James A Berkley
Biographic Data
| ID | 5466818 |
|---|---|
| NAME | James A Berkley |
| GIVEN NAMES | James A |
| FAMILY NAME | Berkley |
| SIGNATURE | BERKLEY J A |
| AFFILIATIONS | Kenya Medical Research Institute |
| ORCID | 0000-0002-1236-849X |
| VERIFIED | Yes |
| TOTAL WORKS | 39 |
| TOTAL CITATIONS | 0 |
| AUTHOR COUNT | 39 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2010 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Enteric dysfunction and enteropathogens among hospitalized south Asian and sub-Saharan African children
Enteropathogens and enteric dysfunction (ED) among acutely ill children in low-and-middle income countries (LMICs) may contribute to poor post-discharge outcomes. Enteropathogen prevalence and fecal ED biomarkers (myeloperoxidase, calprotectin, α-1-antitrypsin) from children aged 2–23 months hospitalized at nine LMIC facilities (n = 811) were compared to community children (n = 248). Host and pathogen correlates of ED biomarkers were identified t…
Infants less than 6 months of age at risk of poor growth and development
box The 2023 WHO guideline on wasting and nutritional oedema includes four recommendations and four good practice statements on the management of infants less than 6 months of age at risk of poor growth and development, prioritising this vulnerable yet often neglected group
Prevention of wasting and nutritional oedema
box Inclusion of prevention in the 2023 WHO guideline on wasting and nutritional oedema is a significant and timely addition, aligning with the global development goal of reducing current wasting prevalence from 6
Infants and children 6–59 months of age with severe wasting and/or nutritional oedema
box The 2023 WHO guideline on wasting and nutritional oedema includes four new recommendations, three updated recommendations and three new good practice statements for the management of severe wasting and nutritional oedema in infants and children 6–59 months of age
Addressing prevention and management of wasting and nutritional oedema in children requires an improved evidence base on resource use and cost-effectiveness of interventions
box Effectiveness studies on the prevention and management of wasting and nutritional oedema should ideally include the evaluation of resource use and cost-effectiveness (CE) to allow future guideline development to appreciate this dimension
Aflatoxin exposure and mortality in acutely ill children
BACKGROUND: Chronic exposure to aflatoxins is associated with liver cancer, impaired child growth, and compromised immune function. The Childhood Acute Illness and Nutrition (CHAIN) Network cohort was established to identify risk factors for mortality in acutely ill children admitted to nine hospitals in four African and two South Asian countries. We examined the role of aflatoxin exposure in inpatient and post-discharge mortality. METHODS: In a …
The contribution of minimally invasive tissue sampling compared to antemortem-derived cause of death determination among inpatient child deaths
Background: Improved causes of death (CoD) understanding in low- and middle-income countries is needed to reduce child mortality. Compared to full autopsy, minimally invasive tissue sampling (MITS), using transcutaneous needle sampling, is a feasible, socially acceptable, and validated method. We aimed to quantify the additional contribution of MITS to CoD attribution based on clinical records and inpatient research data with intensive patient ch…
Prevalence, incidence, and outcome of tuberculosis among young hospitalised children with acute illness in Sub-Saharan Africa and South East Asia
Background: Tuberculosis (TB) is a leading cause of paediatric morbidity and mortality. We sought to identify the prevalence of TB among children admitted to hospital with severe illness and to document incidence of TB, survival, and growth in the six months following discharge from hospital in two TB-endemic countries. Methods: We screened young children 2-23 months old enrolled in the Childhood Acute Illness and Nutrition Network cohort and adm…
Applying WHO Prioritization Criteria for Moderate Wasting
The World Health Organization's 2023 recommendations for managing moderate wasting provide criteria for prioritizing children to receive specially formulated foods (SFF) rather than counseling alone. However, the practical programmatic impact of such prioritization is unclear. This secondary analysis aimed to describe the caseload and treatment outcomes among moderately wasted 6- to 59-month-old Malian children, categorized into higher-priority (…
Global burden of bacterial antimicrobial resistance 1990–2021
BACKGROUND: Antimicrobial resistance (AMR) poses an important global health challenge in the 21st century. A previous study has quantified the global and regional burden of AMR for 2019, followed with additional publications that provided more detailed estimates for several WHO regions by country. To date, there have been no studies that produce comprehensive estimates of AMR burden across locations that encompass historical trends and future for…
Inpatient and postdischarge mortality among children with anaemia and malaria parasitaemia in Kenya
