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4 results on '"Alfred Wanjau"'

1. Identifying and quantifying initial post-discharge needs for clinical review of sick, newborns in Kenya based on a large multi-site, retrospective cohort study

Author

John Wainaina, Esther Lee, Grace Irimu, Jalemba Aluvaala, Mike English, The Clinical Information Network Author Group, Dolphine Mochache, Juma Vitalis, Arnest Namayi, Nyumbile Bonface, Samuel Soita, Christine Manyasi, Jane Mbungu, Joan Baswetty, Caren Emadau, Josephine Aritho, Beatrice Njambi, Esther Mwangi, Charles Nzioki, Wagura Mwangi, Lucy Kinyua, Alfred Wanjau, Magdalene Kuria, Alice Oguda, Otieno George Obop, Esther Njiru, Pauline Njeru, Penina Mwangi, Nancy Mburu, Mary Nguri, Rachel Inginia, Celestine Muteshi, Jeska Kuya, Emma Namulala, Salome Okisa Muyale, Susan Wanjala, Grace Ochieng, Lydia Thuranira, Faith Mueni, Margaret Waweru, Felistus Makokha, Rosemary Mututa, Josephine Ojigo, Joyce Oketch, Beth Maina, Orina Nyakina, Faith Njeru, Judith Onsongo, Bernadette Lusweti, Margaret Wanjiku Mwaura, Peter Muigai, Amilia Ngoda, Zainab Kioni, Esther Muthiani, Loise N. Mwangi, Seline Kulubi, John Ollongo, Joseph Ng’ang’a, and Benjamin Tanui

Subjects
newborn, infant, post-discharge, specialist, follow-up, morbidity, Pediatrics, RJ1-570
Abstract

BackgroundProgress in neonatal care has resulted in a 51% decrease in global neonatal mortality rates from 1990 to 2017. Enhanced survival will put pressure on health care systems to provide appropriate post-discharge, follow-up care but the scale of need for such care is poorly defined.MethodsWe conducted a retrospective cohort study of newborns discharged from 23 public hospital neonatal units (NBUs) in Kenya between January 2018 and June 2023 to identify initial follow-up needs. We first determined pragmatic follow-up categories based on survivors’ clinical conditions and morbidities. We then used individual phenotypes of individual babies to assign them to needing one or more forms of specialized clinical follow-up. We use descriptive statistics to estimate proportions of those with specific needs and patterns of need.FindingsAmong 136,249/159,792 (85.3%) neonates discharged, around one-third (33%) were low birth weight (

Published
2024
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2. Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality

Author

John Wainaina, Morris Ogero, Livingstone Mumelo, Kefa Wairoto, George Mbevi, Timothy Tuti, Paul Mwaniki, Grace Irimu, Mike English, Jalemba Aluvaala, The Clinical Information Network Author Group, Dolphine Mochache, Juma Vitalis, Nyumbile Bonface, Christine Manyasi, Caren Emadau, Charles Nzioki, Wagura Mwangi, Magdalene Kuria, Esther Njiru, Penina Mwangi, Rachel Inginia, Emma Namulala, Grace Ochieng, Lydia Thuranira, Felistus Makokha, Josephine Ojigo, Beth Maina, Bernadette Lusweti, Amilia Ngoda, Jane Mbungu, Joan Baswetty, Josephine Aritho, Beatrice Njambi, Zainab Kioni, Lucy Kinyua, Alice Oguda, Loise N. Mwangi, Nancy Mburu, Celestine Muteshi, Salome Okisa Muyale, Faith Mueni, Rosemary Mututa, Joyce Oketch, Orina Nyakina, Faith Njeru, Margaret Wanjiku Mwaura, Seline Kulubi, Susan Wanjala, Pauline Njeru, John Ollongo, Samuel Soita, Mary Nguri, Margaret Waweru, Otieno George Obop, Jeska Kuya, Esther Muthiani, Esther Mwangi, Joseph Ng’ang’a, Benjamin Tanui, Alfred Wanjau, Judith Onsongo, Peter Muigai, and Arnest Namayi

