IntroductionMotorcycle users involved in crashes are likely to die or be severely injured due to high frequency of head, chest and leg injuries. We carried out a descriptive cross sectional study to determine crash characteristics and injury patterns among motorcycle users attending Kitale district hospital, Kenya.MethodsMotorcycle trauma patients were recruited between 1st August 2013 and 31stOctober 2013. Data collection was done using a pre-tested, coded questionnaire. Frequencies mean (SD) and chi-square was employed in the analysis. Analysis was done using SPSS V.20. Results were considered significant at α = 0.05.ResultsMotorcycle trauma patients formed 39.4% of all road traffic injuries. Males constituted 69.8%, females 30.2% and mean age was 30(±13) years. Riders accounted for majority of injury patients (45%), passengers (38.8%) and pedestrians (15.9%). Mechanism of motorcycle crash was involving motorcycle versus vehicle (45.6%). Riders suffered severe injuries compared to passengers (χ2=129.936, p < 0.001). Head injury patients were assessed as having Glasgow coma scale (GCS) of 70% 9-12, 26% GCS of 13-15 and 7% GCS of 3-8. Injuries sustained by victims included head and neck injury 40%, lower extremity injury 39.9% and chest injury 8.2%. Riders without helmets during the crash sustained head injuries (χ2=111.352, p < 0.001).ConclusionHead injuries and lower extremity injuries accounted for the major proportion of injuries sustained by motorcycle users. Non helmet use was associated with increased risk of head injuries. Morbidity can be mitigated by encouraging use of protective gear like helmets.

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BackgroundMore efforts have been put in place to increase full immunization coverage rates in the last decade. Little is known about the levels and consequences of delaying or vaccinating children in different schedules. Vaccine effectiveness depends on the timing of its administration, and it is not optimal if given early, delayed or not given as recommended. Evidence of non-specific effects of vaccines is well documented and could be linked to timing and sequencing of immunization. This paper documents the levels of coverage, timing and sequencing of routine childhood vaccines.MethodsThe study was conducted between 2007 and 2014 in two informal urban settlements in Nairobi. A total of 3856 children, aged 12–23 months and having a vaccination card seen were included in analysis. Vaccination dates recorded from the cards seen were used to define full immunization coverage, timeliness and sequencing. Proportions, medians and Kaplan-Meier curves were used to assess and describe the levels of full immunization coverage, vaccination delays and sequencing.ResultsThe findings indicate that 67 % of the children were fully immunized by 12 months of age. Missing measles and third doses of polio and pentavalent vaccine were the main reason for not being fully immunized. Delays were highest for third doses of polio and pentavalent and measles. About 22 % of fully immunized children had vaccines in an out-of-sequence manner with 18 % not receiving pentavalent together with polio vaccine as recommended.ConclusionsResults show higher levels of missed opportunities and low coverage of routine childhood vaccinations given at later ages. New strategies are needed to enable health care providers and parents/guardians to work together to increase the levels of completion of all required vaccinations. In particular, more focus is needed on vaccines given in multiple doses (polio, pentavalent and pneumococcal conjugate vaccines).Electronic supplementary materialThe online version of this article (doi:10.1186/s41182-016-0013-x) contains supplementary material, which is available to authorized users.

Background/Aim: In 2005, the sub-county health management team identified a need for information to reduce the lack of skilled attendance at birth. This study assesses the determinants of birth preparedness among women who had given birth in the last 2 years in Tharaka Nithi County, Kenya. Methods: Stratified sampling was used to select 345 pregnant women for interview. Systematic sampling was used so that every 14th client attending a maternal/child health clinic in the sampled facilities was interviewed. A descriptive cross-sectional survey design was used. A chi-squared test and logistic regression were used to analyse the data. Results: Approximately 20% of the interviewed sample were prepared for birth on all six recommended aspects of birth preparedness. The most planned for aspect of birth was hospital birth expenses (74%), followed by place of birth (69%). The least prepared for aspect was transport to a health facility (35%). Conclusions: Higher level of education, higher income, salaried occupation and at least four antenatal care visits all increased the likelihood of being more prepared for birth. A history of stillbirth reduced the likelihood of birth preparedness. It is recommended that the Kenya Ministry of Health improve levels of birth preparedness through the provision of antenatal care.

BackgroundThe World Health Organization recommends Bacillus Calmette-Guérin (BCG) vaccination against tuberculosis be given at birth. However, in many developing countries, pre-term and low birth weight infants get vaccinated only after they gain the desired weight. In Kenya, the ministry of health recommends pre-term and low birth weight infants to be immunized at the time of discharge from hospital irrespective of their weight. This paper seeks to understand the effects of birth weight on timing of BCG vaccine.MethodsThe study was conducted in two Nairobi urban informal settlements, Korogocho and Viwandani which hosts the Nairobi Urban Health and Demographic Surveillance system. All infants born in the study area since September 2006 were included in the study. Data on immunization history and birth weight of the infant were recorded from child’s clinic card. Follow up visits were done every four months to update immunization status of the child. A total of 3,602 infants were included in this analysis. Log normal accelerated failure time parametric model was used to assess the association between low birth weight infants and time to BCG immunization.ResultsIn total, 229 (6.4%) infants were low birth weight. About 16.6% of the low birth weight infants weighed less than 2000 grams and 83.4% weighed between 2000 and 2490 grams. Results showed that, 60% of the low birth weight infants received BCG vaccine after more than five weeks of life. Private health facilities were less likely to administer a BCG vaccine on time compared to public health facilities. The effects of low birth weight on females was 0.60 and 0.97-times that of males for infants weighing 2000–2499 grams and for infants weighing <2000 grams respectively. The effect of low birth weight among infants born in public health facilities was 1.52 and 3.94-times that of infants delivered in private health facilities for infants weighing 2000–2499 grams and those weighing < 2000 grams respectively.ConclusionLow birth weight infants received BCG immunization late compared to normal birth weight infants. Low birth weight infants delivered in public health facilities were more likely to be immunized much later compared to private health facilities.