Acute respiratory infections (ARIs) are a leading cause of under-five mortality globally. In Kenya, the reported prevalence of respiratory syncytial virus (RSV) infections in single-centre studies has varied widely. Our study sought to determine the prevalence of RSV infection in children admitted with ARI fulfilling the WHO criteria for bronchiolitis. This was a prospective cross-sectional prevalence study in five hospitals across central and highland Kenya from April to June 2015. Two hundred and thirty-four participants were enrolled. The overall RSV positive rate was 8.1%, which is lower than in previous Kenyan studies. RSV-positive cases were on average 5 months younger than RSV-negative cases.
motivation, and how combined approaches to knowledge transfer and 'soft skills' development may improve the quality of provider performance.
Background and aimsGaining exposure to global child health can be difficult to organise both financially and logistically. ‘Cases without borders’ aims to evaluate the perceived learning benefits of an online case-exchange programme comparing clinical management between contrasting settings.MethodsOne hour online sessions were carried out over five months between two paediatric departments; a Malawian district hospital and a UK teaching hospital.Clinicians, Nurses and Students from both settings were invited to attend sessions facilitated by a UK registrar in each facility, using Skype or Whatsapp. Proformas divided down the middle, were circulated to participants in advance. The clerking and management of a case from each setting was entered on one side and emailed to the whole group. During the online presentation and discussion, the other hospital considered how that case would be managed in their alternative setting, completing the other side of the proforma. Feedback was collected using an unvalidated perceived learning questionnaire devised by the facilitators using 10 questions on a 5-point likert scale.Results6 exchange sessions were held covering 12 paired paediatric cases (table 1).Feedback was collected from 13 participants (7 Malawi, 6 UK). Mean score of all 10 questions was 4.26 out of 5 for all responders (4.3 for Malawi, 4.2 for UK), indicating perceived learning was high and similar for both groups. There was no significant difference in mean scores between the groups (p>0.05 using Mann-Whitney-U) for all feedback questions.ConclusionsCases without borders was perceived to enhance learning across settings, equally benefiting both sides, suggesting it is a suitable model for telemedicine programmes. Qualitative feedback suggests potential for increased interest and participation in evidence-based medicine and global child health in both contexts. Future iterations would benefit from an improved internet connexion and a larger feedback sample using a validated feedback tool.Abstract G285(P) Table 1MalawiOrganophosphate poisoning Asthma exacerbation Malaria, Malnutrition and dehydration Diabetic keto-acidosis PJP Pneumonia Sickle-Cell Painful crisis Congenital syphilis Cerebral Malaria Prematurity with RDS Sepsis and metabolic condition Rheumatic fever and Sydenham’s chorea Bronchiolitis
BackgroundAcute respiratory infections (ARI) continue to be a leading cause of under-five mortality in the developing world. Distinguishing between bacterial and viral causes can be challenging, and although the majority are likely to be viral, most are treated as bacterial pneumonia. In Kenya, the prevalence of Respiratory Syncytial Virus (RSV) in previous, single-centre studies have varied greatly.AimsTo determine the prevalence of RSV infection in children admitted with ARI to five hospitals in Kenya, and to analyse if there were any significant associations between RSV infection and clinical signs.MethodsA prospective cross-sectional prevalence study was conducted in five different district hospitals across central and highland Kenya from April to June 2015. Lead paediatricians were Global Links volunteers (RCPCH). Children admitted who fitted the WHO criteria for bronchiolitis had bedside RSV immunochromatography testing, and data collected about their demographics, symtpoms and signs.Results234 participants were enrolled across the five hospitals. The overall RSV positive rate was 8.1%, although this varied between the sites. The average age of RSV positive cases was 3.9 months and RSV negative 9.2 months. Difficulty in feeding was the only clinical sign significantly associated with an RSV positive result.ConclusionThis is the first published study to look at the RSV prevalence rate in children admitted with ARIs in these areas across central and highland Kenya. The RSV rate of 8.1% is much lower than that previously reported in other parts of Kenya. Much further work is needed to better understand the viral aetiology of paediatric ARIs across the different areas of Kenya to be able to make evidenced based decisions for future public health programs and clinical guidelines.
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