Carina King
Biographic Data
| ID | 5454479 |
|---|---|
| NAME | Carina King |
| GIVEN NAMES | Carina |
| FAMILY NAME | King |
| SIGNATURE | KING C |
| AFFILIATIONS | Karolinska Institutet |
| ORCID | 0000-0002-6885-6716 |
| VERIFIED | Yes |
| TOTAL WORKS | 42 |
| TOTAL CITATIONS | 7 |
| AUTHOR COUNT | 42 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2013 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Knowledge of pulse oximetry, indications for oxygen therapy, and integrated management of childhood illness among health care workers in Nigerian primary and secondary health facilities
Background The WHO’s Integrated Management of Childhood Illness (IMCI) strategy aims to reduce deaths among children under the age of five. Pulse oximetry, a simple non-invasive method for measuring peripheral oxygen saturation - an indicator of severe illness, can enhance IMCI implementation. In Nigeria, despite efforts to incorporate pulse oximetry into IMCI, its adoption is sub-optimal. We assessed healthcare workers’ (HCWs) knowledge of pulse…
Outcome and management of 2–59-month-old Nigerian children with chest indrawing pneumonia at primary-level healthcare facilities
Background: In 2012, World Health Organization (WHO) recommended outpatient oral amoxicillin for children aged 2-59 months with chest indrawing pneumonia without general danger signs, based on randomised trials. We assessed mortality and case management for such children routinely managed at primary healthcare centres (PHCs) in Lagos, Nigeria. Methods: This prospective observational cohort study (September 2021-September 2023) was conducted in Ik…
The feasibility of promoting recreational physical activity to manage type 2 diabetes in urban Bangladesh
Urbanisation has contributed to increased sedentary behaviour, which is a major risk factor for non-communicable diseases. In South Asia, the type 2 diabetes burden is rapidly increasing, and there is a need to understand the effect of different social categories, such as gender, socio-economic status, and diabetes status, in shaping opportunities to participate in physical activity. We used a rapid participatory qualitative research methodology …
Development and validation of a novel clinical risk score to predict hypoxaemia in children with pneumonia using the WHO PREPARE dataset
BACKGROUND: Hypoxaemia predicts mortality at all levels of care, and appropriate management can reduce preventable deaths. However, pulse oximetry and oxygen therapy remain inaccessible in many primary care health facilities. We aimed to develop and validate a simple risk score comprising commonly evaluated clinical features to predict hypoxaemia in 2-59-month-old children with pneumonia. METHODS: Data from seven studies conducted in five countri…
Challenges in the medical oxygen ecosystem of Peru
Medical oxygen is essential in the management of several human disease conditions including acute respiratory conditions across the life course, and yet access remains unequal in many low- and middle-income countries, including Peru. This study explores Peru’s challenges in ensuring reliable oxygen supplies, with a focus on those laid bare or exacerbated by the COVID-19 pandemic, to inform strategies for improving medical oxygen access. Using a p…
A cluster randomised controlled trial of community groups using Participatory Learning and Action to prevent and control diabetes and intermediate hyperglycaemia in rural Bangladesh
Community mobilisation through Participatory Learning and Action (PLA) has been shown to be effective for a range of health outcomes, including diabetes. Using a cluster randomised controlled trial we evaluated the impact of a PLA community mobilisation intervention for diabetes prevention and control when implemented in rural Bangladesh in 2021–2022 and adapted to the evolving context of the COVID-19 pandemic. 108 PLA groups held a minimum of 13…
The burden of common mental disorders and their association with diabetes in rural Bangladesh
Background: Type 2 diabetes mellitus (T2DM) and common mental disorders (CMDs), including depression and anxiety, are significant public health challenges, particularly in low- and middle-income countries (LMICs). However, evidence on the distribution and associations between T2DM and CMDs in rural LMIC populations remains limited. We aimed to examine this relationship in a sample of adults from rural Bangladesh. Methods: In this cross-sectional …
Patient and caregiver perceptions of oxygen therapy in facility-based settings for acute hypoxemic conditions