Subjects
newborn, inpatient, hypothermia, mortality, warm chain, Pediatrics, RJ1-570
Abstract

BackgroundReports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes.ObjectivesThis study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality.MethodsA retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C–36.4°C) and hypothermia (

Published
2024
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3. Pulse oximetry adoption and oxygen orders at paediatric admission over 7 years in Kenya: a multihospital retrospective cohort study

Author

Grace Irimu, George Mbevi, Samuel Akech, Mike English, Jalemba Aluvaala, Ambrose Agweyu, Mercy Chepkirui, Paul Mwaniki, Emma Namulala, Juma Vitalis, Rachel Inginia, Melab Musabi, Grace Ochieng, Lydia Thuranira, Esther Njiru, Charles Nzioki, Caren Emadau, Christine Manyasi, Agnes Mithamo, Fred Were, Roselyne Malangachi, Supa Tunje, Magdalene Kuria, Mary Waiyego, Beth Maina, Catherine Mutinda, Laura Oyiengo, Muthoni Ogola, Edith Gicheha, Lynda Isaaka, Timothy Tuti, Naomi Muinga, Joseph Nganga, Esther Mwangi, Esther Muthiani, Mary Nguri, Samuel Soita, Margaret Waweru, Alfred Wanjau, Caroline Mwangi, John Wainaina, Livingstone Mumelo, Nyumbile Bonface, Wagura Mwangi, Penina Mwangi, Josephine Ojigo, Bernadette Lusweti, Amilia Ngoda, Dolphine Mochache, Jane Mbungu, Joan Baswetty, Josephine Aritho, Beatrice Njambi, Zainab Kioni, Alice Oguda, Nancy Mburu, Celestine Muteshi, Salome Okisa Muyale, Faith Mueni, Rosemary Mututa, Joyce Oketch, Orina Nyakina, Faith Njeru, Margaret Wanjiku Mwaura, Seline Kulubi, Susan Wanjala, Pauline Njeru, John Ollongo, Jeska Kuya, Benjamin Tanui, Judith Onsongo, Peter Muigai, Arnest Namayi, Cynthia Khaenzi, Monica Musa, David Kibiwott Kimutai, Rukia Aden, Elizabeth Atieno Jowi, Cecilia Muithya, Penina Musyoka, Mwangi Ngina, Felicitas Makokha, Angeline Ithondeka, Julie Barasa, Meshack Liru, Elizabeth Kibaru, Alice Nkirote Nyaribari, Joyce Akuka, Joyce Wangari, Aggrey Nzavaye Emenwa, Patricia Nafula Wesakania, George Lipesa, Marystella Mutenyo, Joyce Mbogho, Ann Jambi, Felisters Mucheke, Lucy Kinyua Jeniffer, Margaret Kethi, Salome Nashimiyu Situma, Nancy Gachaja, Loise N Mwangi, Ruth Mwai, Irginia Wangari Muruga, Abigael Bwire, Naomi Situma, Hellen Mwaura, Caroline Lavu, Jane Hore Olum, Rebecca Chelimo, Ann Wambugu, Epharus Njeri Mburu, Linda Awino Tindi, Jane Akumu, Ruth Otieno, Slessor Osok, Rebbecca Mukami Mbogo, Judith Mirenja, Mary Akoth Oruko, Caroline Muthuri, Elizabeth Kosiom, Dorcas Cherop, Faith Marete, Johanness Simiyu, Collince Danga, Arthur Otieno Oyugi, and Fredrick Keya Okoth

