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O PROFWASUNNAAGGREY, N PROFWEREFREDRICK. "Implementation of a structured paediatric admission record for district hospitals in Kenya–results of a pilot study. BMC Int Health Hum Rights . 2006 Jul 20; 6 : 9 . PMID: 16857044 [PubMed] Mwakyusa S, Wamae A, Wasunna A, Were F, Esamai F, Ogutu B, Muriit.". In: BMC Int Health Hum Rights . 2006 Jul 20; 6 : 9 . John Benjamins Publishing Company; 2006. Abstract
KEMRI Centre for Geographic Medicine Research-Coast, P,O, Box 43640, Nairobi, Kenya. sekela_mwakyusa@yahoo.com BACKGROUND: The structured admission form is an apparently simple measure to improve data quality. Poor motivation, lack of supervision, lack of resources and other factors are conceivably major barriers to their successful use in a Kenyan public hospital setting. Here we have examined the feasibility and acceptability of a structured paediatric admission record (PAR) for district hospitals as a means of improving documentation of illness. METHODS: The PAR was primarily based on symptoms and signs included in the Integrated Management of Childhood Illness (IMCI) diagnostic algorithms. It was introduced with a three-hour training session, repeated subsequently for those absent, aiming for complete coverage of admitting clinical staff. Data from consecutive records before (n = 163) and from a 60% random sample of dates after intervention (n = 705) were then collected to evaluate record quality. The post-intervention period was further divided into four 2-month blocks by open, feedback meetings for hospital staff on the uptake and completeness of the PAR. RESULTS: The frequency of use of the PAR increased from 50% in the first 2 months to 84% in the final 2 months, although there was significant variation in use among clinicians. The quality of documentation also improved considerably over time. For example documentation of skin turgor in cases of diarrhoea improved from 2% pre-intervention to 83% in the final 2 months of observation. Even in the area of preventive care documentation of immunization status improved from 1% of children before intervention to 21% in the final 2 months. CONCLUSION: The PAR was well accepted by most clinicians and greatly improved documentation of features recommended by IMCI for identifying and classifying severity of common diseases. The PAR could provide a useful platform for implementing standard referral care treatment guidelines. PMID: 16857044 [PubMed] PMCID: PMC1555611
O. DROYATSIDONALDP, O. DROYATSIDONALDP, O PROFWASUNNAAGGREY, N PROFMUSOKERACHEL. "Incidence of rickets of prematurity at Kenyatta National Hospital, Nairobi.East Afr Med J. 1999 Feb;76(2):63-6. PMID: 10442123 [PubMed - indexed for MEDLINE] Oyatsi DP, Musoke RN, Wasunna AO.". In: East Afr Med J. 1999 Feb;76(2):63-6. John Benjamins Publishing Company; 1999. Abstract
BACKGROUND: Reports of osteopaenia/rickets of prematurity are on the increase due to improved survival rates of low birthweight infants. OBJECTIVE: To establish the incidence of rickets of prematurity by the age of six months in premature infants born at Kenyatta National Hospital, Nairobi. DESIGN: Prospective cohort study. SETTING: Newborn unit and paediatric outpatient follow up clinic of Kenyatta National Hospital. SUBJECTS: Successive surviving infants of birthweight less than 2000 g residents in Nairobi. RESULTS: Incidence of rickets of prematurity by six months of age was 58.8%. Rickets appeared more commonly in male infants compared to female infants. CONCLUSION: Rickets of prematurity is a common problem in the premature infants seen at Kenyatta National Hospital. Routine vitamin D supplements to premature infants in adequate doses of at least 400iu per day should be adopted in our centre.
O PROFWASUNNAAGGREY, W. DRIRIMUGRACE, N PROFWEREFREDRICK. "Irimu G, Wamae A, Wasunna A, Were F, Ntoburi S, Opiyo N, Ayieko P, Peshu N, English M.Developing and introducing evidence based clinical practice guidelines for serious illness in Kenya.Arch Dis Child. 2008 Sep;93(9):799-804.". In: Arch Dis Child. 2008 Sep;93(9):799-804. John Benjamins Publishing Company; 2008. Abstract
{ BACKGROUND: Birth asphyxia kills 0.7 to 1.6 million newborns a year globally with 99% of deaths in developing countries. Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya. METHODS/PRINCIPAL FINDINGS: We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group

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