BACKGROUND: Anaemia and malaria are leading causes of paediatric hospitalisation and inpatient mortality in sub-Saharan Africa. However, there is limited empirical data on survival following hospital discharge. We aimed to estimate independent effects of anaemia and malaria parasitaemia on inpatient and 1 year postdischarge mortality among Kenyan children. METHODS: A retrospective cohort study among children admitted to Kilifi County Hospital (KC…
Stunting in the first year of life
Malnutrition among infants aged below 6 months has been largely overlooked creating gaps in our understanding of factors underlying stunting in early infancy. Recent evidence suggests that pre-natal and early childhood factors may contribute more to driving childhood stunting than previously appreciated. The study was set up to examine pathways including parental and household characteristics, birth size and gestation, and illness in infancy with…
Prediction of inpatient mortality in hospitalised children in low- and middle-income countries
Background: Risk prediction tools for acutely ill children have been developed in high- and low-income settings, but few are validated or incorporated into clinical guidelines. We aimed to assess the performance of existing paediatric early warning scores for use in low- and middle-income countries using clinical data from a recent large multi-country study in Africa and South-Asia. Methods: We used data (children across three nutritional strata)…
Derivation and external validation of a clinical prognostic model identifying children at risk of death following presentation for diarrheal care
Diarrhea continues to be a leading cause of death for children under-five. Amongst children treated for acute diarrhea, mortality risk remains elevated during and after acute medical management. Identification of those at highest risk would enable better targeting of interventions, but available prognostic tools lack validation. We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) to build clinical prognostic mod…
Clinical epidemiology of Covid-19 among hospitalized children in rural western Kenya
The epidemiology of pediatric COVID-19 in sub-Saharan Africa and the role of fecal-oral transmission in SARS-CoV-2 are poorly understood. Among children and adolescents in Kenya, we identify correlates of COVID-19 infection, document the clinical outcomes of infection, and evaluate the prevalence and viability of SARS-CoV-2 in stool. We recruited a prospective cohort of hospitalized children aged two months to 15 years in western Kenya between Ma…
Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
Objective: To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height Z -score (WHZ) and weight-for-age Z -score (WAZ) for predicting death over periods of 1, 3 and 6 months follow-up in children. Design: Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual an…
Anthropometric criteria for best-identifying children at high risk of mortality
Objective: To understand which anthropometric diagnostic criteria best discriminate higher from lower risk of death in children and explore programme implications. Design: A multiple cohort individual data meta-analysis of mortality risk (within 6 months of measurement) by anthropometric case definitions. Sensitivity, specificity, informedness and inclusivity in predicting mortality, face validity and compatibility with current standards and prac…
Global burden of bacterial antimicrobial resistance in 2019
BACKGROUND: Antimicrobial resistance (AMR) poses a major threat to human health around the world. Previous publications have estimated the effect of AMR on incidence, deaths, hospital length of stay, and health-care costs for specific pathogen-drug combinations in select locations. To our knowledge, this study presents the most comprehensive estimates of AMR burden to date. METHODS: We estimated deaths and disability-adjusted life-years (DALYs) a…
Model for developing context-sensitive responses to vulnerability in research
Health research in low-resource settings often involves individuals and populations defined as ‘vulnerable’. There is growing attention in the literature to the ethical dilemmas that frontline research staff face while conducting such research. However, there is little documented as to how research staff might support one another in identifying and handling these dilemmas in different contexts. Over the course of conducting empirical ethics resea…
Gender-related influences on adherence to advice and treatment-seeking guidance for infants and young children post-hospital discharge in Bangladesh
A complex web of gender related influences at health systems/services and household/community levels have important implications for young children's recovery post-discharge. Immediate interventions with potential for positive impact include awareness-raising among all stakeholders - including male family members - on how gender influences child health and recovery, and how to reduce adverse consequences of gender-based discrimination. Specific i…
Applying a gender lens to understand pathways through care for acutely ill young children in Kenyan urban informal settlements
