Paediatric anaemia in rural Kenya and the role of travel time to emergency care services
BackgroundAccess to emergency care (EC) services is crucial for severe anaemia outcome. Limited information exists on the association between travel times to EC services and the presentation and severity of anaemia upon hospital admission. Here, we investigate the association between travel time and...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Epidemiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fepid.2025.1578522/full |
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| author | Moses M. Musau Moses M. Musau Cynthia Khazenzi Samuel Akech Evans Omondi Evans Omondi Emelda A. Okiro Emelda A. Okiro Robert W. Snow Robert W. Snow Peter M. Macharia Peter M. Macharia Alice Kamau Alice Kamau |
| author_facet | Moses M. Musau Moses M. Musau Cynthia Khazenzi Samuel Akech Evans Omondi Evans Omondi Emelda A. Okiro Emelda A. Okiro Robert W. Snow Robert W. Snow Peter M. Macharia Peter M. Macharia Alice Kamau Alice Kamau |
| author_sort | Moses M. Musau |
| collection | DOAJ |
| description | BackgroundAccess to emergency care (EC) services is crucial for severe anaemia outcome. Limited information exists on the association between travel times to EC services and the presentation and severity of anaemia upon hospital admission. Here, we investigate the association between travel time and presentation of severe anaemia (compared to mild/moderate anaemia) at admission in western Kenya.MethodsData from January 2020 to July 2023 from Busia County Referral Hospital were assembled for paediatric admissions aged 1–59 months residing in Busia County. Travel time from a patient's village to the hospital was calculated using a least cost path algorithm. Anaemia severity was categorised as mild (Hb ≥ 7–<10 g dl−1), moderate (Hb ≥ 5–<7 g dl−1) and severe (Hb < 5 g dl−1). We fitted a geostatistical model accounting for covariates to estimate the association between travel times to EC services and severe anaemia presentation.ResultsSevere anaemia admissions had the highest median travel time of 36 min (IQR: 25,54) (p-value: <0.001). Compared to children living within a 30 min travel time to the hospital, the adjusted odds ratio (AOR) of severe anaemia presentation relative to mild/moderate anaemia was 2.44 (95% CI: 1.63–3.55) for those residing within 30-59 min. For travel times of 60–89 min, the AOR was 3.55 (95% CI: 1.86–6.10) and for ≥90 min, the AOR was 3.41 (95% CI: 1.49–7.67).ConclusionTravel time is significantly associated with the severity of paediatric anaemia presentations at hospitals. Addressing disparities in travel times such as strategic bolstering of lower-level facilities to offer EC services, is crucial for implementing new interventions and optimizing existing hospital-linked interventions to enhance healthcare delivery. |
| format | Article |
| id | doaj-art-cd7a3b0ab5024864a28b403fe2d8ad09 |
| institution | Kabale University |
| issn | 2674-1199 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Epidemiology |
| spelling | doaj-art-cd7a3b0ab5024864a28b403fe2d8ad092025-08-20T03:49:45ZengFrontiers Media S.A.Frontiers in Epidemiology2674-11992025-05-01510.3389/fepid.2025.15785221578522Paediatric anaemia in rural Kenya and the role of travel time to emergency care servicesMoses M. Musau0Moses M. Musau1Cynthia Khazenzi2Samuel Akech3Evans Omondi4Evans Omondi5Emelda A. Okiro6Emelda A. Okiro7Robert W. Snow8Robert W. Snow9Peter M. Macharia10Peter M. Macharia11Alice Kamau12Alice Kamau13Epidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)—Wellcome Trust Research Programme, Nairobi, KenyaInstitute of Mathematical Sciences, Strathmore University, Nairobi, KenyaEpidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)—Wellcome Trust Research Programme, Nairobi, KenyaEpidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)—Wellcome Trust Research Programme, Nairobi, KenyaInstitute of Mathematical Sciences, Strathmore University, Nairobi, KenyaAfrican Population and Health Research Center, Nairobi, KenyaEpidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)—Wellcome Trust Research Programme, Nairobi, KenyaCentre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United KingdomEpidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)—Wellcome Trust Research Programme, Nairobi, KenyaCentre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United KingdomEpidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)—Wellcome Trust Research Programme, Nairobi, KenyaDepartment of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, BelgiumEpidemiology and Demography Department, Kenya Medical Research Institute (KEMRI)—Wellcome Trust Research Programme, Nairobi, KenyaDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United KingdomBackgroundAccess to emergency care (EC) services is crucial for severe anaemia outcome. Limited information exists on the association between travel times to EC services and the presentation and severity of anaemia upon hospital admission. Here, we investigate the association between travel time and presentation of severe anaemia (compared to mild/moderate anaemia) at admission in western Kenya.MethodsData from January 2020 to July 2023 from Busia County Referral Hospital were assembled for paediatric admissions aged 1–59 months residing in Busia County. Travel time from a patient's village to the hospital was calculated using a least cost path algorithm. Anaemia severity was categorised as mild (Hb ≥ 7–<10 g dl−1), moderate (Hb ≥ 5–<7 g dl−1) and severe (Hb < 5 g dl−1). We fitted a geostatistical model accounting for covariates to estimate the association between travel times to EC services and severe anaemia presentation.ResultsSevere anaemia admissions had the highest median travel time of 36 min (IQR: 25,54) (p-value: <0.001). Compared to children living within a 30 min travel time to the hospital, the adjusted odds ratio (AOR) of severe anaemia presentation relative to mild/moderate anaemia was 2.44 (95% CI: 1.63–3.55) for those residing within 30-59 min. For travel times of 60–89 min, the AOR was 3.55 (95% CI: 1.86–6.10) and for ≥90 min, the AOR was 3.41 (95% CI: 1.49–7.67).ConclusionTravel time is significantly associated with the severity of paediatric anaemia presentations at hospitals. Addressing disparities in travel times such as strategic bolstering of lower-level facilities to offer EC services, is crucial for implementing new interventions and optimizing existing hospital-linked interventions to enhance healthcare delivery.https://www.frontiersin.org/articles/10.3389/fepid.2025.1578522/fullanaemiahospitalisationaccesstravel timemodel-based geostatistics |
| spellingShingle | Moses M. Musau Moses M. Musau Cynthia Khazenzi Samuel Akech Evans Omondi Evans Omondi Emelda A. Okiro Emelda A. Okiro Robert W. Snow Robert W. Snow Peter M. Macharia Peter M. Macharia Alice Kamau Alice Kamau Paediatric anaemia in rural Kenya and the role of travel time to emergency care services Frontiers in Epidemiology anaemia hospitalisation access travel time model-based geostatistics |
| title | Paediatric anaemia in rural Kenya and the role of travel time to emergency care services |
| title_full | Paediatric anaemia in rural Kenya and the role of travel time to emergency care services |
| title_fullStr | Paediatric anaemia in rural Kenya and the role of travel time to emergency care services |
| title_full_unstemmed | Paediatric anaemia in rural Kenya and the role of travel time to emergency care services |
| title_short | Paediatric anaemia in rural Kenya and the role of travel time to emergency care services |
| title_sort | paediatric anaemia in rural kenya and the role of travel time to emergency care services |
| topic | anaemia hospitalisation access travel time model-based geostatistics |
| url | https://www.frontiersin.org/articles/10.3389/fepid.2025.1578522/full |
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