Risk factors and barriers to case management of neonatal pneumonia: protocol for a pan-India qualitative study of stakeholder perceptions

Nair, N. Sreekumaran; Lewis, Leslie Edward; Lakiang, Theophilus; Godinho, Myron Anthony; Murthy, Shruti; Venkatesh, Bhumika T

doi:10.1136/bmjopen-2017-017403

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…The clinical manifestations of neonatal pneumonia comprise fever, cough, dyspnea, heart failure, sepsis, and even death . The causes of neonatal pneumonia are multitudinous and are linked to malnutrition, unsafe sanitation, air pollution, and bacterial infection . Currently, approaches for the remedy of neonatal pneumonia encompass antibiotic therapy, oxygen uptake, aerosol inhalation and chest physical therapy .…”

Section: Introductionmentioning

confidence: 99%

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Retracted: Notoginsenoside R1 protects WI‐38 cells against lipopolysaccharide‐triggered injury via adjusting the miR‐181a/TLR4 axis

Qian

Shao

et al. 2019

J of Cellular Biochemistry

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Notoginsenoside R1 (NGR1) is a neoteric phytoestrogen extracted from Panax notoginseng, and possesses comprehensive pharmacological functions in multitudinous ailments. But, whether NGR1 is utilized in neonatal pneumonia is not clear. This research study aspired to disclose the protective activity of NGR1 in neonatal pneumonia. WI-38 cells were co-stimulated with NGR1 and lipopolysaccharide (LPS, 10 ng/mL), CCK-8 and flow cytometry assays were implemented for cell viability and apoptosis assessment. Real-time quantitative plymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and Western blot analysis were executed for inflammatory cytokine determination. MicroRNA-181a (miR-181a) expression was evaluated through RT-qPCR, simultaneously, the impact of miR-181a was estimated in NGR1 and LPS co-managed cells. Dual luciferase report assay was performed to disclose the relation between miR-181a and Toll-like receptor 4 (TLR4). The nuclear factor-κB (NF-κB) and TAK1/JNK pathways were ultimately appraised.We found that NGR1 decreased cell viability, evoked apoptosis and impeded interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) expression and secretions in LPS-managed WI-38 cells. MiR-181a expression was enhanced by NGR1, and miR-181a inhibition inverted the impacts of NGR1 in LPSmanaged WI-38 cells. Besides, TLR4 was predicted to be a firsthand direct target of miR-181a. Furthermore, NGR1 hindered NF-κB and TAK1/JNK pathways through modulating TLR4. These discoveries disclosed the fact that NGR1 protected WI-38 cells against LPS-triggered injury via adjusting the miR-181a/ TLR4 and NF-κB and TAK1/JNK pathways. K E Y W O R D SmicroRNA-181a, neonatal pneumonia, NF-κB, notoginsenoside R1, TAK1/JNK, toll-like receptor 4 | INTRODUCTIONNeonatal pneumonia is a universal ailment among newborns, and is also a major reason for neonatal death. 1 Statistical evidence displays that about 156 million new events of neonatal pneumonia take place around the world each year, and 95% of neonatal pneumonia episodes happen in the developing countries. 2 The clinical manifestations of neonatal pneumonia comprise fever, cough, dyspnea, heart failure, sepsis, and even death. 3,4 The causes of neonatal pneumonia are multitudinous and are linked to malnutrition, unsafe sanitation,

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Section: Introductionmentioning

confidence: 99%

“…air pollution, and bacterial infection. 5,6 Currently, approaches for the remedy of neonatal pneumonia encompass antibiotic therapy, oxygen uptake, aerosol inhalation and chest physical therapy. 2,7,8 Management of neonatal pneumonia has recently concentrated on decrease of edema, inflammatory exudation, and amelioration of pulmonary ventilation function.…”

mentioning

confidence: 99%

Retracted: Notoginsenoside R1 protects WI‐38 cells against lipopolysaccharide‐triggered injury via adjusting the miR‐181a/TLR4 axis

Qian

Shao

et al. 2019

J of Cellular Biochemistry

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“…This protocol is part of a project consisting of three reviews (two systematic reviews 13 and one scoping review 14 ) and a qualitative study 15 on neonatal pneumonia in India. The other systematic review and planned meta-analysis will consolidate and appraise the evidence relating to the predictors of mortality due to neonatal pneumonia in India, and has been described elsewhere.…”

Section: Introductionmentioning

confidence: 99%

“… 14 In addition to the three reviews, a qualitative study will attempt to capture perceptions of stakeholders in the neonatal healthcare system. 15 …”

