Related Experiment Video
Updated: Aug 18, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Management of Multisystem Inflammatory Syndrome in Children (MIS-C) in resource limited settings: The Kenyan
Angela Migowa1,2, Pauline Samia3,4,5, Sean Del Rossi3
1Department of Paediatrics and Child Health, Aga Khan University, 3rd Parklands Avenue, P.O.BOX 30270 00100 GPO, Nairobi, Kenya. angela.migowa@aku.edu.
Insights
Multisystem inflammatory syndrome in children (MIS-C) presents unique challenges in low-middle income countries. Limited access to diagnostics and treatment, as seen in Kenya, impacts patient outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Growing concerns about multisystem inflammatory syndrome in children (MIS-C) emerged during the COVID-19 pandemic.
- Limited data exists on MIS-C in low-middle income countries (LMICs).
Purpose of the Study:
- To describe the clinico-epidemiological profile of MIS-C in Kenya.
- To highlight management challenges and diagnostic/treatment inequities for MIS-C in LMICs.
Main Methods:
- Retrospective study conducted across three Kenyan hospitals.
- Chart review using adapted WHO data collection tool for socio-demographic and treatment data.
Main Results:
- Twenty pediatric MIS-C cases identified (Aug 2020-Aug 2021); 70% male.
- Common symptoms: fever, tachycardia, oral mucosal changes, peripheral inflammation.
- Four patients required critical care; cardiac involvement noted in 4/6 evaluated; limited access to COVID-19 testing and therapies.
Conclusions:
- First case series of MIS-C in East and Central Africa.
- Significant inequities in access to timely COVID-19 testing, diagnostics, and treatment for MIS-C patients in Kenya.
- Highlights the need for improved healthcare infrastructure and resources for MIS-C management in LMICs.
Background:
Since the onset of the recent COVID-19 pandemic, there have been growing concerns regarding multisystem inflammatory syndrome in children (MIS-C). This study aims to describe the clinico-epidemiological profile and challenges in management of MIS-C in low-middle income countries by highlighting the Kenyan experience.
Methods:
A retrospective study at the Aga Khan University Hospital Nairobi, Avenue Hospital Kisumu and Kapsabet County Referral Hospital was undertaken to identify cases of MIS-C. A detailed chart review using the World Health Organization (WHO) data collection tool was adapted to incorporate information on socio-demographic details and treatment regimens.
Findings:
Twenty children with MIS-C were identified across the three facilities between August 1st 2020 and August 31st 2021. Seventy percent of the children were male (14 of 20). COVID-19 PCR testing was done for five children and only one was positive. The commonest clinical symptoms were fever (90%), tachycardia (80%), prolonged capillary refill (80%), oral mucosal changes (65%) and peripheral cutaneous inflammation (50%). Four children required admission into the critical care unit for ventilation support and inotropic support. Cardiac evaluation was available for six patients four of whom had myocardial dysfunction, three had valvulitis and one had pericarditis. Immunoglobulin therapy was availed to two children and systemic steroids provided for three children. There were no documented mortalities.
Interpretation:
We describe the first case series of MIS-C in East and Central Africa. Majority of suspected cases of MIS-C did not have access to timely COVID-19 testing and other appropriate evaluations which highlights the iniquity in access to diagnostics and treatment.
More Related Videos
Related Concept Videos
01:26Nephrotic Syndrome II : Assessment and Medical Management
01:24Nephrotic Syndrome III : Nursing Management
01:20Acute Kidney Injury V: Interprofessional Care
01:22Acute Kidney Injury VI: Nursing Management
01:22Acute Kidney Injury I: Introduction
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...