ArticleArchives of disease in childhood2016
Characteristics of admissions and variations in the use of basic investigations, treatments and outcomes in Kenyan hospitals within a new Clinical Information Network.
Article in Archives of disease in childhood, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 1 of them a synthesis that pooled it.
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Who cites it
65 citing papers in PubMed, 1 synthesis or guideline pooled it, 90 citations in OpenAlex.
- Prognostic models for predicting in-hospital paediatric mortality in resource-limited countries: a systematic review.BMJ open · 2020Pooled it
- A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia.The New England journal of medicine · 2025Trial
- Pairwise joint modeling of clustered and high-dimensional outcomes with covariate missingness in pediatric pneumonia care.Pharmaceutical statistics · 2022Trial
- Effect of enhancing audit and feedback on uptake of childhood pneumonia treatment policy in hospitals that are part of a clinical network: a cluster randomized trial.Implementation science : IS · 2019Trial
- Trial
- Using sentinel surveillance system data to characterize severe malaria illness and quality of malaria case management among hospitalized patients in Kenya, 2017-2024.Malaria journal · 2026Article
- Septic pulmonary embolism in Somali children: a retrospective study from a tertiary hospital.Frontiers in pediatrics · 2026Article
- Paediatric anaemia in rural Kenya and the role of travel time to emergency care services.Frontiers in epidemiology · 2025Article
- Prediction of inpatient mortality in hospitalised children in low- and middle-income countries: An external validation of paediatric mortality risk scores.Journal of global health · 2024Article
- Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic.BMC infectious diseases · 2024Article
- Characteristics of children readmitted with severe pneumonia in Kenyan hospitals.BMC public health · 2024Article
- Prevalence, mortality, and aetiology of paediatric shock in a tertiary hospital in Malawi: A cohort study.PLOS global public health · 2024Article
- External validation of an admission risk score for predicting inpatient paediatric mortality in two Kenyan public hospitals.Wellcome open research · 2024Article
- Identifying critically ill children in Malawi: A modified qSOFA score for low-resource settings.PLOS global public health · 2024Article
- Mortality by Admission Diagnosis in Children 1-60 Months of Age Admitted to a Tertiary Care Government Hospital in Malawi.The American journal of tropical medicine and hygiene · 2023Article
- Pediatric prognostic models predicting inhospital child mortality in resource-limited settings: An external validation study.Health science reports · 2023Article
- Assessment of neonatal referral infrastructure and clinical characteristics of referred neonates in three first referral hospitals in Nairobi County, Kenya.Wellcome open research · 2023Article
- Development of a small and sick newborn clinical audit tool and its implementation guide using a human-centred design approach newborn clinical audit process and design.PLOS global public health · 2023Article
- Improving facility-based care: eliciting tacit knowledge to advance intervention design.BMJ global health · 2022Article
- Improving health and social systems for all children in LMICs: structural innovations to deliver high-quality services.Lancet (London, England) · 2022Review
5 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundLack of detailed information about hospital activities, processes and outcomes hampers planning, performance monitoring and improvement in low-income countries (LIC). Clinical networks offer one means to advance methods for data collection and use, informing wider health system development in time, but are rare in LIC. We report baseline data from a new Clinical Information Network (CIN) in Kenya seeking to promote data-informed improvement and learning.
methodsData from 13 hospitals engaged in the Kenyan CIN between April 2014 and March 2015 were captured from medical and laboratory records. We use these data to characterise clinical care and outcomes of hospital admission.
resultsData were available for a total of 30 042 children aged between 2 months and 15 years. Malaria (in five hospitals), pneumonia and diarrhoea/dehydration (all hospitals) accounted for the majority of diagnoses and comorbidity was found in 17 710 (59%) patients. Overall, 1808 deaths (6%) occurred (range per hospital 2.5%-11.1%) with 1037 deaths (57.4%) occurring by day 2 of admission (range 41%-67.8%). While malaria investigations are commonly done, clinical health workers rarely investigate for other possible causes of fever, test for blood glucose in severe illness or ascertain HIV status of admissions. Adherence to clinical guideline-recommended treatment for malaria, pneumonia, meningitis and acute severe malnutrition varied widely across hospitals.
conclusionDeveloping clinical networks is feasible with appropriate support. Early data demonstrate that hospital mortality remains high in Kenya, that resources to investigate severe illness are limited, that care provided and outcomes vary widely and that adoption of effective interventions remains slow. Findings suggest considerable scope for improving care within and across sites.
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