Publications
258 results found
Nokes TN, 2008, Incidence and clinical characteristics of group a rotavirus infections among children admitted to hospital in Kilifi, Kenya, PLoS Medicine, Vol: 5, Pages: 1154-1162
Heikens A, 2008, Case management of HIV-infected severely malnourished children: challenges in the area of highest prevalence, The Lancet, Vol: 371, Pages: 1305-1307
Akech K, 2008, Survival and haematological recovery of children with severe malaria transfused in accordance to WHO guidelines in Kilifi, Kenya, Malaria Journal, Vol: 7
Hassall I, Ngina L, Kongo W, et al., 2007, The acceptability to women in Mombasa, Kenya, of the donation and transfusion of umbilical cord blood for severe anaemia in young children, Vox Sanguinis, Vol: 94, Pages: 125-131, ISSN: 1423-0410
Background and Objectives Severe anaemia, for which a blood transfusion can belife saving, is common in hospitalized children in sub-Saharan Africa but blood fortransfusion is often in short supply. Umbilical cord blood is usually thrown away butcould be a useful source of red cells for small volume transfusions in young childrenin this setting. The objective of this study was to evaluate the attitudes of womenusing the maternity services of the provincial hospital in Mombasa, Kenya, towardscord blood donation and transfusion, and essential aspects of this process includinginformed consent and the acceptability of screening for human immunodeficiencyvirus (HIV) infection.Materials and Methods A structured questionnaire was developed based on dataprovided by focus group discussions with women attending the hospital’smaternity unit and administered to women who had recently delivered at thehospital.Results Of the 180 women who completed a questionnaire, the donation and transfusionof cord blood were acceptable to 81% and 78%, respectively. Ninety per centof women who supported cord blood donation were willing to undergo further HIVtesting at the time of delivery. Seventy-seven per cent of women wanted informedconsent to be sought for cord blood donation and 66% of these felt they could makethis decision alone.Conclusion The donation of umbilical cord blood and its transfusion are acceptableto the majority of women delivering at Coast Provincial General Hospital, Mombasa.Findings from the study will benefit the planned cord blood donation programme atthis facility
Khor AVS, 2007, A Mal functional variant is associated with protection against invasive pneumococcal disease, bacteremia, malaria and tuberculosis, Nature Genetics, Vol: 39, Pages: 523-528
Maitland CRJC, 2007, Phase III trials required to resolve clinical equipoise over optimal fluid management in children with severe malaria, PLoS Clinical Trials, Vol: 2
Idro M, 2007, Burden, features, and outcome of neurological involvement in acute falciparum malaria in Kenyan children, Journal of the American Medical Association, Vol: 297, Pages: 2232-2240
Seaton AH, 2007, Population pharmacokinetics of a single daily intramuscular dose of gentamicin in children with severe malnutrition, Journal of Antimicrobial Chemotherapy, Vol: 59, Pages: 681-689
Bejon K, 2007, Defining Childhood severe falciparum malaria for intervention studies, PLoS Medicine, Vol: 4, Pages: 1333-1340
Khor AVS, 2007, Positive replication and linkage disequilibrium mapping of the chromosome 21q22.1 malaria susceptibility locus, Genes and Immunity, Vol: 8, Pages: 570-576
Maitland K, Berkley JA, Shebbe M, et al., 2006, Children with severe malnutrition: Can those at highest risk of death be identified with the WHO protocol?, PLOS MEDICINE, Vol: 3, Pages: 2431-2439, ISSN: 1549-1277
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- Citations: 125
Akech S, Gwer S, Idro R, et al., 2006, Correction: Volume Expansion with Albumin Compared to Gelofusine in Children with Severe Malaria: Results of a Controlled Trial, PLoS Clinical Trials, Vol: 1, Pages: e37-e37
Maitland K, Akech S, Gwer S, et al., 2006, Very low mortality associated with albumin infusion in Kenyan children with severe malaria, AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, Vol: 75, Pages: 99-99, ISSN: 0002-9637
