Clinical signs predicting severe illness in young infants (&lt;60 days) in Bolivia

Mazzi, Eduardo; Bartos, Andres E; Weber, Martin

doi:10.1093/tropej/fmq005

Cited by 14 publications

(12 citation statements)

References 18 publications

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“…According to bicentric study in Bolivia conducted by Mazzi et al jaundice was present as per IMNCI in 0-7 days and 7-59 days as 49% and 32.8% infants as compared to 29% and 31% in the present study respectively. In this study jaundice as per gold standard, present in 0-7 days and 7-59 days infants was 55% and 38.5% infants as compared to 28% and 18.8% in the present study respectively [14]. This high diagnosis of jaundice according to IMNCI and gold standard was similar to that in the present study.…”

Section: Jaundice Diagnostic Agreementsupporting

confidence: 87%

Validation of WHO-IMNCI algorithm for jaundice in 0-2 months aged infants

Bansal¹,

Sharma

2019

Int J Pediatr Res

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Background: For effective management of these major childhood illnesses, WHO and UNICEF have developed the "Integrated Management of Neonatal and Childhood Illness" (IMNCI) Strategy. Present study is to evaluate the utility of the WHO/UNICEF algorithm for Integrated Management of Neonatal and Childhood Illness (IMNCI) for jaundice up to 2 months of age. Methods: Present study is Prospective observational comparative study. Total of 150 subjects were taken from Emergency and Outpatient Department of Pediatrics. The treatment steps were identified as according to the 'Assess and Classify' module of IMNCI algorithm. All relevant investigations were performed, using appropriate methods. Blood sugar was done in all recruited children and serum bilirubin levels were done in all infants presented with jaundice. Based on this detailed clinical evaluation and relevant investigations, final diagnosis were made and therapies were given. These diagnosis and treatments were considered as the 'Gold Standard' for comparison. Results: There were 150 young infants, of whom 81(54%) were male and 69(46%) were female infants. Total of 73 infants were admitted, 12 from OPD and 61 from Emergency. 77 infants were sent home after initial management in hospital. Severe jaundice was present in 12 infants according to IMNCI and 6 infants according to Gold Standard in 0-2 months of age. The predictive utility of algorithm for the diagnosis of severe jaundice with a sensitivity of 100%, specificity of 75%, positive predictive value of 50% and negative predictive value of 100% in 0-2 months of age group. Conclusion: Algorithm performed well in identifying severe jaundice with the sensitivity of 100% and specificity of 95%.

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Section: Jaundice Diagnostic Agreementsupporting

confidence: 87%

Validation of WHO-IMNCI algorithm for jaundice in 0-2 months aged infants

Bansal¹,

Sharma

2019

Int J Pediatr Res

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“…To apportion the envelope of pSBI cases to infection syndromes (meningitis, sepsis, or pneumonia), site-specific data from the second multicountry WHO Young Infant Study of Neonatal Sepsis (9) were used (Bolivia (13), Ghana (14), India (15,16), and South Africa (17). Meta-analyses (see Supplementary Information online) resulted in the following estimates: neonatal sepsis accounted for 25% (95% CI: 16–34%) of pSBI cases, five data sets, N = 532; neonatal meningitis accounted for 3% (95% CI: 0.3–6%), two data sets, N = 217; and neonatal pneumonia accounted for 8% (95% CI: 2–13%), five data sets, N = 532 ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010

