Background: There is laboratory evidence of altered immune function in children with malaria. Bacterial infections have been documented to complicate severe forms of malaria. However, it remains unclear whether such infections are attributable to the malaria, other risk factors, or are coincidental. Objective: To determine the prevalence of bacteraemia and urinary tract infections (UTI) in febrile hospitalised children with and without malaria. Design: A cross-sectional survey. Setting: General paediatric wards, Kenyatta National Hospital, Nairobi. Subjects: Children aged between three months and 12 years admitted with an acute febrile illness, with no obvious focus of bacterial infection. Materials and Methods: Using a standardised questionnaire, information on sociodemography, symptomatology, and nutritional status was obtained. Malaria slides, blood and urine cultures were performed on each child. Results: Malaria parasitaemia was present in 158 (60%) of 264 children presenting with acute febrile illness with no obvious focus of bacterial infection. Bacteria were isolated from blood and/or urine of 62 (23%) of all enrolled children. Bacteraemia was prevalent among 11.4% of 158 children with malaria and among 13.2% of 106 without malaria. Gram-positive organisms comprised 28.1% of blood isolates, gram-negative 62.5%, and atypical bacteria 9.4%. UTI was prevalent among 13.3% of 158 children with malaria and 16.0% of 106 children without malaria. Gram-positive organisms comprised 18.4%, gram-negative 78.9%, and atypical bacteria 2.6% of the urine isolates. Presence of malaria parasitaemia was not associated with an increased risk of bacteraemia (OR 0.9, 95% CI [0.4-0.7], or UTI (OR 0.8 95% CI [0.4-1.6] in this study population. Conclusion: Among children hospitalised in Nairobi with fever and no obvious bacterial infective focus, there should be a high index of suspicion for malaria, followed by bacteraemia and UTI. Malaria parasitaemia does not appear to be associated with increased risk of bacterial co-infection.

Objective Lack of proper menstrual hygiene predisposes women to different infectious and chronic obstetric and gynecological problems. A Facility based cross-sectional study was implemented from October 1-December 10, 2018. The data was collected using structured, pretested questioners among female high school students. Systematic random sampling technique was implemented. Data was entered and analyzed through Epi data 3.1 and SPSS respectively. Therefore, this study aimed to assess knowledge, attitude, practice and its associated factors of menstrual hygiene among high school students in North Wollo Zone, Woldia, Ethiopia. Results This study revealed that 365(89.2%), 200(48.9%) and 196(47.9%) of the study participants have good knowledge, good practice and good attitude about menstrual hygiene respectively. Being grade 10 students [AOR=3.96, 95% CI =2.0-7.8], and having good practice of menstrual hygiene (AOR=2.52, 95% CI= 1.26-5) had positive association with menstrual hygiene knowledge. Maternal education level (AOR=1.86, 95% CI=1.18-2.9), being grade 10 students (AOR =2.3, 95% CI=1.48-3.56) were associated factors for practicing menstrual hygiene. Being grade 10 students (AOR=1.9, 95% CI=1.2-2.8), age ≥18 years (AOR=1.67, 95% CI=1.09-2.55) were statistically and positively associated with the attitude of menstrual hygiene.

BackgroundSub-Saharan Africa continues to document high pediatric tuberculosis (TB) burden, especially among the urban poor. One recommended preventive strategy involves tracking and isoniazid preventive therapy (IPT) for children under 5 years in close contact with infectious TB. However, sub-optimal effectiveness has been documented in diverse settings. We conducted a study to elucidate correlates to IPT strategy failure in children below 5 years in high burden settings.MethodsA prospective longitudinal cohort study was done in informal settlings in Nairobi, where children under 5 years in household contact with recently diagnosed smear positive TB adults were enrolled. Consent was sought. Structured questionnaires administered sought information on index case treatment, socio-demographics and TB knowledge. Contacts underwent baseline clinical screening exclude TB and/or pre-existing chronic conditions. Contacts were then put on daily isoniazid for 6 months and monitored for new TB disease, compliance and side effects. Follow-up continued for another 6 months.ResultsAt baseline, 428 contacts were screened, and 14(3.2%) had evidence of TB disease, hence excluded. Of 414 contacts put on IPT, 368 (88.8%) completed the 1 year follow-up. Operational challenges were reported by 258(70%) households, while 82(22%) reported side effects. Good compliance was documented in 89% (CI:80.2–96.2). By endpoint, 6(1.6%) contacts developed evidence of new TB disease and required definitive anti-tuberculosis therapy. The main factor associated with IPT failure was under-nutrition of contacts (p = 0.023).ConclusionUnder-nutrition was associated with IPT failure for child contacts below 5 years in high burden, resource limited settings. IPT effectiveness could be optimized through nutrition support of contacts.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2719-8) contains supplementary material, which is available to authorized users.