Akech S, Gwer S, Idro R, et al., 2006, Volume Expansion with Albumin Compared to Gelofusine in Children with Severe Malaria: Results of a Controlled Trial, PLOS Clinical Trials, Vol: 1, ISSN: 1555-5887
OBJECTIVES: Previous studies have shown that in children with severe malaria, resuscitation with albumin infusion results in a lower mortality than resuscitation with saline infusion. Whether the apparent benefit of albumin is due solely to its colloidal properties, and thus might also be achieved with other synthetic colloids, or due to the many other unique physiological properties of albumin is unknown. As albumin is costly and not readily available in Africa, examination of more affordable colloids is warranted. In order to inform the design of definitive phase III trials we compared volume expansion with Gelofusine (succinylated modified fluid gelatin 4% intravenous infusion) with albumin. DESIGN: This study was a phase II safety and efficacy study. SETTING: The study was conducted at Kilifi District Hospital, Kenya. PARTICIPANTS: The participants were children admitted with severe falciparum malaria (impaired consciousness or deep breathing), metabolic acidosis (base deficit > 8 mmol/l), and clinical features of shock. INTERVENTIONS: The interventions were volume resuscitation with either 4.5% human albumin solution or Gelofusine. OUTCOME MEASURES: Primary endpoints were the resolution of shock and acidosis; secondary endpoints were in-hospital mortality and adverse events including neurological sequelae. RESULTS: A total of 88 children were enrolled: 44 received Gelofusine and 44 received albumin. There was no significant difference in the resolution of shock or acidosis between the groups. Whilst no participant developed pulmonary oedema or fluid overload, fatal neurological events were more common in the group receiving gelatin-based intervention fluids. Mortality was lower in patients receiving albumin (1/44; 2.3%) than in those treated with Gelofusine (7/44; 16%) by intention to treat (Fisher's exact test, p = 0.06), or 1/40 (2.5%) and 4/40 (10%), respectively, for those treated per protocol (p = 0.36). Meta-analysis of published trials to provide a su
Maitland K, 2006, How do we treat children with severe malaria?, HOT TOPICS IN INFECTION AND IMMUNITY IN CHILDREN III, Vol: 582, Pages: 9-21, ISSN: 0065-2598
Bates K, 2006, Are laboratory services coming of age in sub-Saharan Africa?, Clinical Infectious Diseases, Vol: 42, Pages: 383-384
Maitland K, 2006, Severe malaria: lessons learned from the management of critical illness in children, Trends in Parasitology, Vol: 22, Pages: 457-462
Casals-Pascual DJ, 2006, Lactate levels in severe malarial anaemia are associated with haemozoin-containing neutrophils and low levels of IL-12, Malaria Journal, Vol: 5
Casals-Pascual DJ, 2006, Suppression of erythropoiesis in malarial anemia is associated with hemozoin in vitro and in vivo, Blood, Vol: 108, Pages: 2569-2577
Idro K, 2006, Research priorities in the management of severe Plasmodium falciparum malaria in children, Annals of Tropical Medicine and Parasitology, Vol: 100, Pages: 95-108
Idro R, Otieno G, White S, et al., 2005, Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria, MALARIA JOURNAL, Vol: 4
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- Citations: 21
Molyneux EM, Maitland K, 2005, Intravenous fluids--getting the balance right., N Engl J Med, Vol: 353, Pages: 941-944
Maitland K, Nadel S, Pollard AJ, et al., 2005, Management of severe malaria in children: proposed guidelines for the United Kingdom, British Medical Journal, Vol: 331, Pages: 337-343, ISSN: 0959-8146
Berkley J, Mwangi I, Griffiths K, et al., 2005, Assessment of severe malnutrition among hospitalized children in rural Kenya: comparison of weight for height and mid upper arm circumference, JAMA, Vol: 294, Pages: 591-597, ISSN: 0098-7484
Williams TN, Wambua S, Uyoga S, et al., 2005, Both heterozygous and homozygous alpha+ thalassemias protect against severe and fatal Plasmodium falciparum malaria on the coast of Kenya, Blood, Vol: 106, Pages: 368-371, ISSN: 0006-4971
Berkley JA, Maitland K, Mwangi I, et al., 2005, Use of clinical syndromes to target antibiotic prescribing in seriously ill children in malaria endemic area: observational study., BMJ, Vol: 330
