Implementation of the ANISA Protocol in Sylhet, Bangladesh

Mitra, Dipak Kumar; Mahmud, Arif; Begum, Nazma; Rafiqullah, Iftekhar; Roy, Arunangshu D.; Moin, Syed Mamun Ibne; Islam, Maksuda; Quaiyum, Abdul; Ferdous, Jannatul; Applegate, Jennifer A.; Saha, Samir K.; Baqui, Abdullah H

doi:10.1097/inf.0000000000001108

Cited by 11 publications

(16 citation statements)

References 17 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ANISA is a multi-country cohort study conducted in Bangladesh, India, and Pakistan with a goal of providing data for designing appropriate treatment regimens and prevention strategies to reduce the burden of bacterial and viral infections in neonates and young infants. Details of this study have been described previously [ 23 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…The Project for Advancing Health of Newborns and Mothers (Projahnmo) research group implemented the ANISA study in two rural sub-districts (Zakigang and Kanaighat) of Sylhet district under Sylhet division, located in the north-eastern part of Bangladesh [ 23 , 25 ]. The study site is about 300 km away from Dhaka (i.e., the capital city of Bangladesh) and 50 km away from Sylhet city (i.e., the divisional headquarter of Sylhet).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Rates and determinants of neonatal mortality in two rural sub-districts of Sylhet, Bangladesh

et al. 2018

Self Cite

View full text Add to dashboard Cite

IntroductionReducing neonatal mortality rate (NMR) is a challenge in many low- and middle-income countries including Bangladesh. In 2014, the estimated NMR in this country was 28 per 1,000 live births. This rate is higher in rural regions compared to the national average. Currently, Sylhet Division has the highest NMR in Bangladesh. Investigating rates and determinants of neonatal mortality in rural regions of this high-risk division is particularly important to implement evidence-based programs. This study examined rates and determinants of neonatal deaths in a large rural cohort in Sylhet Division.MethodsWe analyzed data from a multi-country cohort study, Aetiology of Neonatal Infections in South Asia. From November 2011 to December 2013, this study was conducted in two rural sub-districts in Sylhet Division. Community health workers followed 28,960 pregnant women and their newborns up to two months postpartum and collected data on pregnancy outcomes and newborns’ survival status. The NMR was obtained by dividing total number of neonatal deaths with all studied newborns. Logistic regression was employed to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with neonatal mortality. Stata 14.0 was used for data analysis.ResultsThis study analyzed data of 21,227 newborns. The NMR was 43.4 (95% CI: 39.3–48.0) per 1,000 live births (N = 922). Multivariable analysis showed that the odds of neonatal mortality were significantly higher among male newborns (AOR: 1.5, 95% CI: 1.2–1.8), babies born before 34 weeks of gestation (AOR: 5.0, 95% CI: 4.1–6.1), those who were twins or triplets (AOR: 6.2, 95% CI: 3.6–10.9), and first-born child (AOR: 2.9, 95% CI: 1.6–5.3). Additionally, maternal age 30–35 years (AOR: 1.4, 95% CI: 1.-1.8), history of child death (AOR: 1.6, 95% CI: 1.2–2.2), and delivery complications (AOR: 2.1, 95% CI: 1.6–2.6) had positive associations with neonatal deaths.ConclusionPublic health programs in Bangladesh need to adopt a comprehensive strategy to address the individual, maternal, and intrapartum factors associated with neonatal mortality in rural regions. Interventions should aim to prioritize managing pre-term deliveries, first-born child, and delivery complications among pregnant women.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Rates and determinants of neonatal mortality in two rural sub-districts of Sylhet, Bangladesh

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…The study, Aetiology of Neonatal Infection in South Asia (ANISA), was a multi-centric study conducted in five sites of three countries of South Asia including a site in Sylhet district in Bangladesh. This paper used data from the Bangladesh site only and detailed of the study methods were published [ 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Can facility delivery reduce the risk of intrapartum complications-related perinatal mortality? Findings from a cohort study

