{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:23:30Z","timestamp":1777382610083,"version":"3.51.4"},"reference-count":26,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T00:00:00Z","timestamp":1720051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Lancet Microbe"],"published-print":{"date-parts":[[2025,1]]},"DOI":"10.1016\/j.lanmic.2024.07.008","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T04:44:05Z","timestamp":1733201045000},"page":"100945","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of health system limitations on the use of blood culture and sensitivity testing in Kenyan county hospitals: an interview-based qualitative study using causal loop diagrams"],"prefix":"10.1016","volume":"6","author":[{"given":"Felix","family":"Bahati","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edna","family":"Mutua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Akech","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"English","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Nyamwaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackline","family":"Gachoki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"McKnight","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.lanmic.2024.07.008_bib2","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/S0140-6736(24)01867-1","article-title":"Global burden of bacterial antimicrobial resistance 1990\u20132021: a systematic analysis with forecasts to 2050","volume":"404","year":"2024","journal-title":"Lancet"},{"key":"10.1016\/j.lanmic.2024.07.008_bib3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-017-2713-1","article-title":"Antimicrobial resistance in Africa: a systematic review","volume":"17","author":"Tadesse","year":"2017","journal-title":"BMC Infect Dis"},{"key":"10.1016\/j.lanmic.2024.07.008_bib5","first-page":"27","article-title":"Antimicrobial resistance in the African region: issues, challenges and actions proposed. Key determinants for the African region","volume":"16","author":"Ndihokubwayo","year":"2013","journal-title":"Afr Health Monit"},{"key":"10.1016\/j.lanmic.2024.07.008_bib6","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/S0377-1237(09)80020-8","article-title":"WHONET software for the surveillance of antimicrobial susceptibility","volume":"65","author":"Agarwal","year":"2009","journal-title":"Med J\u00a0Armed Forces India"},{"key":"10.1016\/j.lanmic.2024.07.008_bib7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ijid.2020.07.084","article-title":"Antibiotic use in Kenyan public hospitals: prevalence, appropriateness and link to guideline availability","volume":"99","author":"Maina","year":"2020","journal-title":"Int J\u00a0Infect Dis"},{"key":"10.1016\/j.lanmic.2024.07.008_bib8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-023-04343-0","article-title":"Blood culture versus antibiotic use for neonatal inpatients in 61\u00a0hospitals implementing with the NEST360 Alliance in Kenya, Malawi, Nigeria, and Tanzania: a cross-sectional study","volume":"23","author":"Murless-Collins","year":"2023","journal-title":"BMC Pediatr"},{"key":"10.1016\/j.lanmic.2024.07.008_bib11","doi-asserted-by":"crossref","first-page":"256","DOI":"10.12688\/wellcomeopenres.18289.1","article-title":"The CINAMR (Clinical Information Network-Antimicrobial Resistance) Project: a pilot microbial surveillance using hospitals linked to regional laboratories in Kenya: study protocol","volume":"7","author":"Akech","year":"2022","journal-title":"Wellcome Open Res"},{"key":"10.1016\/j.lanmic.2024.07.008_bib12","first-page":"347","article-title":"Qualitative study design and data collection BT\u2014evaluation methods in biomedical and health informatics","author":"Friedman","year":"2022"},{"key":"10.1016\/j.lanmic.2024.07.008_bib13","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2016-000028","article-title":"Improving documentation of clinical care within a clinical information network: an essential initial step in efforts to understand and improve care in Kenyan hospitals","volume":"1","author":"Tuti","year":"2016","journal-title":"BMJ Glob Health"},{"key":"10.1016\/j.lanmic.2024.07.008_bib14","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"Saunders","year":"2018","journal-title":"Qual Quant"},{"key":"10.1016\/j.lanmic.2024.07.008_bib15","doi-asserted-by":"crossref","DOI":"10.1080\/16549716.2020.1761657","article-title":"Evaluating hospital performance in antibiotic stewardship to guide action at national and local levels in a lower-middle income setting","volume":"12","author":"McKnight","year":"2019","journal-title":"Glob Health Action"},{"key":"10.1016\/j.lanmic.2024.07.008_bib16","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/j.cmi.2021.05.037","article-title":"Surveillance strategies using routine microbiology for antimicrobial resistance in low- and middle-income countries","volume":"27","author":"Lim","year":"2022","journal-title":"Clin Microbiol Infect"},{"key":"10.1016\/j.lanmic.2024.07.008_bib17","series-title":"The international encyclopedia of communication research methods","first-page":"1","article-title":"Axial