Congenital anomalies in Santa Catarina: case distribution and trends in 2010–2018

Objective: To evaluate the distribution of cases of congenital anomalies in the state of Santa Catarina by health macro-region, to determine the frequency according to maternal and neonatal variables, to estimate the related mortality, and the trends in the period 2010–2018. Methods: An ecological time-series study with secondary data on congenital anomalies and the sociodemographic and health variables of mothers and newborns living in Santa Catarina, from 2010 to 2018. For temporal trend analysis, generalized linear regression was performed using the Prais-Winsten method with robust variance. Results: The average prevalence of congenital anomalies in the period was 8.9 cases per 1,000 live births, being 9.4 cases by 1,000 live births in 2010 and, in 2018, 8.2/1,000. The trend remained stable in the analyzed period. The major malformations were musculoskeletal, hip, and foot malformations, with a proportion ≥30%. There was a higher prevalence of congenital anomalies in low birthweight, preterm, male livebirths with Apgar≤7, born by cesarean section, mothers of older age (≥40 years), and less educated (less than eight years of study). Infant mortality due to congenital malformations was 2.6 deaths/1,000 live births, representing about 25.8% of the total infant deaths in the period. Conclusions: The frequency of congenital anomalies and the mortality with anomalies was stable in the studied period in Santa Catarina. The presence of anomalies was associated with low birth weight, prematurity, and low Apgar score. The highest proportion of congenital anomalies was in the musculoskeletal system.

Modelling Neonatal Mortality Rate in Nigeria Using a Continuous Poisson-Lindley Distribution

Nigeria’s effort to reduce under-five mortality has been biased in favour of childhood mortality to the neglect of neonates and as such the literature is short of adequate information on the determinants of neonatal mortality, whereas studies have shown that about half of infant deaths occur in the neonatal period. Knowledge of the determinants of neonatal mortality is essential for the design of intervention programmes that will enhance neonatal survival. Therefore, this study was conducted to investigate the trends in neonatal mortality in Nigeria. It also proposed a Poisson based continuous probability distribution called Poisson-Lindley distribution to neonatal mortality rate in Nigeria. Some properties of the new model and other relevant measures were obtained. The unknown parameters of the model were also estimated using the method of maximum likelihood. The fitness of the proposed model to the neonatal mortality rate was considered using a dataset on neonatal mortality rate from 1967 to 2019.

Hubungan Pengetahuan Ibu Mengenai Manajemen Laktasi Dengan Pemberian ASI Eksklusif : Literature Review

