Trends in the incidence of possible severe bacterial infection and case fatality rates in rural communities in Sub-Saharan Africa, South Asia and Latin America, 2010–2013: a multicenter prospective cohort study
Year: 2016
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Possible severe bacterial infections (pSBI) continue to be a leading cause of global neonatal mortality annually. With the recent publications of simplified antibiotic regimens for treatment of pSBI where referral is not possible, it is important to know how and where to target these regimens, but data on the incidence and outcomes of pSBI are limited. METHODS: We used data prospectively collected at 7 rural community-based sites in 6 low and middle income countries participating in the NICHD Global Network's Maternal and Newborn Health Registry, between January 1, 2010 and December 31, 2013. Participants included pregnant women and their live born neonates followed for 6 weeks after delivery and assessed for maternal and infant outcomes. RESULTS: In a cohort of 248,539 infants born alive between 2010 and 2013, 32,088 (13 %) neonates met symptomatic criteria for pSBI. The incidence of pSBI during the first 6 weeks of life varied 10 fold from 3 % (Zambia) to 36 % (Pakistan), and overall case fatality rates varied 8 fold from 5 % (Kenya) to 42 % (Zambia). Significant variations in incidence of pSBI during the study period, with proportions decreasing in 3 sites (Argentina, Kenya and Nagpur, India), remaining stable in 3 sites (Zambia, Guatemala, Belgaum, India) and increasing in 1 site (Pakistan), cannot be explained solely by changing rates of facility deliveries. Case fatality rates did not vary over time. CONCLUSIONS: In a prospective population based registry with trained data collectors, there were wide variations in the incidence and case fatality of pSBI in rural communities and in trends over time. Regardless of these variations, the burden of pSBI is still high and strategies to implement timely diagnosis and treatment are still urgently needed to reduce neonatal mortality. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov ( NCT01073475 ).
Source: Reproductive Health
Authors: Patricia L. Hibberd, Nellie I. Hansen, Marie E. Wang, Shivaprasad S. Goudar, Omrana Pasha, Fabian Esamai, Elwyn Chomba, Ana Garces, Fernando Althabe, Richard J. Derman, Robert L. Goldenberg, Edward A. Liechty, Waldemar A. Carlo, K. Michael Hambidge, Nancy F. Krebs, Pierre Buekens, Elizabeth M. McClure, Marion Koso-Thomas, Archana B. Patel
Institutions: Massachusetts General Hospital, RTI International, Jawaharlal Nehru Medical College, Aga Khan University, Moi University, University of Zambia, Institute of Nutrition of Central America and Panama, Instituto de Efectividad Clínica y Sanitaria, Christiana Hospital, Columbia University, Indiana University School of Medicine, University of Alabama at Birmingham, Tulane University, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Lata Medical Research Foundation
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
Awards: Global Network for Women's and Children's Health Research, The Global Network and Preconception Maternal Nutrition, Global Network for Women's & Children's Health Research Data Coordinating Center, Heart Rate Detection during Resuucitation to Reduce Early Neonatal Mortality, AKU Global Network Research Unit, Pediatric Infectious Diseases Research Training, Complementary feeding: a Global Network cluster randomized controlled trial, UMKC-JNMC Global Network for Women's and Children's Health Research Unit, Improving Quality of Care for the Treatment of Childhood Pneumonia, Community-based interventions to reduce mortality from neonatal infection, Columbia University/Aga Khan University Global Network Research Unit, Evidence-Based Global Health Interventions for Mothers and Children, Argentina, Maternal and Child Health Benefits from Reducing Household Air Pollution, Midcareer Investigator Award in Patient-Oriented Research (K24), Global Network for Women's and Children's Health Research, Global Network for Women's and Children's Health, CCHS-JNMC Global Network for Women's & Children's Health Research Unit, Leveraging the Global Network to implement health interventions to improve maternal and child outcomes in a rapidly changing environment, Boston University/Lata Medical Research Foundation Global Network for Women's Children's Health Research Unit
OpenAlex ID: W2397426478