Publications by authors named "Wycliffe Kosgei"
Background: Rheumatic heart disease (RHD) remains as 1 of the major contributors to indirect pregnancy-related mortality and morbidity worldwide and disproportionately affects marginalized populations.
Objectives: In this scoping review, the authors sought to explore the socioeconomic, cultural, and health care access-related causes of global disparities in outcomes of pregnancy among individuals with RHD.
Methods: We performed a literature search of all studies published between January 1, 1990, and January 1, 2022, that investigated causes for disparate outcomes in pregnant individuals with RHD.
Article Synopsis
- Low- and middle-income countries lack sufficient subspecialist care, particularly in maternal-fetal medicine.
- Moi University School of Medicine and Moi Teaching and Referral Hospital in Kenya have established a groundbreaking fellowship program to train specialists in this field.
- The program successfully retains skilled practitioners who now offer essential care to a previously underserved population in Eastern Africa.
Background: More than 90% of gestational diabetes cases are estimated to occur in low-income and middle-income countries (LMICs). Most current guidelines recommend an oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. The OGTT is burdensome, especially in LMICs, resulting in a high proportion of women not being screened.
View Article and Find Full Text PDFBackground And Objective: Children born to mothers living with human immunodeficiency virus (HIV) are at risk for poor health outcomes but data characterizing these associations are limited. Our objective was to determine the impact of maternal viral suppression on growth patterns and malnutrition for infants who are HIV-exposed but uninfected (HEU).
Methods: We conducted a retrospective cohort analysis of clinical data for infants who were HEU and their mothers (September 2015 - March 2019) in Kenya.
Background: Preeclampsia is a major contributor to maternal and neonatal mortality worldwide. Ninety-nine percent of these deaths occur in resource limited settings. One of the greatest barriers to women seeking medical attention remains the cost of care.
View Article and Find Full Text PDFArticle Synopsis
- Gestational diabetes (GDM) is increasingly common globally, particularly in low- and middle-income countries, necessitating more research on its prevalence in high-risk groups, especially pregnant women with HIV in regions like Kenya.
- The STRiDE study, one of the largest GDM studies in Kenya, monitored pregnant women aged 16-50 to assess GDM using various glucose testing methods, including fasting glucose and oral glucose tolerance tests (OGTT).
- The study involved comparing 83 pregnant women with HIV to 249 HIV-negative counterparts, finding no significant differences in glucose levels between the two groups, although marital status differed.
Prevalence of gestational diabetes mellitus based on various screening strategies in western Kenya: a prospective comparison of point of care diagnostic methods.
BMC Pregnancy Childbirth
July 2017
Background: Early diagnosis of gestational diabetes mellitus (GDM) is crucial to prevent short term delivery risks and long term effects such as cardiovascular and metabolic diseases in the mother and infant. Diagnosing GDM in Sub-Saharan Africa (SSA) however, remains sub-optimal due to associated logistical and cost barriers for resource-constrained populations. A cost-effective strategy to screen for GDM in such settings are therefore urgently required.
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