ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Critical Care
Clinical Characteristics and Outcomes of Children Admitted to Adult Intensive care and High-Dependency Units in Kenya: A Multicenter Registry-Based Analysis
Provisionally accepted
Wambui Mwangi1
Carolyne Muiru2
Ronnie Kaddu3Nabukwangwa Simiyu4Demet Sulemanji5
Peter Oduor6Dilanthi Gamage7Teddy Thaddeus Abonyo2Patricia Wangeci6Thomas Kabanya8Selina Mutuku9Annastacia Kioko4Peter Mburu Kamau10Eunice Tole2
Abi EC Beane11
Rashan Haniffa11Arjen Dondorp11
Marcus J Schultz12
Job Van Woensel13David Misango2
Luigi Pisani11*
Wangari Waweru-Siika2- 1Mwai Kibaki Hospital, Othaya, Kenya
- 2The Aga Khan University Hospital Nairobi, Nairobi, Kenya
- 3Aga Khan Hospital Mombasa, Mombasa, Kenya
- 4Kisii Teaching and Referral Hospital, Kisii, Kenya
- 5Critical Care Society of Kenya, Nairobi, Kenya
- 6Egerton University, Njoro, Kenya
- 7National Intensive Care Surveillance-MORU, Colombo, Sri Lanka
- 8Nyeri Provincial General Hospital, Nyeri, Kenya
- 9Critical Society of Kenya, Nairobi, Kenya
- 10MP Shah Hospital, Nairobi, Kenya
- 11Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- 12Amsterdam Institute of Global Health and Development, Amsterdam, Netherlands
- 13Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
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ABSTRACT Problem There is limited information on the prevalence, clinical features and outcomes of pediatric patients admitted to adult intensive care units (ICUs) or high-dependency units (HDUs) in low and middle income countries (LMICs). Objective To evaluate the clinical characteristics and outcomes of critically ill children admitted to adult ICU or HDU in Kenya. Methods We conducted a registry–enabled study leveraging on data collected progressively in the Kenya Critical Care Registry comprising six ICUs and five HDUs. We included all consecutive encounters of patients younger than 18 years who were admitted to the study units from January 2021 to June 2022. Outcomes The primary outcome was ICU or HDU mortality; secondary outcomes included clinical management, duration of invasive ventilation, length of stay in the ICU or HDU and risk factors for mortality. Results Of the 5012 ICU and HDU admissions, 466 (9.1%) were patients younger than 18 years. Their median age was 2.0 [0.4 to 9.0] years, with 173 (37.1%) children being under one year. Medical admissions accounted for 357 (76.6%) cases, while 109
Keywords: Outcome, intensive care unit, Children, LMIC (low and middle income countries), Kenya, High dependency unit, Mortality
Received: 23 Jul 2025; Accepted: 12 Nov 2025.
Copyright: © 2025 Mwangi, Muiru, Kaddu, Simiyu, Sulemanji, Oduor, Gamage, Abonyo, Wangeci, Kabanya, Mutuku, Kioko, Kamau, Tole, Beane, Haniffa, Dondorp, Schultz, Van Woensel, Misango, Pisani and Waweru-Siika. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Luigi Pisani, luigipisani@gmail.com
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