Section: Introductionmentioning

confidence: 99%

Factors associated with neonatal pneumonia in India: protocol for a systematic review and planned meta-analysis

et al. 2018

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IntroductionIndia accounts for more neonatal deaths than any other country. There is a lack of consolidated evidence from India regarding the determining factors of pneumonia in neonates. This systematic review is aimed to consolidate and appraise the evidence on risk factors and determinants of pneumonia among neonates in India.Methods and analysisThis protocol is part of a project consisting of three reviews (two systematic reviews and one scoping review) and a qualitative study on neonatal pneumonia in India. English language observational studies which report risk factors and determinants of neonatal pneumonia in India will be eligible for inclusion. Electronic searching of nine databases, and hand searching will be done. Two authors will independently conduct screening (title, abstract and full-text stages), extract data and assess risk of bias. A meta-analysis is planned to be performed with random-effects model. A narrative synthesis will be used to summarise the characteristics and findings of the review, if a meta-analysis cannot be performed. If there are more than 10 studies, publication bias will be assessed. Sensitivity and subgroup analysis will performed based on data availability. The quality of our review will be assessed by using ‘Assessing the Methodological quality of Systematic Reviews’ and ‘Grades of Recommendation, Assessment, Development and Evaluation’.Ethics and disseminationThe protocol of the entire project has been approved by the host institution’s ethics body (Institutional Ethics Committee, Manipal University, Manipal, India), and the ‘Health Ministry Screening Committee’ under the Ministry of Health and Family Welfare, Government of India. The study findings will be disseminated among relevant stakeholders using knowledge dissemination workshops, policy briefs, publications, etc.PROSPERO registration numberCRD42016044019.

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“…Basic socio-economic status data on each child's household (education of caregivers and household assets) and pre-admission treatment-seeking data were collected. We (MFU, MAH, MAI) purposively selected 17 ill undernourished children [34] from the main CHAIN cohort participants (face to face), ensuring diversity in children by location (8 rural and 9 urban), nutritional status, education of parents and exposure to recent major social disruption such as moving house, death of a parent, and change in the main caregiver. We explained the reasons for the selection of these children, our identity, research objectives and activities to caregivers and family members of children.…”

Section: Recruitment Of Participants and Data Collectionmentioning

confidence: 99%

Parent and Provider Perspectives on Factors Influencing Treatment-Seeking and Recovery After Hospital Discharge Among Undernourished Children Aged 2-23 Months in Bangladesh

Uddin

Molyneux

Muraya

et al. 2020

Preprint

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Background: Post-hospital discharge mortality is high among undernourished children in many low and middle-income countries; often exceeding in-patient mortality rates. Although a number of studies have highlighted a range of potential socio-cultural, economic and health system factors influencing paediatric post-discharge treatment-seeking and recovery, including in Bangladesh, few studies have explored parent and provider perspectives.Methods: As part of a large, multi-country prospective cohort study - the Childhood Acute Illness and Nutrition (CHAIN) Network - we conducted a qualitative study to understand the post-discharge treatment-seeking and recovery experiences of families of undernourished children aged 2-23 months admitted in two icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh) hospitals. To gather parent perspectives, we gathered in-depth qualitative data from family members of 17 purposively selected undernourished children from a rural and urban hospital. These data were supplemented by observations in hospitals and homes and from health worker interviews. We interviewed family members on discharge and again in their homes after discharge over several visits. Results: 13 of the 17 purposively selected children were reported by family members to have fully recovered by the time we completed our interviews; four had died. Important perceived drivers of treatment-seeking and recovery included advice provided while in hospital, media campaigns on hygiene practice, positive social and financial support from family members, relatives and neighbours, and the availability of free treatment. Key challenges included low household incomes, mothers having to juggle multiple responsibilities in addition to caring for the child, lack of support - and in some cases violence - from the child’s father, and family members’ preference for relatively accessible drug shops, physicians or healers over (re)admission to hospital. For most families, a range of challenges interplayed to contribute to early discharge from hospital against medical advice and to non-adherence to follow-up advice. Providers were primarily concerned about an inappropriately high use of antibiotics among families.Conclusion: Development of interventions that address the range of vulnerabilities that many families face is essential to support post-discharge adherence to medical advice and ensure recovery. These data suggest that potential interventions could include strengthening information giving during hospitalization on what post-discharge care is needed and why, reducing direct and indirect costs associated with hospital visits, engaging fathers and other ‘significant others’ in post-discharge advice, and building mobile phone-based support for follow-up care.

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Risk factors and barriers to case management of neonatal pneumonia: protocol for a pan-India qualitative study of stakeholder perceptions

Cited by 7 publications

References 12 publications

Retracted: Notoginsenoside R1 protects WI‐38 cells against lipopolysaccharide‐triggered injury via adjusting the miR‐181a/TLR4 axis

Retracted: Notoginsenoside R1 protects WI‐38 cells against lipopolysaccharide‐triggered injury via adjusting the miR‐181a/TLR4 axis

Factors associated with neonatal pneumonia in India: protocol for a systematic review and planned meta-analysis

Parent and Provider Perspectives on Factors Influencing Treatment-Seeking and Recovery After Hospital Discharge Among Undernourished Children Aged 2-23 Months in Bangladesh

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