Infant mortality rate is one of the highest problems in the world. One of the causes is infection. Most infant deaths can be prevented by exclusive. The purpose of this study was to determine the relationship between mother’s knowledge about lactation management and exclusive breastfeeding through a literature review. This research is a quantitative descriptive type of correlation research. 5 articles use the cross sectional approach. 5 articles use the chi-square statistical test, collecting data using a literature review, accessing Garuda Portal data, 5 articles published in 2-11-2021 by using the keyword : Knowledge, Lactation Management, Exclusi Breastfeeding. The critical study instrument used was using the JBI with 8 questions. The characteristics of respondents in this literature review indude age characteristics in the category of 20-35 years, the category of High School Education, and the category of work. The level of knowledge in the poor category obtained results of 142 (45,3%) and breastfeeding in the category of not giving with results of 172 (54,9%). The results of the analysis using the chi-square test found that there was a relationship with the p value of 0,001. There is a relationship between knowledge of lactation management and exclusive breastfeeding. The results of the literature review can improve health education about exclusive breastfeeding.Keywords: Exclusive Breastfeeding, Management Lactation, Knowledge. AbstrakAngka kematian bayi menjadi salah satu masalah tertinggi di dunia. Salah satu penyebabnya adalah infeksi. Sebagian besar kematian bayi bias dicegah dengan pemberian ASI Eksklusif. Pengetahuan ASI Eksklusif perlu dilakukan penelitian. Tujuan dari penelitian ini adalah untuk mengetahui hubungan pengetahuan ibu mengenai manajemen laktasi dengan pemberian ASI Eksklusif melalui literatur review. Penelitian ini adalah penelitian kuantitatif jenis deskriptif korelasi. Dari 5 artikel yang menggunakan Pendekatan Cross Sectional. Dari 5 artikel menggunakan uji statistic Chi-square, pengumpulan data menggunakan literature review, mengakses data Portal Garuda 5 artikel yang diterbitkan pada tahun 2011-2021. Dengan menggunakan kata kunci : “Pengetahuan, ManajemenLaktasi, Pemberian ASI Eksklusif”, Instrument telaah kritis yang digunakan yaitu dengan menggunakan JBI dengan 8 pertanyaan.karakteristikresponden pada literature review ini karakteristik usia masuk dalam kategori 20-35 tahun, kategori Pendidikan Pendidikan SMA, kategori pekerjaan bekerja. Tingkat pengetahuan dalam kategori kurang didapatkan hasil 142 (45,3%) dan pemberian ASI dalam kategori tidak memberikan dengan hasil 172 (54,9%). Hasil Analisa menggunakan uji chi-square didapatkan ada hubungan dengan nilai p value 0,001. Penelitian ini terdapat hubungan antara pengetahuan manajemen laktasi dengan pemberian ASI Eksklusif. Hasil literatur review dapat meningkatkan penyuluhan Kesehatan tentang pemberian ASI secara Eksklusif.Kata Kunci :ASI Eksklusif, ManajemenLaktasi, pengetahuan.

Morphology of the Dentate Gyrus in a Large Cohort of Sudden Infant Deaths—Interrelation Between Features but Not Diagnosis

Morphological differences in the dentate gyrus (DG) have been reported in sudden unexpected deaths in infancy (SUDI), with the feature of focal granule cell (GC) bilamination (FGCB) reported as increased in unexplained SUDI, including sudden infant death syndrome (SIDS), compared with explained SUDI (eSUDI). However, it remains to be determined how these morphologies relate to each other and their extent along the anteroposterior length. This retrospective study evaluated the prevalence of FGCB, single or clustered ectopic GCs, granule cell dispersion (GCD), heterotopia, hyperconvolution, gaps, thinning, blood vessel dissection (BVD), and cuffing (BV cuffing), in an Australian SUDI cohort, and compared the prevalence of these features in eSUDI and unexplained SUDI. We analyzed 850 formalin-fixed paraffin-embedded serial and subserial sections of the hippocampus at the level of the lateral geniculate nucleus from 90 infants, and identified GCD in 97% of infants, single ectopic cells, hyperconvolution, thinning, and BVD in 60%-80%, heterotopia in 36%, gaps, clusters of ectopic cells and BV cuffing in 9%–15%, and FGCB in 18%. These features are clustered within 3–5 serial sections. The presence of FGCB correlated with single ectopic GCs and hyperconvolution. There were no differences in the prevalence of these features between unexplained SUDI (n = 74) and eSUDI (n = 16). Our findings highlight that DG morphological features are highly localized, extending 14–35 µm at their focal location(s) along the anteroposterior length. Consequently, multiple sections along the longitudinal extent are required to identify them. No feature differentiated SUDI from eSUDI in our cohort, thus we cannot conclude that any of these features are abnormal and it remains to be determined their functional significance.

