Nairobi, Kenya, 17 th September 2025: Every child deserves safe, effective care from the moment they fall sick. Yet in many hospitals across sub-Saharan Africa, treatment often begins before infections are properly diagnosed using laboratory tools. The result? Antibiotics are given indiscriminately, infections go undetected, and antibiotic resistance spreads at alarming rates .
A nti b io tic resistance is among the top ten global health threats globally , with sub-Saharan Africa experiencing the highest death rates. The World Health Organization has set ambitious targets to reduce deaths linked to resistant infections and ensure that antibiotics remain available for use by those who truly need them . T hese goals cannot be met without reliable diagnostics. As Dr. Veronicah Chuchu notes: “ Safe care starts with strong diagnostics; without them, children’s lives hang in the balance .”
This year’s World Patient Safety Day, observed on 17 September under the theme “Safe care for every newborn and every child” with the slogan “Patient safety from the start!” , comes at a critical time . A new study highlights just how urgent the situation is.
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Researchers reviewed medical records of 1,608 children admitted with suspected infections between 2017 and 2021 in a referral hospital in Kenya . The y analyzed infection pattern s, the use of diagnostic tools , and antibiotic resistance . The findings were sobering :
• G astroenteritis, bacterial pneumonia, and sepsis were among the most common infections, echoing global evidence that these are the leading causes of child illness and death , especially in under-immunized and malnourished populations .
• Only 4 in 10 children had cultures requested.
• Of those, just 17% received full antibiotic sensitivity testing — the gold standard for guiding treatment.
• More than 70% of t ested samples had bacteria resistant to multiple antibiotics, and nearly 30% were extensively drug-resistant, leaving doctors with few treatment options.
• Children under five years and those with repeat admi ssions w ere the most vulnerable.
One particularly worrying finding was that 86% of the samples showed no bacteria at all. This can happen when children are given antibiotics at home or at another facility before admission; when samples are too little, poorly collected, or contaminated; or when delays in transport cause bacteria to die before testing. In the absence of reliable results, doctors often rely on broad “catch-all” antibiotics. While sometimes life-saving , this approach drives resistance, prolongs hospital stays, increases costs, and tragically, can still end in death .
These challenges are not unique to Kenya. Across many low- and middle-income countries , d iagnostic services remain weak due to shortages of trained staff, laboratory supplies, and functional equipment. Fewer laboratories are able to perform even basic bacterial culture tests. “ When children are treated without knowing the exact cause of their illness, their safety is compromised from the very start. ” Dr. Chuchu, the lead author of the study, stresses .
So, what must change ? According to the study authors , we must first scale up diagnostic capacity so that every child with an infection has access to cultures and sensitivity testing. Second, we need to strengthen laboratories by investing in infrastructure, skilled personnel, and timely reporting systems. Third, health facilities must mak e lab oratory testing central to treatment decisions rather than defaulting to experience-based therapy.
“ On this World Patient Safety Day, let us commit to ensuring that every child in Kenya, and across Africa, receives safe care from the start ,” Dr. Chuchu conclude s. “ That means building stronger laboratories, training health workers, and making diagnostics as essential as stethoscopes. Only then can we protect children’s health, preserve the power of antibiotics, and save lives. ” Authors highlight.
This research was conducted by the Washington State University Global Health Kenya and Center for Epidemiological Modelling and Analysis (CEMA) at the University of Nairobi, funded by the Fogarty International Center and the National Institute of Allergy and Infectious Diseases of the U.S. National Institutes of Health, and supported by the Paul G. Allen School for Global Health at Washington State University.
About CEMA
The Centre for Epidemiological Modelling and Analysis (CEMA) is a research centre at the University of Nairobi dedicated to improving health outcomes in Kenya and across Africa through data-driven decision-making. It was established as a multidisciplinary consortium of infectious disease specialists, epidemiologists, computer scientists, and data analysts to rapidly gather and analyse clinical, mobility, and epidemiological data, guiding Kenya’s pandemic response. In our work, we recognise the vital interconnectedness of human, animal, and environmental health– essential for safeguarding public health and maintaining the balance of our planet’s ecosystems. For more information, visit https://cema-africa.uonbi.ac.ke/