Khanam

Baqui

Syed³

et al. 2018

Journal of Global Health

Self Cite

View full text Add to dashboard Cite

BackgroundIntrapartum complications increase the risk of perinatal deaths. However, population-based data from developing countries assessing the contribution of intrapartum complications to perinatal deaths is scarce.MethodsUsing data from a cohort of pregnant women followed between 2011 and 2013 in Bangladesh, this study examined the rate and types of intrapartum complications, the association of intrapartum complications with perinatal mortality, and if facility delivery modified the risk of intrapartum-related perinatal deaths. Trained community health workers (CHWs) made two-monthly home visits to identify pregnant women, visited them twice during pregnancy and 10 times in the first two months postpartum. During prenatal visits, CHWs collected data on women’s prior obstetric history, socio-demographic status, and complications during pregnancy. They collected data on intrapartum complications, delivery care, and pregnancy outcome during the first postnatal visit within 7 days of delivery. We examined the association of intrapartum complications and facility delivery with perinatal mortality by estimating odds ratios (OR) and 95% confidence intervals (CI) adjusting for covariates using multivariable logistic regression analysis.ResultsThe overall facility delivery rate was low (3922/24 271; 16.2%). Any intrapartum complications among pregnant women were 20.9% (5,061/24,271) and perinatal mortality was 64.7 per 1000 birth. Compared to women who delivered at home, the risk of perinatal mortality was 2.4 times higher (OR = 2.40; 95% CI = 2.08-2.76) when delivered in a public health facility and 1.3 times higher (OR = 1.32, 95% CI = 1.06-1.64) when delivered in a private health facility. Compared to women who had no intrapartum complications and delivered at home, women with intrapartum complications who delivered at home had a substantially higher risk of perinatal mortality (OR = 3.45; 95% CI = 3.04-3.91). Compared to women with intrapartum complications who delivered at home, the risk of perinatal mortality among women with intrapartum complications was 43.0% lower for women who delivered in a public health facility (OR = 0.57; 95% CI = 0.42-0.78) and 58.0% lower when delivered in a private health facility (OR = 0.42; 95% CI = 0.28-0.63).ConclusionsMaternal health programs need to promote timely recognition of intrapartum complications and delivery in health facilities to improve perinatal outcomes, particularly in populations where overall facility delivery rates are low. The differential risk between public and private health facilities may be due to differences in quality of care. Efforts should be made to improve the quality of care in all health facilities.

show abstract

“…Details of the study population and design were discussed elsewhere [17]. Briefly, the study was conducted in an established surveillance site in two rural sub-districts (Kanaighat and Zakiganj) of Sylhet division of Bangladesh between June 2011 and December 2013 in a population of about 400,000 with an approximate annual births of 10,000.…”

Section: Methodsmentioning

confidence: 99%

Patterns and Determinants of Care-Seeking for Antepartum and Intrapartum Complications in Rural Bangladesh: Results from a Cohort Study

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundThe burden of maternal complications during antepartum and intrapartum periods is high and care seeking from a trained provider is low, particularly in low middle income countries of sub-Saharan Africa and South Asia. Identification of barriers to access to trained care and development of strategies to address them will contribute to improvements in maternal health. Using data from a community-based cohort of pregnant women, this study identified the prevalence of antepartum and intrapartum complications and determinants of care-seeking for these complications in rural Bangladesh.MethodsThe study was conducted in 24,274 pregnant women between June 2011 and December 2013 in rural Sylhet district of Bangladesh. Women were interviewed during pregnancy to collect data on demographic and socioeconomic characteristics; prior miscarriages, stillbirths, live births, and neonatal deaths; as well as data on their ability to make decision to go to health center alone. They were interviewed within the first 7 days of child birth to collect data on self-reported antepartum and intrapartum complications and care seeking for those complications.Bivariate analysis was conducted to explore association between predisposing (socio-demographic), enabling (economic), perceived need, and service related factors with care-seeking for self-reported antepartum and intrapartum complications. Multivariable multinomial logistic regression was performed to examine the association of selected factors with care-seeking for self-reported antepartum and intrapartum complications adjusting for co-variates.ResultsSelf-reported antepartum and intrapartum complications among women were 14.8% and 20.9% respectively. Among women with any antepartum complication, 58.9% sought care and of these 46.5% received care from a trained provider. Of the women with intrapartum complications, 61.4% sought care and of them 46.5% did so from a trained provider. Care-seeking for both antepartum and intrapartum complications from a trained provider was significantly higher for women with higher household wealth status, higher literacy level of both women and their husbands, and for those living close to a health facility (<10 km). Women’s decision making ability to go to health centre alone was associated with untrained care only for antepartum complications, but was associated with both trained and untrained care for intrapartum complications.ConclusionsNearly 40.0% of the women who experienced either an antepartum or intrapartum complications did not seek care from any provider and 11.5% -14.9% received care from untrained providers, primarily because of economic and geographic barriers to access. Development and evaluation of context specific, cost-effective, and sustainable strategies that will address these barriers to access to care for the maternal complications will enhance care seeking from trained health care providers and improve maternal health.

show abstract

Implementation of the ANISA Protocol in Sylhet, Bangladesh

Abstract: Our research team, with support from the ANISA coordination center, has successfully addressed these challenges and is implementing the study protocol while maintaining the high quality benchmark set by the coordination center.

Cited by 11 publications

References 17 publications

Rates and determinants of neonatal mortality in two rural sub-districts of Sylhet, Bangladesh

Rates and determinants of neonatal mortality in two rural sub-districts of Sylhet, Bangladesh

Can facility delivery reduce the risk of intrapartum complications-related perinatal mortality? Findings from a cohort study

Patterns and Determinants of Care-Seeking for Antepartum and Intrapartum Complications in Rural Bangladesh: Results from a Cohort Study

Contact Info

Product

Resources

About