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13 results on '"Pillay, Ashendri"'

2. Impact of age on antimicrobial prescriptions in hospitalized children at three academic centres in South Africa: a point prevalence survey.

Author

Pillay, Ashendri, Chetty, Terusha, Moore, David P, Waggie, Zainab, Nakwa, Firdose L, Kwawegen, Alison van, Thomas, Reenu, Karsas, Maria, Cloete, Jeané, Balakrishna, Yusentha, Reddy, Tarylee, Archary, Moherndran, Goga, Ameena, and Jeena, Prakash

Subjects
*HOSPITAL care of children, *NEWBORN infants, *ANTIMICROBIAL stewardship, *DRUG prescribing, *INFANTS
Abstract

Antimicrobial resistance is a global threat in children, and the emergence of multi-drug-resistant organisms is of concern. This secondary analysis of an antimicrobial point prevalence survey (PPS) in children evaluates the impact of age on antimicrobial use. The mean antimicrobial prescriptions were assessed in neonates, infants, young children (1–5 years), school-going children (6–12 years), and adolescents (13–15 years) from a cross-sectional PPS at three academic hospitals between September 2021 and January 2022. Primary and secondary diagnoses, antibiotic type (World Health Organization AWaRe and Anatomical Therapeutic Chemical classifications), and the incidence of healthcare-associated infections (HAI) were evaluated per age category. Multiple regression models were used to analyse age-related risk factors for HAI. The number of antimicrobials per child (1.7–1.9 per patient) was higher in neonates and infants compared to children 6–12 years old (1.4 per patient). Watch antibiotics, especially carbapenems, were commonly prescribed in neonates (32.5%) and infants (42.2%). Reserve antimicrobial use was notable in neonates (4.7%) and infants (4.1%). The incidence risk ratio (IRR) of HAI was higher in neonates and infants (IRR 2.13; 95% CI 1.23–3.70, IRR 2.20; 95% CI 1.40–3.45, respectively) compared to 6- to 12-year-olds. On multivariate analysis of participants according to age, being HIV infected, length of stay >6 days, high McCabe severity score, having surgery and receipt of blood transfusion were associated with an increased risk of HAI (P  < .001 for all) while on univariate analysis only, being premature and/or underweight was associated with an increased risk of HAI in infants (P  < .001 for both). Infants with risk factors for HAI significantly influenced antimicrobial prescribing, underscoring the necessity for tailored antimicrobial stewardship and enhanced surveillance. The increased use of Watch antibiotics, particularly carbapenems, in infants warrants closer scrutiny. Further research is required to identify inappropriate antimicrobial use in high-risk hospitalized young children. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Antibiotic and Antifungal use in Paediatric Departments at Three Academic Hospitals in South Africa

Author

Moore, David P, primary, Chetty, Terusha, additional, Pillay, Ashendri, additional, Karsas, Maria, additional, Cloete, Jeané, additional, Balakrishna, Yusentha, additional, Reddy, Tarylee, additional, Archary, Moherndran, additional, van Kwawegen, Alison, additional, Thomas, Reenu, additional, Nakwa, Firdose L, additional, Waggie, Zainab, additional, Magrath, Stephanie, additional, Goga, Ameena, additional, and Jeena, Prakash, additional

Published
2023
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9. CHEDIAK-HIGASHI SYNDROME: A NOVEL MUTATION.

Author

Buldeo, Suvarna, Pillay, Ashendri, Chateau, Antoinette, Dube-Pule, Anele, and Naicker, Thirona

Subjects
*CHEDIAK-Higashi syndrome, *GENETIC disorder diagnosis, *OPHTHALMOLOGY, *MEDICAL screening, *CLINICAL trials
Abstract

At the age of six weeks, a female patient whose family was known to our clinic presented for elective screening. The white cells on her peripheral smear showed giant inclusions and the ophthalmological examination revealed aplastic fovea with hypopigmented fundi. A clinical diagnosis of Chediak-Higashi syndrome was made. [ABSTRACT FROM AUTHOR]

Published
2024

10. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries.

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Centre de pathologie sexuelle masculine, UCL - (SLuc) Service d'endocrinologie et de nutrition, Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rabie, Helena, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Martyn-Dickens, Charles, Sylverken, Justice, Enimil, Anthony, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Sigwadhi, Lovemore Nyasha, Hermans, Michel, Otokoye, John Otshudiema, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Zumla, Alimuddin, Sewankambo, Nelson K, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Suleman, Fatima, Adejumo, Prisca, Noormahomed, Emilia V, Deckelbaum, Richard J, Fowler, Mary Glenn, Tshilolo, Léon, Smith, Gerald, Mills, Edward J, Umar, Lawal W, Siedner, Mark J, Kruger, Mariana, Rosenthal, Philip J, Mellors, John W, Mofenson, Lynne M, African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Centre de pathologie sexuelle masculine, UCL - (SLuc) Service d'endocrinologie et de nutrition, Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rabie, Helena, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Martyn-Dickens, Charles, Sylverken, Justice, Enimil, Anthony, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Sigwadhi, Lovemore Nyasha, Hermans, Michel, Otokoye, John Otshudiema, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Zumla, Alimuddin, Sewankambo, Nelson K, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Suleman, Fatima, Adejumo, Prisca, Noormahomed, Emilia V, Deckelbaum, Richard J, Fowler, Mary Glenn, Tshilolo, Léon, Smith, Gerald, Mills, Edward J, Umar, Lawal W, Siedner, Mark J, Kruger, Mariana, Rosenthal, Philip J, Mellors, John W, Mofenson, Lynne M, and African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents

Abstract

IMPORTANCE: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a retrospective record review of data from 25 hospitals in the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda from March 1 to December 31, 2020, and included 469 hospitalized patients aged 0 to 19 years with SARS-CoV-2 infection. EXPOSURES: Age, sex, preexisting comorbidities, and region of residence. MAIN OUTCOMES AND MEASURES: An ordinal primary outcome scale was used comprising 5 categories: (1) hospitalization without oxygen supplementation, (2) hospitalization with oxygen supplementation, (3) ICU admission, (4) invasive mechanical ventilation, and (5) death. The secondary outcome was length of hospital stay. RESULTS: Among 469 hospitalized children and adolescents, the median age was 5.9 years (IQR, 1.6-11.1 years); 245 patients (52.4%) were male, and 115 (24.5%) had comorbidities. A total of 39 patients (8.3%) were from central Africa, 172 (36.7%) from eastern Africa, 208 (44.3%) from southern Africa, and 50 (10.7%) from western Africa. Eighteen patients had suspected (n = 6) or confirmed (n = 12) multisystem inflammatory syndrome in children. Thirty-nine patients (8.3%) died, including 22 of 69 patients (31.9%) who required intensive care unit admission and 4 of 18 patients (22.2%) with suspected or confirmed multisystem inflammatory syndrome in children. Among 468 patients, 418 (89.3%) were discharged, and 16 (3.4%) remained hospitalized. The likelihood of outcomes with higher vs lower severity among children younger than 1 year expressed as adjusted odds ratio (aOR) was 4.89 (95% CI, 1.44-16.61) times higher than that of adolescents aged 15 to

Published
2022

11. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries

Author

Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rabie, Helena, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Martyn-Dickens, Charles, Sylverken, Justice, Enimil, Anthony, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Sigwadhi, Lovemore Nyasha, Hermans, Michel, Otokoye, John Otshudiema, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Zumla, Alimuddin, Sewankambo, Nelson K, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Suleman, Fatima, Adejumo, Prisca, Noormahomed, Emilia V, Deckelbaum, Richard J, Fowler, Mary Glenn, Tshilolo, Léon, Smith, Gerald, Mills, Edward J, Umar, Lawal W, Siedner, Mark J, Kruger, Mariana, Rosenthal, Philip J, Mellors, John W, Mofenson, Lynne M, African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Centre de pathologie sexuelle masculine, and UCL - (SLuc) Service d'endocrinologie et de nutrition

Subjects
Male, Adolescent, SARS-CoV-2, Pneumonia, Viral, Oxygen Inhalation Therapy, COVID-19, Infant, Length of Stay, Respiration, Artificial, Child, Preschool, Pediatrics, Perinatology and Child Health, Outcome Assessment, Health Care, Humans, Female, Child, Child, Hospitalized, Pandemics, Africa South of the Sahara
Abstract

IMPORTANCE: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a retrospective record review of data from 25 hospitals in the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda from March 1 to December 31, 2020, and included 469 hospitalized patients aged 0 to 19 years with SARS-CoV-2 infection. EXPOSURES: Age, sex, preexisting comorbidities, and region of residence. MAIN OUTCOMES AND MEASURES: An ordinal primary outcome scale was used comprising 5 categories: (1) hospitalization without oxygen supplementation, (2) hospitalization with oxygen supplementation, (3) ICU admission, (4) invasive mechanical ventilation, and (5) death. The secondary outcome was length of hospital stay. RESULTS: Among 469 hospitalized children and adolescents, the median age was 5.9 years (IQR, 1.6-11.1 years); 245 patients (52.4%) were male, and 115 (24.5%) had comorbidities. A total of 39 patients (8.3%) were from central Africa, 172 (36.7%) from eastern Africa, 208 (44.3%) from southern Africa, and 50 (10.7%) from western Africa. Eighteen patients had suspected (n = 6) or confirmed (n = 12) multisystem inflammatory syndrome in children. Thirty-nine patients (8.3%) died, including 22 of 69 patients (31.9%) who required intensive care unit admission and 4 of 18 patients (22.2%) with suspected or confirmed multisystem inflammatory syndrome in children. Among 468 patients, 418 (89.3%) were discharged, and 16 (3.4%) remained hospitalized. The likelihood of outcomes with higher vs lower severity among children younger than 1 year expressed as adjusted odds ratio (aOR) was 4.89 (95% CI, 1.44-16.61) times higher than that of adolescents aged 15 to 19 years. The presence of hypertension (aOR, 5.91; 95% CI, 1.89-18.50), chronic lung disease (aOR, 2.97; 95% CI, 1.65-5.37), or a hematological disorder (aOR, 3.10; 95% CI, 1.04-9.24) was associated with severe outcomes. Age younger than 1 year (adjusted subdistribution hazard ratio [asHR], 0.48; 95% CI, 0.27-0.87), the presence of 1 comorbidity (asHR, 0.54; 95% CI, 0.40-0.72), and the presence of 2 or more comorbidities (asHR, 0.26; 95% CI, 0.18-0.38) were associated with reduced rates of hospital discharge. CONCLUSIONS AND RELEVANCE: In this cohort study of children and adolescents hospitalized with COVID-19 in sub-Saharan Africa, high rates of morbidity and mortality were observed among infants and patients with noncommunicable disease comorbidities, suggesting that COVID-19 vaccination and therapeutic interventions are needed for young populations in this region.

Published
2022

13. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries.

Author

Nachega, Jean B., Sam-Agudu, Nadia A., Machekano, Rhoderick N., Rabie, Helena, van der Zalm, Marieke M., Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B., Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W., Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, and Agbeno, Evans K.

Published
2022
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