Stool Xpert had similar performance compared with sputum/gastric aspirate Xpert to detect TB. Urine LAM had lower sensitivity and specificity, but increased among children with severe immunosuppression. Stool Xpert and urine LAM can aid rapid detection of TB in HIV-infected children using easily accessible samples.

Background:The blood monocyte-to-lymphocyte ratio (MLR) is associated with active tuberculosis (TB) in adults, but has not been evaluated as a TB diagnostic biomarker in HIVinfected children in whom respiratory sampling is difficult. Setting:In a cohort of HIV-infected hospitalized Kenyan children initiating antiretroviral therapy, absolute monocyte and lymphocyte counts were determined at enrollment and 4, 12, and 24 weeks thereafter.Methods: Children were classified as confirmed, unconfirmed, or unlikely pulmonary TB. ROC curves of MLR cutoff values were generated to distinguish children with confirmed TB from those with unconfirmed and unlikely TB. General estimating equations were used to estimate change in MLR over time by TB status.Results: Of 160 children with median age 23 months, 13 (8.1%) had confirmed TB and 67 (41.9%) had unconfirmed TB. Median MLR among children with confirmed TB [0.407

NCT02063880.

The study sought to establish the relationship between monitoring and evaluation practices and performance of County Maternal Health programmes in Kenya. The combined monitoring and evaluation practices included planning for M&E, stakeholder engagement, capacity building for M&E, and M&E data use. The study adopted a descriptive survey research design. To obtain 282 respondents, stratified random sampling was used. A self-administered structured questionnaire was the study's research instrument. Using descriptive narratives, qualitative data was analyzed within specific themes. Quantitative data was analyzed descriptively using measures of central tendencies and measures of dispersion. Regression was conducted for testing the study hypotheses. Data was presented using frequency tables. The study found that stakeholders’ engagement in M&E and capacity building for M&E influenced the performance of County Maternal Health Programmes in Kenya. The study also found that the respondents agreed that planning for M&E and the data management for M&E. This implied that the combined monitoring and evaluation practices influence performance of County Maternal Health Programmes in Kenya.The study found a strong correlation between the performance of county maternal health programmes and combined monitoring and evaluation practices. The study concluded that combined planning for M&E monitoring and evaluation practices influenced the performance of county maternal health programmes. The study suggests that management develop an effective methodology as well as raise awareness of M&E activities for the success of the project. The study also suggests that human resources issues such as workers charged with monitoring and evaluation ought to have technical capabilities, and roles and duties of monitoring and evaluation personnel should be outlined at the start of projects. To ensure M&E sustainability health sector reforms, investments in strong and vibrant technical harmonization platforms that can sustain the change agenda at all times and every required level.

Effective monitoring and evaluation practices is widely known to help improve performance, the quality and effectiveness of planning and decision making and achievement of results. This is because monitoring focuses on the implementation process and progress towards the achievement of project objectives. Despite the Kenya Government’s effort to promote County Maternal Health programmes through legal frameworks such as the county integrated monitoring and evaluation practices tool, and while there is empirical evidence that monitoring and evaluation practices contributes to enhanced performance, actual performance of county health sector across Kenya remains poor. The purpose of the study was to establish moderating influence of contextual determinants on the relationship between monitoring and evaluation practices and performance of County Maternal Health programmes in Kenya. The paradigm that is suitable for this study is pragmatism. The study adopted a descriptive survey research design. The study targeted 8 regional blocks in Kenya (Central,, Western Coast, Eastern, Rift Valley, North Eastern, Nyanza, Nairobi) where one county from each block was selected. From these counties the target population was 1165 respondents including Medical officers, Clinical Officers, Trained Community health workers, Nurses, County Health Management Team and County Delivery Unit officers from level 4 and 5 hospitals. Sampling procedure for this study was guided by the research design which is descriptive survey design. Stratified random sampling was used to obtain 282 respondents from which information was obtained for this study. The research instruments that were used for data collection are: a self-administered structured questionnaire and interview guides. Descriptive and inferential data analysis techniques were used in this study. Regression was conducted for testing the study hypothesis. The research established that there was a strong correlation between the performance of county maternal health programmes and contextual determinants (r=0.638, p=0.000<0.05). The study found that after introduction of contextual determinants into the relationship, and the interaction term in model 2 increased the R square by 0.08. This implies that the interaction between contextual determinants and monitoring and evaluation practices explains 8.0% variations in performance of county maternal health programmes. The study concluded that contextual determinants significantly moderate the relationship between monitoring and evaluation practices and performance of County Maternal Health Programmes in Kenya. The study recommends investing in robust and dynamic technical coordination platforms that can sustain the agenda for change. and at all levels is necessary to ensure the sustainability of M&E reforms in the health sector.