Background: Access to oxygen therapy is essential for ensuring a functioning health care system. Despite its widespread application across multiple patient groups and all ages, there is a lack of understanding about community perceptions and experiences while receiving oxygen therapy for acute conditions. We aimed to understand patient and caregiver perceptions of oxygen therapy in facility-based settings for acute hypoxemic conditions. Methods: …
Rethinking Vulnerability in the Nordic countries
The COVID-19 pandemic has highlighted the need to rethink our understanding of vulnerability. This conversation has started to emerge in different forums across the Nordics. In this context, the Nordics have seen different responses to the COVID-19 pandemic. In this piece, we present three dimensions needed to push beyond the traditional notions of categories in understanding vulnerability. We also present different examples on how vulnerability …
‘Let him die in peace’
INTRODUCTION: Efforts to improve oxygen access have focused mainly on the supply side, but it is important to understand demand barriers, such as oxygen refusal among caregivers. We therefore aimed to understand caregiver, community and healthcare provider (HCP) perspectives and experiences of medical oxygen treatments and how these shape oxygen acceptance among caregivers of sick children in Lagos and Jigawa states, which are two contrasting set…
Covid-19 knowledge and practices in Jigawa State, Nigeria
Population knowledge of COVID-19 and adherence to prevention measures may not be equitably distributed, limiting the success of public health measures. We aimed to understand whether COVID-19 knowledge differed by socio-economic status in a rural low-income setting of Jigawa State, Nigeria. We conducted a secondary analysis of the baseline cross-sectional survey of the INSPIRING cluster randomised controlled trial in Kiyawa Local Government Area,…
Exploring different health care providers ́ perceptions on the management of diarrhoea in cholera hotspots in the Democratic Republic of Congo
Global cholera guidelines support wider healthcare system strengthening interventions, alongside vertical outbreak responses, to end cholera. Well-trained healthcare providers are essential for a resilient health system and can create synergies with childhood diarrhoea, which has higher mortality. We explored how the main provider groups for diarrhoea in cholera hotspots interact, decide on treatment, and reflect on possible limiting factors and …
The Covid-19 quandemic
BACKGROUND: The terms syndemic and infodemic have both been applied to the COVID-19 pandemic, and emphasize concurrent socio-cultural dynamics that are distinct from the epidemiological outbreak itself. We argue that the COVID-19 pandemic has exposed yet another important socio-political dynamic that can best be captured by the concept of a quandemic - a portmanteau of "quantification" and "pandemic". MAIN TEXT: The use of quantifiable metrics in…
Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study
BACKGROUND: Wider healthcare-strengthening interventions are recommended in cholera hotspots and could benefit other types of diarrhoeal diseases which contribute to greater mortality than cholera. OBJECTIVE: Describe facility capacity and provider knowledge for case management of diarrhoea and cholera surveillance in cholera hotspots in the Democratic Republic of Congo (DRC) among health facilities, drug shops, and traditional health practitione…
Exploring the feeding practices of mothers of under-five children and how household members influence exclusive breastfeeding in Jigawa State, Nigeria – A qualitative study
Child nutrition interventions in low-income settings are variably effective as strategies often focus on primary caregivers, with less attention given to other household members. This study explored the influence of household members on exclusive breastfeeding and the feeding practices of mothers of under-five children in Jigawa State, Northern Nigeria. As part of a cluster randomised controlled trial in Jigawa State, we conducted an ethnographic…
Enablers and barriers to implementing cholera interventions in Nigeria
Nigeria accounts for a substantial cholera burden globally, particularly in its northeast region, where insurgency is persistent and widespread. We used participatory group model building workshops to explore enablers and barriers to implementing known cholera interventions, including water, sanitation and hygiene, surveillance and laboratory, case management, community engagement, oral cholera vaccine, and leadership and coordination, as well as…