et al. 2013

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Background:Survivors of neonatal infections are at risk of neurodevelopmental impairment (NDI), a burden not previously systematically quantified and yet important for program priority setting. Systematic reviews and meta-analyses were undertaken and applied in a three-step compartmental model to estimate NDI cases after severe neonatal bacterial infection in South Asia, sub-Saharan Africa, and Latin America in neonates of >32 wk gestation (or >1,500 g).Methods:We estimated cases of sepsis, meningitis, pneumonia, or no severe bacterial infection from among estimated cases of possible severe bacterial infection ((pSBI) step 1). We applied respective case fatality risks ((CFRs) step 2) and the NDI risk among survivors (step 3). For neonatal tetanus, incidence estimates were based on the estimated deaths, CFRs, and risk of subsequent NDI.Results:For 2010, we estimated 1.7 million (uncertainty range: 1.1–2.4 million) cases of neonatal sepsis, 200,000 (21,000–350,000) cases of meningitis, 510,000 cases (150,000–930,000) of pneumonia, and 79,000 cases (70,000–930,000) of tetanus in neonates >32 wk gestation (or >1,500 g). Among the survivors, we estimated moderate to severe NDI after neonatal meningitis in 23% (95% confidence interval: 19–26%) of survivors, 18,000 (2,700–35,000) cases, and after neonatal tetanus in 16% (6–27%), 4,700 cases (1,700–8,900).Conclusion:Data are lacking for impairment after neonatal sepsis and pneumonia, especially among those of >32 wk gestation. Improved recognition and treatment of pSBI will reduce neonatal mortality. Lack of follow-up data for survivors of severe bacterial infections, particularly sepsis, was striking. Given the high incidence of sepsis, even minor NDI would be of major public health importance. Prevention of neonatal infection, improved case management, and support for children with NDI are all important strategies, currently receiving limited policy attention.

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“…None of these were defined according to internationally recognised criteria. However, it is likely that some are similar to that defined in the Young Infants Clinical Signs Study [ 138 ] which could be used more frequently. In contrast, growth was assessed using comparable criteria across the majority of studies.…”

Section: Discussionmentioning

confidence: 99%

Survival, Morbidity, Growth and Developmental Delay for Babies Born Preterm in Low and Middle Income Countries – A Systematic Review of Outcomes Measured

2015

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BackgroundPremature birth is the leading cause of neonatal death and second leading in children under 5. Information on outcomes of preterm babies surviving the early neonatal period is sparse although it is considered a major determinant of immediate and long-term morbidity.MethodsSystematic review of studies reporting outcomes for preterm babies in low and middle income settings was conducted using electronic databases, citation tracking, expert recommendations and “grey literature”. Reviewers screened titles, abstracts and articles. Data was extracted using inclusion and exclusion criteria, study site and facilities, assessment methods and outcomes of mortality, morbidity, growth and development. The Child Health Epidemiology Reference Group criteria (CHERG) were used to assess quality.FindingsOf 197 eligible publications, few (10.7%) were high quality (CHERG). The majority (83.3%) report on the outcome of a sample of preterm babies at time of birth or admission. Only 16.0% studies report population-based data using standardised mortality definitions. In 50.5% of studies, gestational age assessment method was unclear. Only 15.8% followed-up infants for 2 years or more. Growth was reported using standardised definitions but recommended morbidity definitions were rarely used. The criteria for assessment of neurodevelopmental outcomes was variable with few standardised tools - Bayley II was used in approximately 33% of studies, few studies undertook sensory assessments.ConclusionsTo determine the relative contribution of preterm birth to the burden of disease in children and to inform the planning of healthcare interventions to address this burden, a renewed understanding of the assessment and documentation of outcomes for babies born preterm is needed. More studies assessing outcomes for preterm babies who survive the immediate newborn period are needed. More consistent use of data is vital with clear and aligned definitions of health outcomes in newborn (preterm or term) and intervention packages aimed to save lives and improve health.

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Clinical signs predicting severe illness in young infants (<60 days) in Bolivia

Cited by 14 publications

References 18 publications

Validation of WHO-IMNCI algorithm for jaundice in 0-2 months aged infants

Validation of WHO-IMNCI algorithm for jaundice in 0-2 months aged infants

Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010

Survival, Morbidity, Growth and Developmental Delay for Babies Born Preterm in Low and Middle Income Countries – A Systematic Review of Outcomes Measured

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