scholarly journals Perceived Demographic and Socio-Economic Factors Contributing to Poor Outcome of Neonatal Sepsis at Paediatric Unit Kenyatta National Hospital

2021 ◽  
Vol 4 (1) ◽  
pp. 16-23
Author(s):  
Kimaiyo Jepkosgei ◽  
Abednego Ongeso ◽  
Blasio Omuga
Keyword(s):  
Socioeconomic Status ◽  
Neonatal Sepsis ◽  
Community Empowerment ◽  
World Health ◽  
National Hospital ◽  
Factors Associated ◽  
Kenyatta National Hospital ◽  
Paediatric Unit ◽  
Study Results ◽  
Poor Outcomes

Introduction: Globally sepsis is still a known case of high mortality and mobility rates among neonates. This is despite having been advances in healthcare quality. The World Health Organization estimates that more than 40% of deaths occurring among infants aged below five years happen during the neonatal phase and they result in 3.1 infant deaths annually. Objective: This study sought to establish the perceived demographic and socioeconomic status of poor outcomes of neonatal sepsis at Kenyatta national hospital paediatric unit. Methodology: This was a hospital-based descriptive cross-sectional study conducted in the Paediatric Unit of Kenyatta National Hospital. A total of 175 mothers of neonates with neonatal sepsis admitted in KNH selected using consecutive sampling methods were recruited into the study. A validated researcher-administered semi-structured questionnaire was used to collect the data. Descriptive statistics involved the calculation of measures of central tendencies like means, modes and medians between variables. Association between the study variables was estimated using both chi-square and odds ratio statistics at a 95% confidence interval. The study results were presented in tables, graphs and charts, as appropriate. Results:  Maternal demographic factors associated with poor outcomes of neonatal sepsis included - younger or advanced maternal age (X2 = 4.735, df = 2, p = 0.031); low education level (X2 = 6.362, df = 1, p = 0.012) and short birth intervals of < 2 years (X2 = 5.108, df = 2, p = 0.023). Maternal socioeconomic factors associated with poor outcomes of neonatal sepsis included - low household income level (X2 = 6.163, df = 1, p = 0.014); large family sizes of ≥5 members (X2 = 4.844, df = 1, p = 0.028) and lack of a health insurance cover (X2 = 5.382, df = 1, p = 0.019). Conclusion: Various maternal demographics, maternal socio-economic were significant perceived determinants of poor outcomes of neonatal sepsis in Kenyatta National Hospital’s Paediatric Unit.  Recommendations: The national government with the help of county governments and development partners should invest in community empowerment programs that aim to improve the socioeconomic status of caregivers and their households. In addition, further investments in the health care system are needed to make it more affordable to all and particularly to the low-income group.

scholarly journals Prevalence, antimicrobial susceptibility patterns, serotypes and risk factors for group B streptococcus rectovaginal isolates among pregnant women at Kenyatta National Hospital, Kenya; A cross-sectional study

2019 ◽  
Author(s):  
Jisuvei Clayton Salano ◽  
Osoti Alfred ◽  
Maina Anne Njeri
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Group B Streptococcus ◽  
Penicillin G ◽  
National Hospital ◽  
Factors Associated ◽  
Kenyatta National Hospital ◽  
Group B ◽  
Susceptibility Patterns

Abstract Background: Estimates of group B streptococcus (GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS. Methods: We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization. Results: A total of 292 women were enrolled. Median age was 30 years (Interquatile range {IQR} 26-35) with a median gestational age of 35 weeks (IQR 30-37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/60 (72.4%) isolates, ampicillin in 32/60 (55.2%) isolates, clindamycin in 14/60 (30.4%) isolates, and vancomycin in 14 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization.Conclusion: The prevalence of GBS colonization was high among mothers attending antenatal clinic at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.

scholarly journals Exploring Strategies to Improve Adherence to Immunization Schedule: A Study among Children Attending Maternal and Child Health Clinic at Kenyatta National Hospital, Nairobi, Kenya

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Esther Cheptanui Muathe ◽  
Mary Kamau ◽  
Eve Rajula
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Text Messages ◽  
World Health ◽  
Health Clinic ◽  
Immunization Schedule ◽  
National Hospital ◽  
Kenyatta National Hospital ◽  
Child Health Clinic ◽  
And Child Health

Background. Globally, immunization is among the major contributors to public health, preventing 20% of childhood mortality annually. The highest fatality rates from vaccine preventable diseases are usually among children under five. Despite immunization guidelines put in place by the World Health Organization, globally, 1.5 million children die annually related to inadequate vaccination coverage. Existing literature indicate that there is an increase in nonadherence to immunization schedule in developing countries, and therefore, there is an increased demand to improve adherence to immunization schedule. Objective. To explore strategies that will improve adherence to immunization schedule among children under 24 months attending the Maternal and Child Health clinic at Kenyatta National Hospital. Methods. A cross-sectional mixed method study involving caregivers (n=214) of well babies attending the Maternal and Child Health clinic. Data was collected using semistructured questionnaires, focus group discussions, and key informant interviews and analyzed using SPSS V.20. Results. There was a significant relationship between the level of education and marital status of the caregivers and adherence to immunization schedule. Barriers found that is related to adherence to immunization schedule included far distance from health facility, baby’s sickness, and vaccine stock-outs while employment of a caregiver was a constrainer factor. Conclusion. The enabling factors to current strategies of improving adherence to immunization schedule were having more health facilities near residential areas, using text messages reminders a day before the clinic date to remind caregivers of the due date for the clinic, and constant availability of vaccines. The health system strategies that would improve adherence to immunization schedules were more flexible clinic hours, availability of vaccines on daily basis, phone call reminders by health care providers, and increasing awareness on the importance of both vaccinations and adherence to immunization schedule.