coding","author":"Scott","year":"2017"},{"key":"10.1016\/j.lanmic.2024.07.008_bib18","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1002\/sdr.1480","article-title":"Building confidence in causal maps generated from purposive text data: mapping transcripts of the Federal Reserve","volume":"28","author":"Kim","year":"2012","journal-title":"Syst Dyn Rev"},{"key":"10.1016\/j.lanmic.2024.07.008_bib19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/phrs.2021.1604352","article-title":"Diverse approaches to creating and using causal loop diagrams in public health research: recommendations from a scoping review","volume":"42","author":"Baugh Littlejohns","year":"2021","journal-title":"Public Health Rev"},{"key":"10.1016\/j.lanmic.2024.07.008_bib20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-019-4862-y","article-title":"Public health system challenges in the Free State, South Africa: a situation appraisal to inform health system strengthening","volume":"20","author":"Malakoane","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.lanmic.2024.07.008_bib21","doi-asserted-by":"crossref","DOI":"10.1002\/smll.202370194","article-title":"Rapid visible detection of African swine fever virus using hybridization chain reaction-sensitized magnetic nanoclusters and affinity chromatography","volume":"19","author":"Lee","year":"2023","journal-title":"Small"},{"key":"10.1016\/j.lanmic.2024.07.008_bib22","doi-asserted-by":"crossref","first-page":"12968","DOI":"10.3390\/ijerph191912968","article-title":"Pattern of antimicrobial susceptibility and antimicrobial treatment of neonates admitted with suspected sepsis in a teaching hospital in Ghana, 2021","volume":"19","author":"Omenako","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"10.1016\/j.lanmic.2024.07.008_bib23","first-page":"355","article-title":"Impact of low blood culture usage on rates of antimicrobial resistance","volume":"82","author":"Lim","year":"2021","journal-title":"J\u00a0Infect"},{"key":"10.1016\/j.lanmic.2024.07.008_bib24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjgh-2023-012512","article-title":"The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam","volume":"8","author":"Bigio","year":"2023","journal-title":"BMJ Glob Health"},{"key":"10.1016\/j.lanmic.2024.07.008_bib25","first-page":"1","article-title":"\u2018We are called the et cetera\u2019: experiences of the poor with health financing reforms that target them in Kenya","volume":"18","author":"Kabia","year":"2019","journal-title":"Int J\u00a0Equity Health"},{"key":"10.1016\/j.lanmic.2024.07.008_bib26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fpubh.2020.00258","article-title":"A\u00a0feasible laboratory-strengthening intervention yielding a sustainable clinical bacteriology sector to support antimicrobial stewardship in a large referral hospital in Ethiopia","volume":"8","author":"Yansouni","year":"2020","journal-title":"Front Public Health"},{"key":"10.1016\/j.lanmic.2024.07.008_bib27","doi-asserted-by":"crossref","first-page":"e1196","DOI":"10.1016\/S2214-109X(18)30386-3","article-title":"High-quality health systems in the Sustainable Development Goals era: time for a revolution","volume":"6","author":"Kruk","year":"2018","journal-title":"Lancet Glob Health"},{"key":"10.1016\/j.lanmic.2024.07.008_bib28","doi-asserted-by":"crossref","first-page":"52","DOI":"10.2471\/BLT.07.042994","article-title":"Beyond good intentions: lessons on equipment donation from an African hospital","volume":"86","author":"Howie","year":"2008","journal-title":"Bull World Health Organ"},{"key":"10.1016\/j.lanmic.2024.07.008_bib29","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1007\/s11517-011-0786-3","article-title":"Effectiveness of medical equipment donations to\u00a0improve health systems: how much medical equipment is broken\u00a0in the developing world?","volume":"49","author":"Perry","year":"2011","journal-title":"Med Biol Eng Comput"},{"key":"10.1016\/j.lanmic.2024.07.008_bib30","doi-asserted-by":"crossref","DOI":"10.1080\/16549716.2021.1964172","article-title":"Information asymmetry in the Kenyan medical laboratory sector","volume":"14","author":"Bahati","year":"2021","journal-title":"Glob Health Action"}],"container-title":["The Lancet Microbe"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666524724001988?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666524724001988?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T23:32:34Z","timestamp":1736551954000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2666524724001988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["S2666524724001988"],"URL":"https:\/\/doi.org\/10.1016\/j.lanmic.2024.07.008","relation":{},"ISSN":["2666-5247"],"issn-type":[{"value":"2666-5247","type":"print"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Effects of health system limitations on the use of blood culture and sensitivity testing in Kenyan county hospitals: an interview-based qualitative study using causal loop diagrams","name":"articletitle","label":"Article Title"},{"value":"The Lancet Microbe","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.lanmic.2024.07.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2024 The Author(s). Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"100945"}}