Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: a systematic review and meta-analysis

Abstract

SummaryBackgroundBacterial infections are a leading cause of the 2·9 million annual neonatal deaths. Treatment is usually based on clinical diagnosis of possible severe bacterial infection (pSBI). To guide programme planning, we have undertaken the first estimates of neonatal pSBI, by sex and by region, for sub-Saharan Africa, south Asia, and Latin America.MethodsWe included data for pSBI incidence in neonates of 32 weeks' gestation or more (or birthweight ≥1500 g) with livebirth denominator data, undertaking a systematic review and forming an investigator group to obtain unpublished data. We calculated pooled risk estimates for neonatal pSBI and case fatality risk, by sex and by region. We then applied these risk estimates to estimates of livebirths in sub-Saharan Africa, south Asia, and Latin America to estimate cases and associated deaths in 2012.FindingsWe included data from 22 studies, for 259 944 neonates and 20 196 pSBI cases, with most of the data (18 of the 22 studies) coming from the investigator group. The pooled estimate of pSBI incidence risk was 7·6% (95% CI 6·1–9·2%) and the case-fatality risk associated with pSBI was 9·8% (7·4–12·2). We estimated that in 2012 there were 6·9 million cases (uncertainty range 5·5 million–8·3 million) of pSBI in neonates needing treatment: 3·5 million (2·8 million–4·2 million) in south Asia, 2·6 million (2·1 million–3·1 million) in sub-Saharan Africa, and 0·8 million (0·7 million–1·0 million) in Latin America. The risk of pSBI was greater in boys (risk ratio 1·12, 95% CI 1·06–1·18) than girls. We estimated that there were 0·68 million (0·46 million–0·92 million) neonatal deaths associated with pSBI in 2012.InterpretationThe need-to-treat population for pSBI in these three regions is high, with ten cases of pSBI diagnosed for each associated neonatal death. Deaths and disability can be reduced through improved prevention, detection, and case management.FundingThe Wellcome Trust and the Bill & Melinda Gates Foundation through grants to Child Health Epidemiology Reference Group (CHERG) and Save the Children's Saving Newborn Lives programme.

Trends in profiles of bacteria causing neonatal sepsis in Central Nigeria Hospital

“…It is estimated that sub-Saharan Africa had 2.6 million cases of serious bacterial infection in 2012, the highest for any WHO region with a case fatality of 14% (1). Mortality rates are high for neonatal sepsis and reports show that 17%-41% of neonatal deaths in Nigeria are from sepsis (2)(3)(4)(5).…”

Colonization of Extended-Spectrum-β-Lactamase- and NDM-1-Producing Enterobacteriaceae among Pregnant Women in the Community in a Low-Income Country: a Potential Reservoir for Transmission of Multiresistant Enterobacteriaceae to Neonates

“…evere bacterial infections are responsible for a large number of neonatal deaths in low-income countries (LICs) (1,2), with Enterobacteriaceae most frequently isolated in neonatal sepsis (3,4). The production of plasmid-borne extended-spectrum ␤-lactamases (ESBL) is the main mechanism of resistance against expanded-spectrum cephalosporins (ESC) among Enterobacteriaceae, with the CTX-M-15 variant being the most common enzyme (5).…”

The Effect of Numbing Needles Pain with Topical Anaesthesia on Preterms’ Exposure to Neonatal Sepsis

“…The presence of any one of seven clinical signs and symptoms predicted severe bacterial illness (on the basis of an experienced pediatrician's assessment) with a sensitivity of 85% and specificity of 75%, in those seeking care. [33] During hospital stay all premature infants in the present study were exposed to procedural needle punctures and more than half and less than half of them behave calmly and had minimal pain intensity during it respectively as well. Yuhico [30] found that needle punctures are one of the most common procedures that children experience as part of routine medical care.…”