scholarly journals Prevalence, antimicrobial susceptibility patterns, serotypes and risk factors for group B streptococcus rectovaginal isolates among pregnant women at Kenyatta National Hospital, Kenya; A cross-sectional study

2020 ◽  
Author(s):  
Jisuvei Clayton Salano ◽  
Osoti Alfred ◽  
Maina Anne Njeri
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Group B Streptococcus ◽  
Penicillin G ◽  
National Hospital ◽  
Factors Associated ◽  
Kenyatta National Hospital ◽  
Group B ◽  
Susceptibility Patterns

Abstract Background Estimates of group B streptococcus ( GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS. Methods We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization. Results A total of 292 women were enrolled. Median age was 30 years (Interquatile range {IQR} 26-35) with a median gestational age of 35 weeks (IQR 30-37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/58 (72.4%) isolates, ampicillin in 32/58 (55.2%) isolates, clindamycin in 14/46 (30.4%) isolates, and vancomycin in 14/58 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization. Conclusion The prevalence of GBS colonization was high among mothers attending antenatal clinic at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.

scholarly journals Risk Factors Associated with Severity of Nongenetic Intellectual Disability (Mental Retardation) among Children Aged 2–18 Years Attending Kenyatta National Hospital

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Mathieu Nemerimana ◽  
Margaret Njambi Chege ◽  
Eunice Ajode Odhiambo
Keyword(s):  
Risk Factors ◽  
Intellectual Disability ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Perinatal Complications ◽  
National Hospital ◽  
Cross Sectional ◽  
Factors Associated ◽  
Kenyatta National Hospital ◽  
Increased Risk

Background. Many of the nongenetic causal risk factors of intellectual disability (ID) can be prevented if they are identified early. There is paucity on information regarding potential risk factors associated with this condition in Kenya. This study aimed to establish risk factors associated with severity of nongenetic intellectual disability (ID) among children presenting with this condition at Kenyatta National Hospital (KNH). Methods. A hospital-based cross-sectional study was conducted over the period between March and June 2017 in pediatric and child/youth mental health departments of Kenyatta National Hospital (KNH), Kenya. It included children aged 2–18 years diagnosed with ID without underlying known genetic cause. Results. Of 97 patients with nongenetic ID, 24% had mild ID, 40% moderate, 23% severe-profound, and 10% unspecified ID. The mean age of children was 5.6 (±3.6) years. Male children were predominant (62%). Three independent factors including “labor complications” [AOR = 9.45, 95% CI = 1.23–113.29, P=0.036], “admission to neonatal intensive care unit” [AOR = 8.09, 95% CI = 2.11–31.07, P=0.002], and “cerebral palsy” [AOR = 21.18, CI = 4.18–107.40, P≤0.001] were significantly associated with increased risk of severe/profound nongenetic ID. Conclusion. The present study findings suggest that perinatal complications as well as postnatal insults are associated with increased risk of developing severe-profound intellectual disability, implying that this occurrence may be reduced with appropriate antenatal, perinatal, and neonatal healthcare interventions.

scholarly journals Prevalence of nutritional anemia in children of high socioeconomic status in a tertiary care center

2021 ◽  
Vol 8 (10) ◽  
pp. 359-361
Author(s):  
Pradeep Kalaiselvam ◽  
Suresh Chelliah ◽  
Meganathan Pachamuthu
Keyword(s):  
Socioeconomic Status ◽  
Care Center ◽  
Tertiary Care ◽  
Age Groups ◽  
Hypochromic Anemia ◽  
World Health ◽  
High Socioeconomic Status ◽  
Nutritional Anemia ◽  
Study Results ◽  
Tertiary Center

Background: Anemia is a highly prevalent condition developed in children belonging to all socioeconomic status and is mainly caused due to iron deficiency in nutrition. Aim: To identify the Prevalence of nutritional anemia in children of high socioeconomic status. Methods: Children between 6 months and 14 years of age belonging to high socioeconomic status, admitted in pediatric ward of Kauvery Hospital, a tertiary center at Trichy were included in the study. Children with hemolytic anemia, chronic illnesses, and those who received blood transfusion were excluded from the study. The World Health Organization classification was used for grading the severity of anemia as mild, moderate, and severe based on hemoglobin levels for the age. Modified Kuppuswamy scale 2016 was used to assess the socioeconomic status of the children. Children belonging to upper and upper middle socioeconomic status were included in the study. Results: The overall prevalence of anemia among the study population was 44.5%. Out of 400 subjects, 178 participants were anemic. Of the 178 anemic children, 78.1% were in the age group of 6 months–5 years, 20.2% in 5–11 years, and 1.7% in 12–14 years. Among children between 6 and 23 months, 75 were anemic. Almost all patients showed microcytic hypochromic anemia. There were a significantly higher number of overweight and obese children among those anemic in all age groups. Conclusion: This study concludes that every other child is anemic even in families of high socioeconomic status, especially <2 years of age. There is an urgent need to screen and treat all children regardless of their socioeconomic status or body mass index.

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