scholarly journals Severe bacterial neonatal infections in Madagascar, Senegal, and Cambodia: A multicentric community-based cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003681
Author(s):  
Bich-Tram Huynh ◽  
Elsa Kermorvant-Duchemin ◽  
Rattanak Chheang ◽  
Frederique Randrianirina ◽  
Abdoulaye Seck ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Bacterial Infection ◽  
Pregnant Women ◽  
Rural Site ◽  
Urban Site ◽  
Community Based ◽  
Neonatal Deaths ◽  
Live Births ◽  
Rural Sites

Background Severe bacterial infections (SBIs) are a leading cause of neonatal deaths in low- and middle-income countries (LMICs). However, most data came from hospitals, which do not include neonates who did not seek care or were treated outside the hospital. Studies from the community are scarce, and few among those available were conducted with high-quality microbiological techniques. The burden of SBI at the community level is therefore largely unknown. We aimed here to describe the incidence, etiology, risk factors, and antibiotic resistance profiles of community-acquired neonatal SBI in 3 LMICs. Methods and findings The BIRDY study is a prospective multicentric community-based mother and child cohort study and was conducted in both urban and rural areas in Madagascar (2012 to 2018), Cambodia (2014 to 2018), and Senegal (2014 to 2018). All pregnant women within a geographically defined population were identified and enrolled. Their neonates were actively followed from birth to 28 days to document all episodes of SBI. A total of 3,858 pregnant women (2,273 (58.9%) in Madagascar, 814 (21.1%) in Cambodia, and 771 (20.0%) in Senegal) were enrolled in the study, and, of these, 31.2% were primigravidae. Women enrolled in the urban sites represented 39.6% (900/2,273), 45.5% (370/814), and 61.9% (477/771), and those enrolled in the rural sites represented 60.4% (1,373/2,273), 54.5% (444/814), and 38.1% (294/771) of the total in Madagascar, Cambodia, and Senegal, respectively. Among the 3,688 recruited newborns, 49.6% were male and 8.7% were low birth weight (LBW). The incidence of possible severe bacterial infection (pSBI; clinical diagnosis based on WHO guidelines of the Integrated Management of Childhood Illness) was 196.3 [95% confidence interval (CI) 176.5 to 218.2], 110.1 [88.3 to 137.3], and 78.3 [59.5 to 103] per 1,000 live births in Madagascar, Cambodia, and Senegal, respectively. The incidence of pSBI differed between urban and rural sites in all study countries. In Madagascar, we estimated an incidence of 161.0 pSBI per 1,000 live births [133.5 to 194] in the urban site and 219.0 [192.6 to 249.1] pSBI per 1,000 live births in the rural site (p = 0.008). In Cambodia, estimated incidences were 141.1 [105.4 to 189.0] and 85.3 [61.0 to 119.4] pSBI per 1,000 live births in urban and rural sites, respectively (p = 0.025), while in Senegal, we estimated 103.6 [76.0 to 141.2] pSBI and 41.5 [23.0 to 75.0] pSBI per 1,000 live births in urban and rural sites, respectively (p = 0.006). The incidences of culture-confirmed SBI were 15.2 [10.6 to 21.8], 6.5 [2.7 to 15.6], and 10.2 [4.8 to 21.3] per 1,000 live births in Madagascar, Cambodia, and Senegal, respectively, with no difference between urban and rural sites in each country. The great majority of early-onset infections occurred during the first 3 days of life (72.7%). The 3 main pathogens isolated were Klebsiella spp. (11/45, 24.4%), Escherichia coli (10/45, 22.2%), and Staphylococcus spp. (11/45, 24.4%). Among the 13 gram-positive isolates, 5 were resistant to gentamicin, and, among the 29 gram-negative isolates, 13 were resistant to gentamicin, with only 1 E. coli out of 10 sensitive to ampicillin. Almost one-third of the isolates were resistant to both first-line drugs recommended for the management of neonatal sepsis (ampicillin and gentamicin). Overall, 38 deaths occurred among neonates with SBI (possible and culture-confirmed SBI together). LBW and foul-smelling amniotic fluid at delivery were common risk factors for early pSBI in all 3 countries. A main limitation of the study was the lack of samples from a significant proportion of infants with pBSI including 35 neonatal deaths. Without these samples, bacterial infection and resistance profiles could not be confirmed. Conclusions In this study, we observed a high incidence of neonatal SBI, particularly in the first 3 days of life, in the community of 3 LMICs. The current treatment for the management of neonatal infection is hindered by antimicrobial resistance. Our findings suggest that microbiological diagnosis of SBI remains a challenge in these settings and support more research on causes of neonatal death and the implementation of early interventions (e.g., follow-up of at-risk newborns during the first days of life) to decrease the burden of neonatal SBI and associated mortality and help achieve Sustainable Development Goal 3.