Women in urban low-income settings are disproportionately impacted by acute child illness and the related treatment-seeking and recovery process. The range of interventions needed to support mothers as they navigate their way through children's illnesses and recovery include: deliberate engagement of men in child health to counteract the dominant perception of child health and care as a 'female-domain'; targeted economic strategies such as cash t…
Vulnerability, Agency, and the Research Encounter
Pediatric clinical research in low-resourced countries involves individuals defined as "vulnerable" in research ethics guidance. Insights from research participants can strengthen the design and oversight of studies. We share family members' perspectives and experiences of an observational clinical study conducted in one Kenyan hospital as part of an integrated empirical ethics study. Employing qualitative methods, we explored how research encoun…
‘Severe malnutrition’
box Malnutrition affects millions worldwide and underlies almost half of deaths in children aged <5 years.1 Progress towards Sustainable Development Goal 2 (End hunger) was already slow but coronavirus-related secondary impacts now threaten nutritional crises described as: Biblical, on steroids, across generations .2 Towards effective actions, effective communication matters. Malnutrition involves a plethora of complex technical terminology. Some…
Vulnerability and agency across treatment-seeking journeys for acutely ill children
To support children's care and recovery, health systems must be more responsive to the needs of families facing multiple and interacting vulnerabilities. Reducing incurred treatment costs, improving interpersonal quality of care, and strengthening continuity of care across facilities is essential. Promising interventions need to be co-designed with community representatives and health providers and carefully tested for unintended negative consequ…
Implications of gestational age at antenatal care attendance on the successful implementation of a maternal respiratory syncytial virus (RSV) vaccine program in coastal Kenya
In a random sample of pregnant women from Kilifi HDSS, Coastal Kenya with card-confirmed ANC clinic attendance, 76.6% would be reached for maternal RSV vaccination within the gestational age window of 28-32 weeks. Widening the vaccination window (26-33 weeks) or (24-36 weeks) would not dramatically increase vaccine coverage and would require consideration of antibody kinetics data that could affect vaccine efficacy
No prominent works on this page.
An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years
There is clear evidence of increasing burden in neonatal admissions at a rural district hospital in contrast to reducing numbers of non-neonatal paediatrics' admissions aged ≤ 5 years. Though the inpatient case fatality for all admissions aged ≤ 5 years declined significantly, neonates now comprise close to 60% of all inpatient deaths. Simple indicators may identify neonates at risk of death
Dynamics and Constraints of Early Infant Diagnosis of HIV Infection in Rural Kenya
A cohort design was used to determine uptake and drop out of 213 HIV-exposed infants eligible for Early Infant Diagnosis (EID) of HIV. To explore service providers and care givers knowledge, attitudes and perceptions of the EID process, observations and in-depth interviews were conducted. 145 (68%) infants enrolled after 2 months of age. 139 (65%) dropped out before follow up to 18 months old. 60 (43%) drop outs occurred within 2 months of enrolm…
Outcomes of prevention of mother to child transmission of the human immunodeficiency virus-1 in rural Kenya—a cohort study
A simple set of risk factors at enrollment can identify mother-infant pairs most at risk of infection or drop out for targeted intervention
Incidence and predictors of attrition from antiretroviral care among adults in a rural HIV clinic in Coastal Kenya
A third of individuals initiating ART were either reported dead or LFU during two years of care, with more than a half of these occurring within six months of treatment initiation. Practical and sustainable biomedical interventions and psychosocial support systems are warranted to improve ART retention in this setting
Maternal perception of malnutrition among infants using verbal and pictorial methods in Kenya
Objective To compare mothers’ perceptions of their own infants’ nutritional status with anthropometric indicators of undernutrition. Design A qualitative study and cross-sectional quantitative survey. The qualitative study involved developing tools to assess mother’s perception. Two methods of verbal description and a pictorial scale were developed. The quantitative survey involved measuring maternal perception and comparing it with the anthropom…
Predictors of the risk of malnutrition among children under the age of 5 years in Somalia
Objective To investigate the predictors of wasting, stunting and low mid-upper arm circumference among children aged 6–59 months in Somalia using data from household cross-sectional surveys from 2007 to 2010 in order to help inform better targeting of nutritional interventions. Design Cross-sectional nutritional assessment surveys using structured interviews were conducted among communities in Somalia each year from 2007 to 2010. A two-stage clus…
