting clinical sequence of events and radiographic findings and suggest that the medial end of the chest tube should be positioned at least 2 cm from the mediastinum on the frontal chest radiograph to avoid these complications.

Upper gastrointestinal findings in diabetic outpatients at Kenyatta National Hospital, Nairobi.

Objective: To determine the prevalence of H. pylori and the associated upper gastrointestinal endoscopic lesions in diabetic outpatients with dyspepsia.

Design: Cross-sectional study.

Theileria parva carrier state in naturally infected and artificially immunised cattle.

Rhipicephalus appendiculatus adult ticks, collected in the field from zebu (Bos indicus) and exotic (Bos tarus) cattle with high antibody titres to Theileria parva schizont antigen, transmitted Theileria parva infection typical of East Coast fever to susceptible cattle. Uninfected R. appendiculatus nymphs applied to naturally recovered zebu and exotic cattle kept under tick-free conditions in the laboratory for 16 and 7 months respectively, transmitted fatal theileriosis to susceptible cattle.

Does pre-scan oxygen improve ultrasonic imaging of the pancreas?

Ultrasonic imaging of the pancreas is often impaired by overlying bowel gas. Oxygen therapy has, in the past, been shown to be effective in reducing the gas in the cysts of pneumatosis coli. Using the same hypothesis, a randomized, single blind study comparing ultrasonic imaging of the pancreas with and without prior oxygen therapy was carried out.

Observations on rinderpest in Kenya, 1986-1989.

Rinderpest was confirmed in Kenya in 1986, 1987, 1988 and 1989. Three epidemiologically distinct events appear to have occurred: repeated outbreaks in West Pokot district related to cross-border movement of stock, an outbreak in Marsabit district in 1987 (thought to have been caused by illegal movement of cattle, possibly in vehicles, from countries further north) and a series of related outbreaks in and near Nairobi between 1988 and 1989 due to the unauthorized movement from abattoirs and holding grounds of slaughter stock possibly introduced from West Pokot or Marsabit. In West Pokot the disease affected unvaccinated calves and yearlings.

Diagnostic yield from barium enemas: a study among patients referred by general practitioners and hospital outpatient departments.

Although the double contrast barium enema is the standard radiological examination of the colon, it is not universally available to patients referred by their general practitioners. A retrospective survey of all double contrast barium enemas carried out over a two year period in one health district was undertaken to determine the diagnostic yield of pathological findings for patients referred by general practitioners and hospital outpatient departments and for patients who had rigid sigmoidoscopy prior to the enema and those who did not. A total of 530 patients were studied.

Confirmation of rinderpest in experimentally and naturally infected cattle using microtitre techniques.

Virulent rinderpest virus was detected by immunoperoxidase staining of microtitre bovine kidney cell cultures within 24 to 48 hours of inoculation with prescapular lymph node and spleen homogenates from experimentally infected steers. Rinderpest virus specific cytopathic effects were evident from 48 hours in microtitre plates and from 72 hours in rolled tube cultures. Nasal and ocular secretions collected from cattle naturally infected with rinderpest and inoculated into bovine kidney cell cultures did not readily yield cytopathic virus in both tubes and microtitre plates, but immunoperoxidase staining of microtitre cultures on the fourth day of inoculation detected replication of virus in cultures inoculated with ocular and nasal secretions from seven of 17 cattle tested.

Low-dose oral administration of human interferon alpha can control the development of Theileria parva infection in cattle.

Two natural human interferon alpha preparations, (nHuIFN-alpha [Cantell]) and (nHuIFN-alpha [ISI]), were used for the oral treatment of cattle experimentally infected with Theileria parva parva. In the first experiment, 8 Friesian bulls were inoculated with a 1 in 10 dilution of a sporozoite stabilate of T.p.

Immunohistological localisation of rinderpest virus in formalin-fixed, paraffin-embedded tissues from experimentally infected cattle.

Six Freesian steers were subcutaneously inoculated with the virulent rinderpest virus strain Kabete "0" and sacrificed at the height of fever. Sections of formalin-fixed, paraffin-embedded tissues were stained according to the peroxidase anti-peroxidase (PAP) technique. Labelling of viral antigen, both in the cytoplasm and in the nuclei of infected cells, was observed in the epithelial cells of the upper and lower alimentary tract and in lymphoid organs, i.

Preliminary observations on rinderpest in pregnant cattle.

A Kabete 'O' strain of rinderpest virus enhanced in virulence was inoculated subcutaneously into four cows which were between six and eight months pregnant. All the cows developed clinical signs of rinderpest from the third day after inoculation and shed high titres of virus in their ocular and vaginal secretions during the course of the clinical disease. Three of the cows died of rinderpest on the third day after the onset of fever but no virus was isolated from their fetuses which were examined post mortem.

Detection of antibody to mycoplasma F38 in goat sera by an enzyme-linked immunosorbent assay.

An indirect enzyme-linked immunosorbent assay (ELISA) was developed to screen goat sera at a single dilution for antibody to mycoplasma F38. Antibody was detected in sera of six convalescent goats following experimental infection. Antibody was also detected in 34 sera three to four weeks after vaccination.

Development and distribution of rinderpest virus antigen in experimentally infected goats.

Three goats, experimentally infected with rinderpest virus were examined for the development and distribution of precipitating antigens in various tissues and secretions using the agar gel immunodiffusion test. Virus antigens were detected in ocular secretions and lymph node biopsies from the second to the fourth and fifth days of pyrexia, respectively, but were not detected in nasal secretions. Precipitating antigens were demonstrated in various lymphoid organs, the lung and abomasum of a goat killed on the fourth day of pyrexia.