Abstract
Purpose
To assess the neonatal referral and transport system for gastroschisis patients referred to a tertiary level hospital in Kenya.
Methods
This was a prospective cross-sectional study carried out at Kenyatta National Hospital (KNH) which recruited patients with gastroschisis using consecutive sampling approach. Data were collected on pre-, intra-transit factors, time and distance covered. Assessment was done using pre and intra transit factors as per the standard transport protocols in literature.
Results
Twenty-nine patients presented with gastroschisis during the eight month study period. Mean age was 7.07 h. There were 16 (55.2%) males and 13 (44.8%) females. Mean birthweight was 2020 g, and a mean gestational age of 36.5 weeks. Mean duration of transit was 5 h. Mean distance from referring facility was 153.1 km.
Most affected factors in the pre-transit protocol were lack of monitoring chart (0%), comment on blood investigations (0%), gastric decompression (3.4%), and prenatal obstetric scan (44.8%).
For intra-transit scores, most affected were incubator use (0%), bowel monitoring (0%), functioning nasogastric tube (13.8%), and adequate bowel cover (34.5%).
Conclusion
This study demonstrates that pre-transit and transit care of neonates with gastroschisis is inadequate in Kenya. Interventions needed, as identified by this study, to promote care of neonates with gastroschisis are advised.
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Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on request.
Abbreviations
- BP:
-
Blood pressure
- CRT:
-
Capillary refill time
- HR:
-
Heart rate
- KNH:
-
Kenyatta national hospital
- PSU:
-
Paediatric surgical unit
- NGT:
-
Nasogastric tube
- RBS:
-
Random blood sugar
- RR:
-
Respiratory rate
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Acknowledgements
We would like to acknowledge the Department of Surgery, University of Nairobi, and the Department of Specialized Surgery, Kenyatta National Hospital.
Funding
No funding was received for conducting this study.
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Contributions
TJ and FO contributed to the study conception and design. The literature search and data analysis were performed by HG. The manuscript was written by HG. TJ, FO and DK critically revised the work. All authors read and approved the final manuscript.
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The authors declare no competing interests.
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The authors have no competing interests to declare that are relevant to the content of this article.
Ethical approval
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University of Nairobi/KNH (Date 25th September 2021/No. P635/07/2021).
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Gohil, H.R., Jumbi, T.M., Kuria, D.K. et al. Assessment of the neonatal referral and transport system for patients with gastroschisis in Kenya. Pediatr Surg Int 39, 130 (2023). https://doi.org/10.1007/s00383-023-05386-1
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DOI: https://doi.org/10.1007/s00383-023-05386-1