Environmental predictors of stunting among children under-five in Somalia
Stunting in Somalia is spatially and temporally heterogeneous. Rainfall and vegetation are major drivers of these variations. The use of environmental covariates for forecasting of stunting is a potentially useful and affordable tool for planning interventions to reduce the high burden of malnutrition in Somalia
Perceptions of childhood undernutrition among rural households on the Kenyan coast – a qualitative study
Perceptions of child nutrition and illness and gendered roles within households influence treatment action, and engagement with nutrition interventions. Community-based nutrition interventions must recognise these complex realities
“If it's issues to do with nutrition…I can decide…”
Gender roles and relations play an important role in child health and nutritional status. While there is increasing recognition of the need to incorporate gender analysis in health planning and programme development, there has been relatively little attention paid to the gendered nature of child nutrition interventions. This qualitative study undertaken in rural Coastal Kenya aimed to explore the interaction between household gender relations and…
The impact of rickets on growth and morbidity during recovery among children with complicated severe acute malnutrition in Kenya
The effects of rickets on children recovery from severe acute malnutrition (SAM) are unknown. Rickets may affect both growth and susceptibility to infectious diseases. We investigated the associations of clinically diagnosed rickets with life-threatening events and anthropometric recovery during 1 year following inpatient treatment for complicated SAM. This was a secondary analysis of clinical trial data among non-human immunodeficiency virus-inf…
Vitamin D deficiency causes rickets in an urban informal settlement in Kenya and is associated with malnutrition
The commonest cause of rickets worldwide is vitamin D deficiency, but studies from sub-Saharan Africa describe an endemic vitamin D-independent form that responds to dietary calcium enrichment. The extent to which calcium-deficiency rickets is the dominant form across sub-Saharan Africa and in other low-latitude areas is unknown. We aimed to characterise the clinical and biochemical features of young children with rickets in a densely populated u…
Severe malnutrition in infants aged <6 months—Outcomes and risk factors in Bangladesh
Severe acute malnutrition (SAM) affects ~4 million infants under 6 months (u6m) worldwide, but evidence underpinning their care is "very low" quality. To inform future research and policy, the objectives of our study were to identify risk factors for infant u6m SAM and describe the clinical and anthropometric outcomes of treatment with current management strategies. We conducted a prospective cohort study in infants u6m in Barisal district, Bangl…
Phenotype is sustained during hospital readmissions following treatment for complicated severe malnutrition among Kenyan children
Hospital readmission is common among children with complicated severe acute malnutrition (cSAM) but not well-characterised. Two distinct cSAM phenotypes, marasmus and kwashiorkor, exist, but their pathophysiology and whether the same phenotype persists at relapse are unclear. We aimed to test the association between cSAM phenotype at index admission and readmission following recovery. We performed secondary data analysis from a multicentre random…
Individualized breastfeeding support for acutely ill, malnourished infants under 6 months old
Reestablishing exclusive breastfeeding is the cornerstone of the 2013 World Health Organization (WHO) treatment guidelines for acute malnutrition in infants less than 6 months. However, no studies have investigated guideline implementation and subsequent outcomes in a public hospital setting in Africa. To facilitate implementation of the WHO 2013 guidelines in Kilifi County Hospital, Kenya, we developed standard operating procedure, recruited, an…
‘Severe malnutrition’
box Malnutrition affects millions worldwide and underlies almost half of deaths in children aged <5 years.1 Progress towards Sustainable Development Goal 2 (End hunger) was already slow but coronavirus-related secondary impacts now threaten nutritional crises described as: Biblical, on steroids, across generations .2 Towards effective actions, effective communication matters. Malnutrition involves a plethora of complex technical terminology. Some…
Vulnerability and agency across treatment-seeking journeys for acutely ill children
To support children's care and recovery, health systems must be more responsive to the needs of families facing multiple and interacting vulnerabilities. Reducing incurred treatment costs, improving interpersonal quality of care, and strengthening continuity of care across facilities is essential. Promising interventions need to be co-designed with community representatives and health providers and carefully tested for unintended negative consequ…