scholarly journals Pregnancy and Breastfeeding During COVID-19 Pandemic: A Systematic Review of Published Pregnancy Cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Carina Rodrigues ◽  
Inês Baía ◽  
Rosa Domingues ◽  
Henrique Barros
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Web Of Science ◽  
Study Quality ◽  
Neonatal Deaths ◽  
Live Births ◽  
Milk Samples ◽  
The Impact

Background: The COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19.Methods: Searches were conducted in PubMed®, Scopus®, Web of Science®, and MedRxiv® up to 26th June 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality.Results: We identified 161 original studies reporting 3,985 cases of pregnant women with COVID-19 (1,007 discharged while pregnant). The 2,059 published cases with pregnancy outcomes resulted in 42 abortions, 21 stillbirths, and 2,015 live births. Preterm birth occurred in 23% of cases. Around 6% of pregnant women required admission to an intensive care unit and 28 died. There were 10 neonatal deaths. From the 163 cases with amniotic fluid, placenta, and/or cord blood analyzed for the SARS-CoV-2 virus, 10 were positive. Sixty-one newborns were positive for SARS-CoV-2. Four breast milk samples from 92 cases showed evidence of SARS-CoV-2.Conclusion: Emerging evidence suggests that vertical transmission is possible, however, there is still a limited number of reported cases with intrapartum samples. Information, counseling and adequate monitoring are essential to prevent and manage adverse effects of SARS-CoV-2 infection during pregnancy.

scholarly journals In situ measurements of speciated atmospheric mercury and the identification of source regions in the Mexico City Metropolitan Area

2009 ◽  
Vol 9 (1) ◽  
pp. 207-220 ◽  
Author(s):  
A. P. Rutter ◽  
D. C. Snyder ◽  
E. A. Stone ◽  
J. J. Schauer ◽  
R. Gonzalez-Abraham ◽  
...  
Keyword(s):  
Point Source ◽  
Mexico City ◽  
Metropolitan Area ◽  
Atmospheric Mercury ◽  
Point Sources ◽  
Rural Site ◽  
Urban Site ◽  
Trajectory Data ◽  
Source Regions ◽  
Rural Sites

Abstract. In order to expand the currently limited understanding of atmospheric mercury source-receptor relationships in the Mexico City Metropolitan Area, real time measurements of atmospheric mercury were made at a downtown urban site, and a rural site on the outskirts of Mexico City, during March 2006. Numerous short-lived increases in particulate mercury (PHg) and reactive gaseous mercury (RGM) concentrations were observed at the urban site during the 17 day study, and less frequent increases in gaseous elemental mercury (GEM) concentrations were measured at both the urban and rural sites. The episodic increases observed were attributed to plume impacts from industrial point source emissions in and around Mexico City. Average concentrations and standard deviations measured during the study were as follows: i) urban site; PHg=187±300 pg m−3, RGM=62±64 pg m−3, GEM=7.2±4.8 ng m−3, and; ii) rural site; GEM=5.0±2.8 ng m−3. Several source regions of atmospheric mercury to the urban and rural sites were determined using Concentration Field Analysis, in which atmospheric mercury measurements were combined with back trajectory data to determine source regions. Only some source regions correlated to mercury emission sources listed in the Federal Pollutant Release and Transfer Register, leaving the rest unaccounted for. Contributions of anthropogenic mercury point sources in and around Mexico City to concentration averages measured at the urban site during the study were estimated to be: 93±3% of reactive mercury (PHg and RGM), and; 81±0.4% of GEM. Point source contributions to GEM measured at the rural site were 72±1%. GEM and reactive mercury (PHg+RGM) were not found to correlate with biomass burning at either of the measurement sites.