OBJECTIVES: To determine how well antibiotic treatment is targeted by simple clinical syndromes and to what extent drug resistance threatens affordable antibiotics. DESIGN: Observational study involving a priori definition of a hierarchy of syndromic indications for antibiotic therapy derived from World Health Organization integrated management of childhood illness and inpatient guidelines and application of these rules to a prospectively collected dataset. SETTING: Kilifi District Hospital, Kenya. PARTICIPANTS: 11,847 acute paediatric admissions. MAIN OUTCOME MEASURES: Presence of invasive bacterial infection (bacteraemia or meningitis) or Plasmodium falciparum parasitaemia; antimicrobial sensitivities of isolated bacteria. RESULTS: 6254 (53%) admissions met criteria for syndromes requiring antibiotics (sick young infants; meningitis/encephalopathy; severe malnutrition; very severe, severe, or mild pneumonia; skin or soft tissue infection): 672 (11%) had an invasive bacterial infection (80% of all invasive bacterial infections identified), and 753 (12%) died (93% of all inpatient deaths). Among P falciparum infected children with a syndromic indication for parenteral antibiotics, an invasive bacterial infection was detected in 4.0-8.8%. For the syndrome of meningitis/encephalopathy, 96/123 (76%) isolates were fully sensitive in vitro to penicillin or chloramphenicol. CONCLUSIONS: Simple clinical syndromes effectively target children admitted with invasive bacterial infection and those at risk of death. Malaria parasitaemia does not justify withholding empirical parenteral antibiotics. Lumbar puncture is critical to the rational use of antibiotics.
Maitland K, Pamba A, English M, et al., 2005, Pre-transfusion management of children with severe malarial anaemia: a randomised controlled trial of intravascular volume expansion., Br J Haematol, Vol: 128, Pages: 393-400, ISSN: 0007-1048
Symptomatic severe malarial anaemia (SMA) has a high fatality rate of 30-40%; most deaths occur in children awaiting blood transfusion. Blood transfusion services in most of Africa are not capable of delivering adequate supplies of safe blood in a timely manner to critically ill children with SMA. Contrary to widely held belief, hypovolaemia, rather than heart failure, has emerged as a common complication in such children. We examined the safety of pre-transfusion management (PTM) by volume expansion, aimed at stabilizing children and obviating the urgency for blood transfusion. Kenyan children with severe falciparum anaemia (haemoglobin <5 g/dl) and respiratory distress were randomly assigned to 20 ml/kg of 4.5% albumin or 0.9% saline or maintenance only (control) while awaiting blood transfusion. PTM was apparently safe since it did not lead to the development of pulmonary oedema or other adverse events. There was no significant difference in the primary outcome [mean percentage reduction in base excess between admission and 8 h (95% confidence interval)] between the control group 42% (19-66%) albumin group 44% (32-57%) and saline group 36% (16-57%); adjusted analysis of variance F=0.31, P=0.7. However, the number of children requiring emergency interventions was significantly greater in the control group, four of 18 (22%) than the saline group 0 of 20 (P=0.03). We have established the safety of this PTM in children with SMA whilst awaiting blood transfusion at a hospital with an adequate blood-banking program. The impact on mortality should be assessed where blood transfusion services are unable to supply emergency transfusions.
Maitland K, Newton C, Marsh K, et al., 2005, Volume status in severe malaria: no evidence provided for the degree of filling of the intravascular compartment., PLoS Med, Vol: 2
Maitland K, Wills B, 2005, Tropical infections: malaria and dengue. In Infectious Diseases in the Pediatric Intensive Care Unit, Infectious Diseases in the Pediatric Intensive Care
Eziefula A, Mwakisha N, Macharia A, et al., 2005, Correlates of red blood cell deformability (RCD) with adverse outcome in severe falciparum malaria: The effect of sequestered parasitized red cells [MIM-AE-70550], ACTA TROPICA, Vol: 95, Pages: S384-S385, ISSN: 0001-706X
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