Linking communities and health facilities to improve child health in low-resource settings
Community–facility linkage interventions are gaining popularity as a way to improve community health in low-income settings. Their aim is to create/strengthen a relationship between community members and local healthcare providers. Representatives from both groups can address health issues together, overcome trust problems, potentially leading to participants’ empowerment to be responsible for their own health. This can be achieved via different …
Pneumonia knowledge and care seeking behavior for children under-five years in Jigawa, Northwest Nigeria
Background: Between 2013 and 2022, Nigeria did not meet globally defined targets for pneumonia control, despite some scale-up of vaccinations, oxygen and antibiotics. A deliberate focus on community-based programs is needed to improve coverage of protective, preventive and treatment interventions. We therefore aimed to describe caregiver knowledge and care seeking behaviour for childhood pneumonia, in a high child mortality setting in Nigeria, to…
Influences of community engagement and health system strengthening for cholera control in cholera reporting countries
The 2030 Global Task Force on Cholera Control Roadmap hinges on strengthening the implementation of multistranded cholera interventions, including community engagement and health system strengthening. However, a composite picture of specific facilitators and barriers for these interventions and any overlapping factors existing between the two, is lacking. Therefore, this study aims to address this shortcoming, focusing on cholera-reporting countr…
Maternal mental well-being and recent child illnesses–A cross-sectional survey analysis from Jigawa State, Nigeria
Child health indicators in Northern Nigeria remain low. The bidirectional association between child health and maternal well-being is also poorly understood. We aim to describe the association between recent child illness, socio-demographic factors and maternal mental well-being in Jigawa State, Nigeria. We analysed a cross-sectional household survey conducted in Kiyawa local government area, Jigawa State, from January 2020 to March 2020 amongst …
Stakeholder perceptions on scaling-up community-led interventions for prevention and control of non-communicable diseases in Bangladesh
Research highlighted the need for a preventative community engagement strategy to address NCDs, and the potential to utilise existing cadres to scale-up community-led interventions. It will be important to work with key stakeholders to address gender issues and ensure flexibility and responsiveness to community concerns. We indicate areas for further implementation research to develop scaled-up models of community-led interventions to address NCD…
Derivation and validation of a novel risk assessment tool to identify children aged 2–59 months at risk of hospitalised pneumonia-related mortality in 20 countries
INTRODUCTION: Existing risk assessment tools to identify children at risk of hospitalised pneumonia-related mortality have shown suboptimal discriminatory value during external validation. Our objective was to derive and validate a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality across various settings. METHODS: We used primary, baseline, patient-level data from 11 studies, incl…
Hypoxemia, hypoglycemia and IMCI danger signs in pediatric outpatients in Malawi
Hypoxemia and hypoglycemia are known risks for mortality in children in low-income settings. Routine screening with pulse oximetry and blood glucose assessments for outpatients could assist in early identification of high-risk children. We assessed the prevalence of hypoglycemia and hypoxemia, and the overlap with Integrated Management of Childhood Illness (IMCI) general danger signs, among children seeking outpatient care in Malawi. A cross-sect…
Changes in non-communicable diseases, diet and exercise in a rural Bangladesh setting before and after the first wave of Covid-19
Prevalence of non-communicable diseases (NCDs) is high in rural Bangladesh. Given the complex multi-directional relationships between NCDs, COVID-19 infections and control measures, exploring pandemic impacts in this context is important. We conducted two cross-sectional surveys of adults ≥30-years in rural Faridpur district, Bangladesh, in February to March 2020 (survey 1, pre-COVID-19), and January to March 2021 (survey 2, post-lockdown). A new…
Covid-19 mortality rate and its associated factors during the first and second waves in Nigeria
COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Poly…