scholarly journals Risk Factors for Community-Based Reports of Gastrointestinal, Respiratory, and Dermal Symptoms: Findings From a Cohort Study in Australia

2014 ◽  
Vol 24 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Nusrat Najnin ◽  
Andrew Forbes ◽  
Martha Sinclair ◽  
Karin Leder
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Community Based

scholarly journals Under-Five Mortality in Buea Health District, Southwest Cameroon: Evidence from a Community-Based Birth Cohort Study of Rate, Causes, and Age-Specific Patterns

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ettamba Agborndip ◽  
Benjamin Momo Kadia ◽  
Domin Sone Majunda Ekaney ◽  
Lawrence Tanyi Mbuagbaw ◽  
Marie Therese Obama ◽  
...  
Keyword(s):  
Cohort Study ◽  
Causes Of Death ◽  
Birth Asphyxia ◽  
Health District ◽  
Birth Cohort Study ◽  
Community Based ◽  
Live Births ◽  
Under Five ◽  
Child Deaths ◽  
The Mean

Background. Updating the knowledge base on the causes and patterns of under-five mortality (U5M) is crucial for the design of suitable interventions to improve survival of children under five. Objectives. To assess the rate, causes, and age-specific patterns of U5M in Buea Health District, Cameroon. Methods. A retrospective cohort study involving 2000 randomly selected households was conducted. Live births registered between September 2004 and September 2009 were recorded. The under-five mortality rate (U5MR) was defined by the number of deaths that occurred on or before 5 years of age per 1000 live births. Causes of death were assigned using the InterVA-4 software. Results. A total of 2210 live births were recorded. There were 92 deaths, and the U5MR was 42 per 1000 live births. The mean age at death was 11±15.9 months. The most frequent causes of death were neonatal causes (37%), malaria (28%), and pneumonia (15%). Deaths during infancy accounted for 64.1% of U5M, with 43.5% neonatal (86% occurring within the first 24 hours of life) and 20.7% postneonatal. The main causes of death in infancy were birth asphyxia (37.5%), pneumonia (17.5%), complications of prematurity (10%), and malaria (10%). Child deaths accounted for 35.8% of U5M. Malaria, pneumonia, and diarrhoeal illnesses accounted for the majority of child deaths. Conclusions. Almost half of U5M occurred during the neonatal period. Improvements in intrapartum care and the prevention and effective treatment of neonatal conditions, malaria, and pneumonia could considerably reduce U5M in Buea.

Intrapartum-Related Stillbirths and Neonatal Deaths in Rural Bangladesh: A Prospective, Community-Based Cohort Study

PEDIATRICS ◽  
2011 ◽  
Vol 127 (5) ◽  
pp. e1182-e1190 ◽  
Author(s):  
M. Ellis ◽  
K. Azad ◽  
B. Banerjee ◽  
S. K. Shaha ◽  
A. Prost ◽  
...  
Keyword(s):  
Cohort Study ◽  
Community Based ◽  
Neonatal Deaths ◽  
Rural Bangladesh

Prevalence and risk factors of osteoporosis in Korea: A community-based cohort study with lumbar spine and hip bone mineral density

Bone ◽  
2010 ◽  
Vol 47 (2) ◽  
pp. 378-387 ◽  
Author(s):  
Chan Soo Shin ◽  
Hyung Jin Choi ◽  
Min Joo Kim ◽  
Jin Taek Kim ◽  
Sung Hoon Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Cohort Study ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Mineral Density ◽  
Community Based

Bacterial infection in elderly nursing home and community-based patients: a prospective cohort study