Risk factors for death in Welsh infants with a congenital anomaly

ObjectivesTo investigate risk factors associated with death of infants with a congenital anomaly in Wales, UK.DesignA population-based cohort study.SettingData from the Welsh Congenital Anomaly Register and Information Service (CARIS) linked to live births and deaths from the Office for National Statistics.PatientsAll live births between 1998 and 2016 with a diagnosis of a congenital anomaly, which was defined as a structural, metabolic, endocrine or genetic defect, as well as rare disease of hereditary origin.Main outcome measuresAdjusted ORs (aORs) were estimated for socio-demographic, maternal, infant and intervention factors associated with death in infancy, using logistic regression for all, isolated, multiple and cardiovascular anomalies.Results30 424 live births affected by congenital anomalies were identified, including 1044 infants who died by the age of 1 year (infant mortality rate: 16.5 per 10 000 live births, case fatality: 3.4%, 30.3% of all infant deaths). Risk factors for infant death were non-white versus white ethnicity (aOR: 2.25; 95% CI: 1.77–2.86); parous versus nulliparous (aOR: 1.24; 95% CI: 1.08–1.41); smoking during pregnancy versus non-smokers/ex-smokers (aOR: 1.20; 95% CI: 1.02–1.40); preterm versus term birth (aOR: 4.38; 95% CI 3.86–4.98); female versus male infants (aOR: 1.28; 95% CI: 1.13–1.46) and the earlier years of the birth cohort (aOR: 0.96; 95% CI: 0.95–0.98 per yearly increase). Infants with a cardiovascular anomaly who received surgery had a lower odds of death than those who did not (aOR: 0.34; 95% CI: 0.15–0.75). Preterm birth was a significant factor for death for all anomalies but the effect of the other characteristics varied according to anomaly group.ConclusionsNearly a third of all infant deaths had an associated anomaly. Improving access to prenatal care, smoking cessation advice, optimising care for preterm infants and surgery may help lower the risk of infant death.

Edukasi Pentingnya Bakteri Asam Laktat (BAL) Terhadap Kesehatan Saluran Cerna Bayi

Infant Mortality Rate is one indicator that determines health status. Every year there are 3 million infant deaths in the world, 80% of which occur in the first 6 days of life, with pneumonia and diarrhea still being the main causes of death. Based on Nurita's research (2019) on postpartum mothers and newborns, which aims to determine the relationship between the frequency of giving colostrum and birth mode with the number of Lactic Acid Bacteria (LAB) colonies in the neonatal gastrointestinal tract. The results of the study found that the number of LAB colonies in babies born vaginally and C-Section was not much different, but the number of LAB colonies would increase in number if breast milk was often given. The education carried out targets an increase in the knowledge of educational participants with the outputs in the form of informative leaflets, educational video, educational X-Banners, activity reports and journal publications. Community service activities begin with licensing arrangements, time contracts, preparation of educational tools and materials, visits to Independent Midwives Practice (PMB, explanations of educational materials, discussions and questions-answers, showing educational videos, and handing over Educational X-Banners. It can be concluded that educational participants are still unfamiliar with lactic acid bacteria (LAB) and their role in the health of the baby's gastrointestinal tract, so further education is needed

Subnational mortality estimates for India in 2019: a baseline for evaluating excess deaths due to the COVID-19 pandemic

BackgroundEstimates of excess mortality are required to assess and compare the impact of the COVID-19 pandemic across populations. For India, reliable baseline prepandemic mortality patterns at national and subnational level are necessary for such assessments. However, available data from the Civil Registration System (CRS) is affected by incompleteness of death recording that varies by sex, age and location.MethodsUnder-reporting of CRS 2019 deaths was assessed for three age groups (< 5 years, 15–59 years and ≥60 years) at subnational level, through comparison with age-specific death rates from alternate sources. Age-specific corrections for under-reporting were applied to derive adjusted death counts by sex for each location. These were used to compute life expectancy (LE) at birth by sex in 2019, which were compared with subnational LEs from the Global Burden of Disease (GBD) 2019 Study.ResultsA total of 9.92 million deaths (95% UI 9.70 to 10.02) were estimated across India in 2019, about 2.28 million more than CRS reports. Adjustments to under-five and elderly mortality accounted for 30% and 56% of additional deaths, respectively. Adjustments in Bihar, Jharkhand, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh accounted for 75% of all additional deaths. Adjusted LEs were below corresponding GBD estimates by ≥2 years for males at national level and in 20 states, and by ≥1 year for females in 12 states.ConclusionsThese results represent the first-ever subnational mortality estimates for India derived from CRS reported deaths, and serve as a baseline for assessing excess mortality from the COVID-19 pandemic. Adjusted life expectancies indicate higher mortality patterns in India than previously perceived. Under-reporting of infant deaths and those among women and the elderly is evident in many locations. Further CRS strengthening is required to improve the empirical basis for local mortality measurement across the country.