Cultural Understanding and Personal Growth Through Taekwondo as Cross-Cultural Activity
The purpose of this study was to explore the benefits of Taekwondo participation related to cross-cultural understanding. Using a series of in-depth interviews with Taekwondo participants, this study investigated whether Taekwondo participation would promote cultural and ethnic understanding and gain new or different cultural perspectives. A total of 12 Taekwondo participants in a Midwestern city were interviewed. From the analysis of the intervi…
Equity impact of participatory learning and action community mobilisation and mHealth interventions to prevent and control type 2 diabetes and intermediate hyperglycaemia in rural Bangladesh
BACKGROUND: A cluster randomised trial of mHealth and participatory learning and action (PLA) community mobilisation interventions showed that PLA significantly reduced the prevalence of intermediate hyperglycaemia and type 2 diabetes mellitus (T2DM) and the incidence of T2DM among adults in rural Bangladesh; mHealth improved knowledge but showed no effect on glycaemic outcomes. We explore the equity of intervention reach and impact. METHODS: Int…
Cultural Understanding and Personal Growth Through Taekwondo as Cross-Cultural Activity
The purpose of this study was to explore the benefits of Taekwondo participation related to cross-cultural understanding. Using a series of in-depth interviews with Taekwondo participants, this study investigated whether Taekwondo participation would promote cultural and ethnic understanding and gain new or different cultural perspectives. A total of 12 Taekwondo participants in a Midwestern city were interviewed. From the analysis of the intervi…
Electronic data capture in a rural African setting
BACKGROUND: As hardware for electronic data capture (EDC), such as smartphones or tablets, becomes cheaper and more widely available, the potential for using such hardware as data capture tools in routine healthcare and research is increasing. OBJECTIVE: We aim to highlight the advantages and disadvantages of four EDC systems being used simultaneously in rural Malawi: two for Android devices (CommCare and ODK Collect), one for PALM and Windows OS…
Stillbirths
An estimated 2.6 million third trimester stillbirths occurred in 2015 (uncertainty range 2.4-3.0 million). The number of stillbirths has reduced more slowly than has maternal mortality or mortality in children younger than 5 years, which were explicitly targeted in the Millennium Development Goals. The Every Newborn Action Plan has the target of 12 or fewer stillbirths per 1000 births in every country by 2030. 94 mainly high-income countries and …
National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000
BACKGROUND: Previous estimates have highlighted a large global burden of stillbirths, with an absence of reliable data from regions where most stillbirths occur. The Every Newborn Action Plan (ENAP) targets national stillbirth rates (SBRs) of 12 or fewer stillbirths per 1000 births by 2030. We estimate SBRs and numbers for 195 countries, including trends from 2000 to 2015. METHODS: We collated SBR data meeting prespecified inclusion criteria from…
Population impact and effectiveness of sequential 13-valent pneumococcal conjugate and monovalent rotavirus vaccine introduction on infant mortality
BACKGROUND: Pneumococcal conjugate vaccine (PCV) and rotavirus vaccine (RV) are key tools for reducing common causes of infant mortality. However, measurement of population-level mortality impact is lacking from sub-Saharan Africa. We evaluated mortality impact and vaccine effectiveness (VE) of PCV13 introduced in November 2011, with subsequent RV1 roll-out in October 2012, in Malawi. METHODS: We conducted two independent community-based birth co…
Barriers to maternal health services during the Ebola outbreak in three West African countries
INTRODUCTION: The Ebola virus disease (EVD) outbreak in West Africa, affecting Guinea, Liberia and Sierra Leone from 2014 to 2016, was a substantial public health crisis with health impacts extending past EVD itself. Access to maternal health services (MHS) was disrupted during the epidemic, with reductions in antenatal care, facility-based deliveries and postnatal care. We aimed to identify and describe barriers related to the uptake and provisi…
Protecting children in low-income and middle-income countries from Covid-19
A saving grace of the COVID-19 pandemic in high-income and upper middle-income countries has been the relative sparing of children. As the disease spreads across low-income and middle-income countries (LMICs), long-standing system vulnerabilities may tragically manifest, and we worry that children will be increasingly impacted, both directly and indirectly. Drawing on our shared child pneumonia experience globally, we highlight these potential im…