Infection ◽  
2013 ◽  
Vol 41 (5) ◽  
pp. 909-916 ◽  
Author(s):  
J. Videcnik Zorman ◽  
L. Lusa ◽  
F. Strle ◽  
V. Maraspin
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Bacterial Infection ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Community Based

scholarly journals The association of maternal risk factors to macrosomia in rural areas of Haryana, India: a community based study

2018 ◽  
Vol 5 (9) ◽  
pp. 3842 ◽  
Author(s):  
Manisha Malik ◽  
Pardeep Khanna ◽  
Ramesh Verma
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Univariate Analysis ◽  
Neonatal Morbidity ◽  
Maternal Risk Factors ◽  
Community Based ◽  
Cross Sectional ◽  
Maternal Risk ◽  
Live Births ◽  
Diabetic Mothers

Background: Macrosomia affects 1-10% of all pregnancies. The macrosomia is reportedly associated with neonatal morbidity, neonatal injury, maternal injury and cesarean delivery. The present study was aimed at finding out prevalence and assessing association of maternal risk factors with macrosomia.Methods: This community based retrospective and cross-sectional study was carried out in 23 rural sub-centres of block Beri, district Jhajjar (Haryana, India) among 920 mothers. A predesigned pretested semistructured questionnaire was used to collect information. Univariate analysis along with logistic regression analysis was performed.Results: The prevalence of macrosomia among live births was 1.3% (n=12). In the present study, mothers from upper and upper middle socio-economic status had six times higher odds of delivering a large baby. Diabetic mothers had seventeen times higher incidence of macrosomia as compared to non-diabetic mothers. Mothers who consumed full course of iron folic acid (IFA) tablets during antenatal period had 24% lesser chances of macrosomia in live births as compared to mothers who did not consume the full course.Conclusions: The findings of the present study emphasize that incidence of macrosomia can be reduced by strengthening antenatal monitoring, prevention of complications, early diagnosis and appropriate and adequate management of treatable risk factors in mothers.

scholarly journals Determinants of Infant Mortality in Southeast Nigeria: Results from the Healthy Beginning Initiative, 2013-2014

2018 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Samantha A Slinkard, BA ◽  
Jennifer R Pharr, PhD ◽  
Tamara Bruno, MPH ◽  
Dina Patel, MSN ◽  
Amaka Ogidi, MEd ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infant Mortality ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Prenatal Screening ◽  
Sub Saharan Africa ◽  
Community Based Interventions ◽  
Community Based ◽  
Live Births ◽  
Enugu State

Background: Neonatal mortality due to preventable factors occurs at high rates throughout sub-Saharan Africa. Community-based interventions increase opportunities for prenatal screening and access to antenatal care services (ANC) services. The Healthy Beginning Initiative (HBI) provided congregation-based prenatal screening and health counseling for 3,047 women in Enugu State. The purpose of this study was to identify determinants for infant mortality among this cohort.Methods: This was a prospective cohort study of post-delivery outcomes at 40 churches in Enugu State, Nigeria between 2013 and 2014. Risk factors for infant mortality were assessed using chi square, odds ratios, and multiple logistic regression.Results: There were 2,436 live births from the 2,379 women who delivered (55 sets of twins and one set of triplets), and 99 cases of neonatal/early postneonatal mortality. The neonatal mortality rate was 40.6 per 1,000 live births. Risk factors associated with neonatal mortality were lack of access to ANC services [OR= 8.81], maternal mortality [OR= 15.28], caesarian section [OR= 2.47], syphilis infection [OR= 6.46], HIV-positive status [OR= 3.87], and preterm birth [OR= 14.14].Conclusions and Global Health Implications: These results signify that culturally-acceptable community-based interventions targeted to increase access to ANC services, post-delivery services for preterm births, and HIV and syphilis screening for expectant mothers are needed to reduce infant mortality in resource-limited settings.Key words: Infant Mortality • Neonatal Mortality • HIV, Antenatal Care • Nigeria • Healthy Beginning InitiativeCopyright © 2018 Slinkard et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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