THE IMPORTANCE OF SOCIALIZATION OF POSYANDU TO IMPROVE POSYANDU VISITING, KNOWLEDGE, AND COMMUNITY ATTITUDE TO IMPROVE IMMUNIZATION ACHIEVEMENTS

Data from WHO shows that every year in the world, there are 1.5 million infant deaths one week old and 1.4 million stillbirths due to not getting immunized. Infant Mortality Rate (IMR) is one of the most critical indicators that determine the degree of health and welfare of a community. This research was conducted to assess the importance of the socialization of posyandu activities and the role of cadres to invite citizens to come to Posyandu because one of the factors that encourage the completeness of immunization is the presence of mothers to Posyandu in addition to other factors that might play a role such as mothers' knowledge and attitudes towards immunization. The design of this study is a quantitative analytic cross-sectional approach carried out in Posyandu Teratai 1, in the January 2020 period. The sample of this study is all mothers who have 5-year-old babies who are in the coverage area of the Posyandu Teratai 1. The independent variable is the routine or non-routine of the respondents present during the implementation of Posyandu Teratai 1, their knowledge and attitudes towards immunization. The dependent variable in this study is the child's immunization status—the statistical analysis used Chi-square with Yates Correction or Fisher Exact alternative test. Results Statistical test results show that routine attendance at the Posyandu (p-value <0.001) plays a substantial role in completing immunization. While knowledge and attitudes do not represent a significant role, but they still have a particular influence on the completeness of immunization (p-values: 0.098 and 0.240). A factor that has a role in increasing the number of immunization outcomes in an area is to encourage the presence of mothers to come to Posyandu routinely. AbstrakData WHO menunjukkan bahwa setiap tahun di dunia terdapat 1,5 juta kematian bayi usia satu minggu dan 1,4 juta bayi lahir mati karena tidak diimunisasi. Angka Kematian Bayi (AKB) merupakan salah satu indikator terpenting yang menentukan derajat kesehatan dan kesejahteraan suatu masyarakat. Penelitian ini dilakukan untuk menilai pentingnya sosialisasi kegiatan posyandu dan peran kader untuk mengajak warga datang ke posyandu karena salah satu faktor yang mendorong kelengkapan imunisasi adalah kehadiran ibu ke posyandu disamping faktor lain yaitu mungkin memainkan peran seperti pengetahuan dan sikap ibu terhadap imunisasi. Desain penelitian ini adalah kuantitatif analitik dengan pendekatan cross sectional yang dilaksanakan di Posyandu Teratai 1 periode Januari 2020. Sampel penelitian ini adalah seluruh ibu yang memiliki bayi berusia 5 tahun yang berada di wilayah cakupan Posyandu Teratai 1. Variabel bebasnya adalah rutin atau tidak rutinnya responden yang hadir selama pelaksanaan Posyandu Teratai 1, pengetahuan dan sikap mereka terhadap imunisasi. Variabel terikat dalam penelitian ini adalah status imunisasi anak—analisis statistik menggunakan uji Chi-square dengan Yates Correction atau uji alternatif Fisher Exact. Hasil Hasil uji statistik menunjukkan bahwa kehadiran rutin di Posyandu (p-value <0,001) berperan penting dalam menyelesaikan imunisasi. Sedangkan pengetahuan dan sikap tidak memiliki peran yang signifikan, tetapi masih memiliki pengaruh khusus terhadap kelengkapan imunisasi (p-values: 0,098 dan 0,240). Salah satu faktor yang berperan dalam peningkatan angka luaran imunisasi di suatu daerah adalah mendorong kehadiran ibu untuk datang ke posyandu secara rutin. Kata kunci: imunisasi; posyandu; kader; pengetahuan; kehadiran