Implications of gestational age at antenatal care attendance on the successful implementation of a maternal respiratory syncytial virus (RSV) vaccine program in coastal Kenya
In a random sample of pregnant women from Kilifi HDSS, Coastal Kenya with card-confirmed ANC clinic attendance, 76.6% would be reached for maternal RSV vaccination within the gestational age window of 28-32 weeks. Widening the vaccination window (26-33 weeks) or (24-36 weeks) would not dramatically increase vaccine coverage and would require consideration of antibody kinetics data that could affect vaccine efficacy
Model for developing context-sensitive responses to vulnerability in research
Health research in low-resource settings often involves individuals and populations defined as ‘vulnerable’. There is growing attention in the literature to the ethical dilemmas that frontline research staff face while conducting such research. However, there is little documented as to how research staff might support one another in identifying and handling these dilemmas in different contexts. Over the course of conducting empirical ethics resea…
Gender-related influences on adherence to advice and treatment-seeking guidance for infants and young children post-hospital discharge in Bangladesh
A complex web of gender related influences at health systems/services and household/community levels have important implications for young children's recovery post-discharge. Immediate interventions with potential for positive impact include awareness-raising among all stakeholders - including male family members - on how gender influences child health and recovery, and how to reduce adverse consequences of gender-based discrimination. Specific i…
Applying a gender lens to understand pathways through care for acutely ill young children in Kenyan urban informal settlements
Women in urban low-income settings are disproportionately impacted by acute child illness and the related treatment-seeking and recovery process. The range of interventions needed to support mothers as they navigate their way through children's illnesses and recovery include: deliberate engagement of men in child health to counteract the dominant perception of child health and care as a 'female-domain'; targeted economic strategies such as cash t…
Vulnerability, Agency, and the Research Encounter
Pediatric clinical research in low-resourced countries involves individuals defined as "vulnerable" in research ethics guidance. Insights from research participants can strengthen the design and oversight of studies. We share family members' perspectives and experiences of an observational clinical study conducted in one Kenyan hospital as part of an integrated empirical ethics study. Employing qualitative methods, we explored how research encoun…
Global burden of bacterial antimicrobial resistance in 2019
BACKGROUND: Antimicrobial resistance (AMR) poses a major threat to human health around the world. Previous publications have estimated the effect of AMR on incidence, deaths, hospital length of stay, and health-care costs for specific pathogen-drug combinations in select locations. To our knowledge, this study presents the most comprehensive estimates of AMR burden to date. METHODS: We estimated deaths and disability-adjusted life-years (DALYs) a…
Derivation and external validation of a clinical prognostic model identifying children at risk of death following presentation for diarrheal care
Diarrhea continues to be a leading cause of death for children under-five. Amongst children treated for acute diarrhea, mortality risk remains elevated during and after acute medical management. Identification of those at highest risk would enable better targeting of interventions, but available prognostic tools lack validation. We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) to build clinical prognostic mod…
Clinical epidemiology of Covid-19 among hospitalized children in rural western Kenya
The epidemiology of pediatric COVID-19 in sub-Saharan Africa and the role of fecal-oral transmission in SARS-CoV-2 are poorly understood. Among children and adolescents in Kenya, we identify correlates of COVID-19 infection, document the clinical outcomes of infection, and evaluate the prevalence and viability of SARS-CoV-2 in stool. We recruited a prospective cohort of hospitalized children aged two months to 15 years in western Kenya between Ma…
Prognostic value of different anthropometric indices over different measurement intervals to predict mortality in 6–59-month-old children
Objective: To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height Z -score (WHZ) and weight-for-age Z -score (WAZ) for predicting death over periods of 1, 3 and 6 months follow-up in children. Design: Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual an…
Medicine (36 works) · Child Nutrition and Water Access (26 works) · Pediatrics (21 works) · Internal Medicine (19 works) · Environmental health (13 works) · Malnutrition (13 works) · Nursing (12 works) · Cohort (11 works) · Child Nutrition and Feeding Issues (10 works) · Public health (10 works)