Background: Pneumococcal pneumonia is the commonest type of bacterial pneumonia worldwide. In Malaysia, the reported incidence of pneumococcal pneumonia is low. This may be due to poor sensitivity of conventional methods. The use of BinaxNOW, a urinary antigen test for Streptococcus pneumoniae can aid in the diagnosis of pneumococcal pneumonia. Objective: To determine the detection rate of pneumococcal pneumonia using BinaxNOW kit and to compare this with the conventional culture method for blood and sputum. Methods: This was a prospective cohort study involving patients 18 year-old and above admitted for community-acquired pneumonia (CAP) or health-care associated pneumonia (HCAP) to UKMMC between December 2011 and June 2012. BinaxNOW test, serology for Mycoplasma, Legionella and Chlamydia and cultures from blood/sputum/other respiratory tract samples and other routine investigations were performed. Results: A total of 102 patients were recruited; 89 (87.3%) with CAP, 13 (12.7%) with HCAP. 57 (55.9%) had pneumonia of unknown aetiology, 11 patients (10.8%) had positive blood cultures, 8 patients (7.8%) had a positive urine BinaxNOW test and 6 patients (5.9%) had positive sputum cultures. Streptococcus pneumoniae was the commonest isolate accounting for 9 cases (8.8%) followed by Klebsiella pneumoniae in 7 cases (6.9%). 8 out of 9 patients with positive urine BinaxNOW test had negative cultures for Streptococcus pneumoniae. One patient grew Streptococcus pneumoniae from the tracheal aspirate however the urine BinaxNOW test was negative. Conclusion: The use of urine BinaxNOW kit in UKMMC increased the detection rate of pneumococcal pneumonia in hospitalized patients.

Introduction: Critical pediatric patients have specific needs, which require special skills, training, equipment, supplies, personnel, and medications. While the knowledge related to enhance survival rate of newborn and children has improved over the past few decades. This study conducted to assess the emergency care capacity in pediatric hospitals at Khartoum state, Sudan. Methods: This is a descriptive cross-sectional hospital-based study, it was conducted in three hospitals at Khartoum, Sudan 2017-2018, to assess emergency care capacity in pediatric hospitals. Data was collected using open-ended questionnaire, and observational checklist. The data scored using dichotomous indicators (absent or present). Results: The study showed that there is shortage in human resources necessary to provide emergency care. However, much essential equipment for emergency care of children was absent in most hospitals, moreover, only 33% of hospitals had Triage system staffed by a trained person. Further, the clinical practice protocols for managing dehydration, neonatal sepsis, and neonatal resuscitation were not traced at the three hospitals. There are a limited laboratory services in one hospital. Conclusion: It is concluded that pediatric specialized hospitals, in Khartoum state, Sudan, have low capacity to provide emergency care for children. Further efforts are needed to improve the emergency care capacity in Khartoum hospitals.