Measuring oxygen access
The COVID-19 pandemic has highlighted global oxygen system deficiencies and revealed gaps in how we understand and measure ‘oxygen access’. We present a case study on oxygen access from 58 health facilities in Lagos state, Nigeria. We found large differences in oxygen access between facilities (primary vs secondary, government vs private) and describe three key domains to consider when measuring oxygen access: availability, cost, use. Of 58 facil…
External validation of the Risc, Risc-Malawi, and PERCH clinical prediction rules to identify risk of death in children hospitalized with pneumonia
BACKGROUND: Existing scores to identify children at risk of hospitalized pneumonia-related mortality lack broad external validation. Our objective was to externally validate three such risk scores. METHODS: We applied the Respiratory Index of Severity in Children (RISC) for HIV-negative children, the RISC-Malawi, and the Pneumonia Etiology Research for Child Health (PERCH) scores to hospitalized children in the Pneumonia REsearch Partnerships to …
Paediatric Emergency Triage, Assessment and Treatment (Etat) – preparedness for implementation at primary care facilities in Malawi
BACKGROUND: The majority of deaths amongst children under 5 years are still due to preventable infectious causes. Emergency care has been identified as a key health system weakness, and referrals are often challenging. OBJECTIVE: We aimed to establish how prepared frontline facilities in Malawi are to implement WHO Emergency Triage Assessment and Treatment (ETAT) guidelines, to support policy and planning decisions. METHODS: We conducted a concur…
Learning from a diabetes mHealth intervention in rural Bangladesh
There is an urgent need for population-based interventions to slow the growth of the diabetes epidemic in low-and middle-income countries. We tested the effectiveness of a population-based mHealth voice messaging intervention for T2DM prevention and control in rural Bangladesh through a cluster randomised controlled trial. mHealth improved knowledge and awareness about T2DM but there was no detectable effect on T2DM occurrence. We conducted mixed…
Care-seeking and managing diabetes in rural Bangladesh
ISRCTN41083256 . Registered on 30/03/2016
Derivation and validation of a novel risk assessment tool to identify children aged 2–59 months at risk of hospitalised pneumonia-related mortality in 20 countries
INTRODUCTION: Existing risk assessment tools to identify children at risk of hospitalised pneumonia-related mortality have shown suboptimal discriminatory value during external validation. Our objective was to derive and validate a novel risk assessment tool to identify children aged 2-59 months at risk of hospitalised pneumonia-related mortality across various settings. METHODS: We used primary, baseline, patient-level data from 11 studies, incl…
Hypoxemia, hypoglycemia and IMCI danger signs in pediatric outpatients in Malawi
Hypoxemia and hypoglycemia are known risks for mortality in children in low-income settings. Routine screening with pulse oximetry and blood glucose assessments for outpatients could assist in early identification of high-risk children. We assessed the prevalence of hypoglycemia and hypoxemia, and the overlap with Integrated Management of Childhood Illness (IMCI) general danger signs, among children seeking outpatient care in Malawi. A cross-sect…
Changes in non-communicable diseases, diet and exercise in a rural Bangladesh setting before and after the first wave of Covid-19
Prevalence of non-communicable diseases (NCDs) is high in rural Bangladesh. Given the complex multi-directional relationships between NCDs, COVID-19 infections and control measures, exploring pandemic impacts in this context is important. We conducted two cross-sectional surveys of adults ≥30-years in rural Faridpur district, Bangladesh, in February to March 2020 (survey 1, pre-COVID-19), and January to March 2021 (survey 2, post-lockdown). A new…
Covid-19 mortality rate and its associated factors during the first and second waves in Nigeria
COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Poly…
Paediatric pneumonia research priorities in the context of Covid-19