Subjects
Medicine
Abstract

Objectives To characterise adoption and explore specific clinical and patient factors that might influence pulse oximetry and oxygen use in low-income and middle-income countries (LMICs) over time; to highlight useful considerations for entities working on programmes to improve access to pulse oximetry and oxygen.Design A multihospital retrospective cohort study.Settings All admissions (n=132 737) to paediatric wards of 18 purposely selected public hospitals in Kenya that joined a Clinical Information Network (CIN) between March 2014 and December 2020.Outcomes Pulse oximetry use and oxygen prescription on admission; we performed growth-curve modelling to investigate the association of patient factors with study outcomes over time while adjusting for hospital factors.Results Overall, pulse oximetry was used in 48.8% (64 722/132 737) of all admission cases. Use rose on average with each month of participation in the CIN (OR: 1.11, 95% CI 1.05 to 1.18) but patterns of adoption were highly variable across hospitals suggesting important factors at hospital level influence use of pulse oximetry. Of those with pulse oximetry measurement, 7% (4510/64 722) had hypoxaemia (SpO2

Published
2021
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4. Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study

Author

Grace Irimu, Morris Ogero, George Mbevi, David Gathara, Samuel Akech, Mike English, Jalemba Aluvaala, Ambrose Agweyu, Mercy Chepkirui, Sylvia Omoke, Lucas Malla, Emma Namulala, Juma Vitalis, Rachel Inginia, Grace Ochieng, Lydia Thuranira, Esther Njiru, Charles Nzioki, Caren Emadau, Christine Manyasi, Fred Were, Magdalene Kuria, Mary Waiyego, Beth Maina, Edith Gicheha, Joseph Nganga, Esther Mwangi, Esther Muthiani, Mary Nguri, Samuel Soita, Margaret Waweru, Alfred Wanjau, Caroline Mwangi, John Wainaina, Livingstone Mumelo, Nyumbile Bonface, Wagura Mwangi, Penina Mwangi, Felistus Makokha, Josephine Ojigo, Bernadette Lusweti, Amilia Ngoda, Dolphine Mochache, Jane Mbungu, Joan Baswetty, Josephine Aritho, Beatrice Njambi, Zainab Kioni, Lucy Kinyua, Alice Oguda, Loise N. Mwangi, Nancy Mburu, Celestine Muteshi, Salome Okisa Muyale, Faith Mueni, Rosemary Mututa, Joyce Oketch, Orina Nyakina, Faith Njeru, Margaret Wanjiku Mwaura, Seline Kulubi, Susan Wanjala, Pauline Njeru, John Ollongo, Otieno George Obop, Jeska Kuya, Benjamin Tanui, Judith Onsongo, Peter Muigai, and Arnest Namayi

Subjects
Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract

Background Most of the deaths among neonates in low-income and middle-income countries (LMICs) can be prevented through universal access to basic high-quality health services including essential facility-based inpatient care. However, poor routine data undermines data-informed efforts to monitor and promote improvements in the quality of newborn care across hospitals.Methods Continuously collected routine patients’ data from structured paper record forms for all admissions to newborn units (NBUs) from 16 purposively selected Kenyan public hospitals that are part of a clinical information network were analysed together with data from all paediatric admissions ages 0–13 years from 14 of these hospitals. Data are used to show the proportion of all admissions and deaths in the neonatal age group and examine morbidity and mortality patterns, stratified by birth weight, and their variation across hospitals.Findings During the 354 hospital months study period, 90 222 patients were admitted to the 14 hospitals contributing NBU and general paediatric ward data. 46% of all the admissions were neonates (aged 0–28 days), but they accounted for 66% of the deaths in the age group 0–13 years. 41 657 inborn neonates were admitted in the NBUs across the 16 hospitals during the study period. 4266/41 657 died giving a crude mortality rate of 10.2% (95% CI 9.97% to 10.55%), with 60% of these deaths occurring on the first-day of admission. Intrapartum-related complications was the single most common diagnosis among the neonates with birth weight of 2000 g or more who died. A threefold variation in mortality across hospitals was observed for birth weight categories 1000–1499 g and 1500–1999 g.Interpretation The high proportion of neonatal deaths in hospitals may reflect changing patterns of childhood mortality. Majority of newborns died of preventable causes (>95%). Despite availability of high-impact low-cost interventions, hospitals have high and very variable mortality proportions after stratification by birth weight.

Published
2021
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