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Background: Pulmonary arterial hypertension is a significant cause of morbidity and mortality and is associated with several risk factors in children with Down's syndrome. Objectives: To determine the prevalence and associated risk factors of pulmonary arterial hypertension in children with Down's syndrome aged 0-12 years seen at Kenyatta National Hospital. Methods: This was a cross-sectional study done over a 3-month period at KNH paediatric wards and outpatient clinics. Children with Down's syndrome aged 0-12 years were recruited into the study. Echocardiography was done on all children to assess for pulmonary arterial hypertension and congenital heart defects. Questionnaires and X-rays were used to assess for other risk factors such as adenoid hypertrophy, reflux and lung disease. Results: 81 children with Down's were enrolled in the study. The prevalence of pulmonary arterial hypertension in these children was 32.1% with 95% CI (21.0-42.0). The prevalence of congenital heart defects was 59.3%, adenoid hypertrophy: 33.3 %, pulmonary manifestations: 35.8 % and reflux disease 9.9%. The risk factors with significant association with PAH were female sex OR= 3.3 with 95% CI (1.1-10.2) and congenital heart disease OR 8.3 with 95% CI (1.9-35.8). In univariate analysis lung disease and upper airway obstruction were not associated with PAH. Conclusion and Recommendations: The prevalence of pulmonary arterial hypertension in children with Down's syndrome was 32% and was significantly associated with female gender and CHD. Early screening for pulmonary arterial hypertension and congenital heart defects is recommended in all children with Down's syndrome. [ABSTRACT FROM AUTHOR]

Background: Bubble Continuous Positive Airway Pressure (BCPAP) is reported to be a safer alternative compared to mechanical ventilation in preterm neonates with respiratory distress syndrome (RDS). The objective of this study was to assess the effects of BCPAP on premature neonates with RDS. Methodology: This was an analytic cross-sectional study done over 7 months involving preterm neonates with RDS admitted at the AIC Kijabe Hospital New Born Unit. The duration of BCPAP support, duration of oxygen therapy and oxygen requirements at 36 weeks gestational age (GA), the GA of the infants when full enteral feeds were tolerated, and the complications of BCPAP were documented. Data was analyzed with SPSS version 17.0. Results: Sixty-one preterm neonates were recruited in the study, 54.1% male and 45.9% female. The median duration of BCPAP treatment was 5 days (IQR 3-7 days), and this was significantly associated with birth weight (p=0.044). The median duration of oxygen therapy was 6 days (IQR 4-17 days) and this was significantly associated with GA (p=0.003). Twenty percent of the neonates required oxygen administration at 36 weeks. The median age of full enteral feeds was 18 days (IQR 12-25 days). There were no major complications of BCPAP (pneumothorax, CPAP belly and nasal trauma). The mortality rate of preterm neonates treated with BCPAP was 13.1%. Conclusion BCPAP exhibited a favorable safety profile, with no major complications reported. It is a safe mode of respiratory support for preterm neonates with RDS and should be readily available in all newborn units. [ABSTRACT FROM AUTHOR]

Objectives: Breastfeeding is crucial for the health of both mothers and infants. This study evaluated the compliance of Kenyatta National Hospital's maternity unit with the Ten Steps of the Baby-Friendly Hospital Initiative (BFHI), a strategy aimed at improving breastfeeding rates. Methods: A short longitudinal survey of the mothers who delivered a live infant at the KNH labour ward, a cross-sectional survey of the health care workers in the labour and postnatal wards and an institutional observation study within the Maternity Unit was done over a one-month period. Systematic sampling was used for the mothers while the healthcare workers were randomly sampled. Results: Out of 103 enrolled mothers, the hospital achieved an overall BFHI compliance rate of 40%. Specifically, Steps 1, 2, 3, 4, 5, and 10 did not meet the required threshold for compliance. The study found that 68% of babies at the hospital were breastfed within the first hour of birth, which is beneficial for newborns. However, infants with morbidity experienced delayed breastfeeding initiation compared to those without co-morbidity. Additionally, 78% of mothers with infants who had health issues did not receive information on postpartum breastfeeding support. Conclusion: Demographic characteristics of mothers did not significantly influence early versus delayed breastfeeding initiation. However, the study emphasizes the importance of improving BFHI compliance in order to enhance breastfeeding practices at the hospital. Encouraging early breastfeeding initiation and providing adequate postpartum breastfeeding support are essential steps to support maternal-infant bonding and positive health outcomes. [ABSTRACT FROM AUTHOR]