Background: Pneumonia remains the leading cause of infectious deaths in children under-five globally. We update the research priorities for childhood pneumonia in the context of the COVID-19 pandemic and explore whether previous priorities have been addressed. Methods: We conducted an eDelphi study from November 2019 to June 2021. Experts were invited to take part, targeting balance by: gender, profession, and high (HIC) and low- and middle-incom…
Accuracy of non-physician health workers in respiratory rate measurement to identify paediatric pneumonia in low- and middle-income countries
Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm
Background: The existing World Health Organization (WHO) pneumonia case management guidelines rely on clinical symptoms and signs for identifying, classifying, and treating pneumonia in children up to 5 years old. We aimed to collate an individual patient-level data set from large, high-quality pre-existing studies on pneumonia in children to identify a set of signs and symptoms with greater validity in the diagnosis, prognosis, and possible trea…
Perceptions of child death in Jigawa State, Nigeria
BACKGROUND: Vital statistics are critical for effective public health and monitoring progress towards child survival. Nigeria has the highest global under-five mortality rate; however, deaths are often under- or misreported. OBJECTIVE: We explored perceptions of child deaths and socio-cultural factors influencing the reporting of child deaths in Jigawa State, Nigeria. METHODS: We conducted a triangulation mixed-methods study in Kiyawa local gover…
Equity impact of participatory learning and action community mobilisation and mHealth interventions to prevent and control type 2 diabetes and intermediate hyperglycaemia in rural Bangladesh
BACKGROUND: A cluster randomised trial of mHealth and participatory learning and action (PLA) community mobilisation interventions showed that PLA significantly reduced the prevalence of intermediate hyperglycaemia and type 2 diabetes mellitus (T2DM) and the incidence of T2DM among adults in rural Bangladesh; mHealth improved knowledge but showed no effect on glycaemic outcomes. We explore the equity of intervention reach and impact. METHODS: Int…
Pneumonia knowledge and care seeking behavior for children under-five years in Jigawa, Northwest Nigeria
Background: Between 2013 and 2022, Nigeria did not meet globally defined targets for pneumonia control, despite some scale-up of vaccinations, oxygen and antibiotics. A deliberate focus on community-based programs is needed to improve coverage of protective, preventive and treatment interventions. We therefore aimed to describe caregiver knowledge and care seeking behaviour for childhood pneumonia, in a high child mortality setting in Nigeria, to…
Influences of community engagement and health system strengthening for cholera control in cholera reporting countries
The 2030 Global Task Force on Cholera Control Roadmap hinges on strengthening the implementation of multistranded cholera interventions, including community engagement and health system strengthening. However, a composite picture of specific facilitators and barriers for these interventions and any overlapping factors existing between the two, is lacking. Therefore, this study aims to address this shortcoming, focusing on cholera-reporting countr…
Maternal mental well-being and recent child illnesses–A cross-sectional survey analysis from Jigawa State, Nigeria
Child health indicators in Northern Nigeria remain low. The bidirectional association between child health and maternal well-being is also poorly understood. We aim to describe the association between recent child illness, socio-demographic factors and maternal mental well-being in Jigawa State, Nigeria. We analysed a cross-sectional household survey conducted in Kiyawa local government area, Jigawa State, from January 2020 to March 2020 amongst …
Stakeholder perceptions on scaling-up community-led interventions for prevention and control of non-communicable diseases in Bangladesh
Research highlighted the need for a preventative community engagement strategy to address NCDs, and the potential to utilise existing cadres to scale-up community-led interventions. It will be important to work with key stakeholders to address gender issues and ensure flexibility and responsiveness to community concerns. We indicate areas for further implementation research to develop scaled-up models of community-led interventions to address NCD…
Medicine (34 works) · Environmental health (19 works) · Nursing (13 works) · Internal Medicine (12 works) · Population (12 works) · Sociology (11 works) · Psychological intervention (10 works) · Computer Science (8 works) · Global Maternal and Child Health (8 works) · Political science (8 works)