Safe care from start: Why better diagnostics can save lives

Christine Muchira
5 Min Read
Picture courtesy of Unsplash
Highlights
  • Only 40% of patients had cultures requested, leaving most infections treated without pathogen identification.
  • 86% of cultures showed no bacterial growth linked to prior antibiotic use, poor sampling, and delays.
  • Rising resistance: Widespread multidrug-resistant organisms (MDROs) threaten standard treatment effectiveness.

Kenya joins the world in marking the World Patient Safety Day Wednesday with a new research highlighting urgent threat to child health due to the underuse of diagnostics and alarming levels of antimicrobial resistance (AMR) among hospitalized children.

This year’s World Patient Safety Day, observed on 17 September under the theme “Safe care for every newborn and every child” with the slogan “Patient safety from the start!”, comes at a critical time. A new study highlights just how urgent the situation is.

In the new research experts noted that safe care starts with strong diagnostics.

Every child deserves safe, effective care from the moment they fall sick, yet in many hospitals across sub-Saharan Africa, experts say treatment often begins before infections are properly diagnosed using laboratory tools.

The result? Antibiotics are given indiscriminately, infections go undetected, and antibiotic resistance spreads at alarming rates.

 The World Health Organization has set ambitious targets to reduce deaths linked to resistant infections and ensure that antibiotics remain available for use by those who truly need them. These goals cannot be met without reliable diagnostics. As Dr. Veronicah Chuchu notes: Safe care starts with strong diagnostics; without them, children’s lives hang in the balance.”

Researchers reviewed medical records of 1,608 children admitted with suspected infections between 2017 and 2021 in a referral hospital in Kenya.

They analyzed infection patterns, the use of diagnostic tools, and antibiotic resistance. The findings were sobering: Gastroenteritis, bacterial pneumonia, and sepsis were among the most common infections, echoing global evidence that these are the leading causes of child illness and death, especially in under-immunized and malnourished populations.

According to the researchers only 4 in 10 children had cultures requested, of those just 17pc received full antibiotic sensitivity testing the gold standard for guiding treatment.

The study shows that more than 70pc of tested samples had bacteria resistant to multiple antibiotics, and nearly 30pc were extensively drug-resistant, leaving doctors with few treatment options.

Children under five years and those with repeat admissions were the most vulnerable.

One particularly worrying finding was that 86pc of the samples showed no bacteria at all.

This can happen when children are given antibiotics at home or at another facility before admission; when samples are too little, poorly collected, or contaminated; or when delays in transport cause bacteria to die before testing. In the absence of reliable results, doctors often rely on broad “catch-all” antibiotics. While sometimes life-saving, this approach drives resistance, prolongs hospital stays, increases costs, and tragically, can still end in death.

According to Dr. Chuchu, the lead author of the study, these challenges are not unique to Kenya. Across many low- and middle-income countries,, diagnostic services remain weak due to shortages of trained staff, laboratory supplies, and functional equipment.

Fewer laboratories are able to perform even basic bacterial culture tests. “When children are treated without knowing the exact cause of their illness, their safety is compromised from the very start.” Dr. Chuchu, the lead author of the study stresses.

What must change?

According to the study authors, we must first scale up diagnostic capacity so that every child with an infection has access to cultures and sensitivity testing. Second, we need to strengthen laboratories by investing in infrastructure, skilled personnel, and timely reporting systems. Third, health facilities must make laboratory testing central to treatment decisions rather than defaulting to experience based therapy.

“On this World Patient Safety Day, let us commit to ensuring that every child in Kenya, and across Africa, receives safe care from the start,” Dr. Chuchu concludes. “That means building stronger laboratories, training health workers, and making diagnostics as essential as stethoscopes. Only then can we protect children’s health, preserve the power of antibiotics, and save lives.” Authors highlight.

This research was conducted by the Washington State University Global Health Kenya and Center for Epidemiological Modelling and Analysis (CEMA) at the University of Nairobi, funded by the Fogarty International Center and the National Institute of Allergy and Infectious Diseases of the U.S. National Institutes of Health, and supported by the Paul G. Allen School for Global Health at Washington State University.

 

Also read https://www.kbc.co.ke/70-of-common-bacteria-in-kenya-now-resistant-to-antibiotics-experts-warn/

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