Background. The prevalence and distribution of endocrine disorders in children in Africa are not well known because most cases are often undiagnosed or diagnosed too late. The awareness of this led to the launch of the Paediatric Endocrinology Training Center for Africa (PETCA) designed to improve quality and access to health care by training paediatricians from Africa in paediatric endocrinology. Methods. The fellowship is undertaken over an 18-month period: six months of clinical and theoretical training in Kenya, nine months of project research at the fellow's home country, and three months of consolidation in Kenya. Upon completion, certified paediatricians are expected to set up centers of excellence. Results. There have been two phases, phase I from January 2008 to October 2012 and phase II from January 2012 to April 2015. Fifty-four fellows from 12 African countries have been certified, 34 (phase I) and 20 (phase II). Over 1,000 patients with wide ranging diabetes and endocrine disorders have been diagnosed and treated and are being followed up at the centers of excellence. Conclusion. The successes of the PETCA initiative demonstrate the impact a capacity building and knowledge transfer model can have on people in resource-poor settings using limited resources.
The prevalence of disorders linked to paediatric endocrinology-including diabetes, obesity, endocrine cancers, and disorders of growth, thyroid function, adrenal glands, and sexual development-is increasing worldwide. More than 42 million children under age 5 years are obese, 1 and more than half a million children under age 14 years have type 1 diabetes. 2 At present, disorders of sexual development are reported in one in every 4500 births. 3 The number of children with these disorders who do not access care is unavailable, since few studies on paediatric endocrine disorders have been done. But in Africa, and elsewhere in the world, the number of paediatric subspecialists is inadequate. To remedy this, concerted eff orts are focused on capacity building of child health subspecialists, including endocrinologists. As of January, 2016, Kenya has eight boardcertifi ed paediatric endocrinologists, compared with only one before 2007, and seven of them are graduates of the Paediatric Endocrinology Training Centre for Africa (PETCA). Launched in 2007, PETCA is a capacity-building initiative developed to fi ll the urgent need for paediatric endocrinology subspecialists across sub-Saharan Africa.Although PETCA is the fi rst of its kind in Africa, similar programmes exist elsewhere-eg, the British Society for Paediatric Endocrinology and Diabetes, Australasia Paediatric Endocrine Group, Canadian Pediatric Endocrine Group, and the Certifi cate Course in Evidence Based Diabetes Management (CCEBDM) in India. These organisations run fellowship programmes that typically include 6-12 months of clinical and theoretical training, followed by
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BackgroundNairobi, Kenya has a population of nearly 4 million with an annual growth rate of 4%. However despite the increased urbanisation across the city, healthcare provision ignores unintentional injuries including falls among children and adolescents.MethodsThe objective of the study was to establish the nature of falls among children aged 0–21 years presenting at the Gertrude’s Children’s Hospital Nairobi, Kenya. The study was retrospective based on the review of hospital records from the year 2004 to 2013. The data was analysed based on age group most at risk for a fall, nature of the fall and the cause of the fall injury.ResultsA total of 11,137 children were treated for injuries over the study period. Of these, 5570 (50%) sustained fall-related injuries. The number of children admitted for falls annually increased by 332.82% from 259 in 2004 to 1,121 in 2013. The highest incidence of falls was among the 6–10 year age group (n = 2081; 37.4%) followed by the 11–15 year age group (n = 1502; 27%). The highest number of injuries were sustained by falls on the same ground level (n = 2361; 42.4%), a high place (n = 884; 15.9%) and from staircases (n = 776; 13.9%). The least number of injuries were from buildings (n = 3; 0.05%) and moving vehicles (n = 2; 0.04%). All injuries were classified by the nature of falls; majority were open and superficial wounds (n = 2703; 48.53%) and dislocation and strain of joints (n = 798; 14.3%) while the least were intracranial injuries (n = 9; 0.2%). Overall falls have not increased more than any other cause of injuries.ConclusionsThe clinical setting of a children’s hospital allows for easy identification of children most at risk of an unintentional injury. Interventions should be put in place in the communities they live in, and there should be more studies on the causes of fall injuries among children. These injuries may be serious enough to require hospital treatment and even result in disability.
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