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Cited by 159Neonatal and Maternal InfectionsBacterial Infections and VaccinesMaternal and Neonatal Healthcare

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

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; on behalf of the neonatal infections estimation team, Seale, Anna C., Blencowe, Hannah, Zaidi, Anita, Ganatra, Hammad, Syed, Sana, Engmann, Cyril, Newton, Charles R. +4 more·2013·Pediatric Research
DOI 10.1038/pr.2013.207PMC PMC3873707
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Abstract

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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  • Prospective studies on the incidence, microbiology and antimicrobial resistance of postpartum infections are lacking.

    “prospective studies on incidence, microbiology and antimicrobial resistance are lacking.”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [2]

    The Discussion’s ‘Data Gaps and Improving the Data’ section identifies missing evidence on neurodevelopmental outcomes after neonatal infections, not prospective studies of postpartum infections. ‘Programmatic Implications’ raises antimicrobial resistance as a concern but does not say that studies of postpartum incidence, microbiology, or resistance are lacking. Searches for postpartum and maternal infection study gaps did not find a passage addressing the claim; page numbers were unavailable in our copy. (LLM, conf=0.77)

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References 69 · Cited by 159

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  1. Liu L Johnson HL Cousens S Child Health Epidemiology Reference Group of WHO and UNICEF Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012 379 2151 61 22579125
  2. Mwaniki MK Atieno M Lawn JE Newton CR Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic review. Lancet 2012 379 445 52 22244654 PMC3273721
  3. Stoll BJ Hansen NI Adams-Chapman I National Institute of Child Health and Human Development Neonatal Research Network Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA 2004 292 2357 65 15547163
  4. Blencowe H Vos T Lee AC Estimates of neonatal morbidities and disabilities at regional and global levels for 2010: introduction, methods overview, and relevant findings from the Global Burden of Disease study Pediatr Res 2013this issue). PMC3873708 24366460
  5. Young Infants Clinical Signs Study Group. Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet 2008 371 135 42 18191685
  6. Lawn JE Blencowe H Darmstadt GL Bhutta ZA Beyond newborn survival: the world you are born into determines your risk of disability-free survival Pediatr Res 2013this issue). PMC3873685 24240732
  7. Roper MH Vandelaer JH Gasse FL Maternal and neonatal tetanus. Lancet 2007 370 1947 59 17854885
  8. Blencowe H Lawn J Vandelaer J Roper M Cousens S Tetanus toxoid immunization to reduce mortality from neonatal tetanus. Int J Epidemiol 2010 39 Suppl 1 i102 9 20348112 PMC2845866
  9. Mazzi E Bartos AE Carlin J Weber MW Darmstadt GL Bolivia Clinical Signs Study Group Clinical signs predicting severe illness in young infants (<60 days) in Bolivia. J Trop Pediatr 2010 56 307 16 20144933
  10. Yeboah-Antwi K Addo-Yobo E Adu-Sarkodie Y Clinico-epidemiological profile and predictors of severe illness in young infants (0-59 days) in Ghana. Ann Trop Paediatr 2008 28 35 43 18318947
  11. Deorari AK Chellani H Carlin JB Clinicoepidemiological profile and predictors of severe illness in young infants (< 60 days) reporting to a hospital in North India. Indian Pediatr 2007 44 739 48 17998574
  12. Narang A Kumar P Narang R Clinico-epidemiological profile and validation of symptoms and signs of severe illness in young infants (< 60 days) reporting to a district hospital. Indian Pediatr 2007 44 751 9 17998575
  13. Jeena PM Adhikari M Carlin JB Qazi S Weber MW Hamer DH Clinical profile and predictors of severe illness in young South African infants (<60 days). S Afr Med J 2008 98 883 8 19177896
  14. Herbert HK Lee AC Chandran A Rudan I Baqui AH Care seeking for neonatal illness in low- and middle-income countries: a systematic review. PLoS Med 2012 9 e1001183 22412355 PMC3295826
  15. Salimpour R Follow-up studies in tetanus neonatorum. Proceedings of the Thirteenth International Congress of Pediatrics vol. 6 Vienna Verlag Wiener Medizinischen Akademie 1971 402 5
  16. Vaidya A Saville N Shrestha BP Costello AM Manandhar DS Osrin D Effects of antenatal multiple micronutrient supplementation on children's weight and size at 2 years of age in Nepal: follow-up of a double-blind randomised controlled trial. Lancet 2008 371 492 9 18262041 PMC2241662
  17. Barlow JL Mung'Ala-Odera V Gona J Newton CR Brain damage after neonatal tetanus in a rural Kenyan hospital. Trop Med Int Health 2001 6 305 8 11348521
  18. Nair H Simoes EA Rudan I Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet 2013 381 1380 90 23369797 PMC3986472
  19. Stoll BJ Hansen NI Sánchez PJ Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics 2011 127 817 26 21518717 PMC3081183
  20. Lawn JE Cousens S Zupan J Lancet Neonatal Survival Steering Team 4 million neonatal deaths: when? Where? Why Lancet 2005 365 891 900 15752534
  21. Mathers CD Fat DM Inoue M Rao C Lopez AD Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ 2005 83 171 7 15798840 PMC2624200
  22. Libster R Edwards KM Levent F Long-term outcomes of group B streptococcal meningitis. Pediatrics 2012 130 e8 15 22689869
  23. Horton R Stumbling around in the dark. Lancet 2005 365 1983 15954215
  24. Gordon AL English M Tumaini Dzombo J Karisa M Newton CR Neurological and developmental outcome of neonatal jaundice and sepsis in rural Kenya. Trop Med Int Health 2005 10 1114 20 16262736
  25. Bennet R Bergdahl S Eriksson M Zetterström R The outcome of neonatal septicemia during fifteen years. Acta Paediatr Scand 1989 78 40 3 2919523
  26. Grether JK Nelson KB Maternal infection and cerebral palsy in infants of normal birth weight. JAMA 1997 278 207 11 9218666
  27. Glass HC Pham TN Danielsen B Towner D Glidden D Wu YW Antenatal and intrapartum risk factors for seizures in term newborns: a population-based study, California 1998–2002. J Pediatr 2009 154 24 8e1 18760807 PMC2635430
  28. Marlow N Pike K Bower E Characteristics of children with cerebral palsy in the ORACLE children study. Dev Med Child Neurol 2012 54 640 6 22458348
  29. Glass HC Bonifacio SL Chau V Recurrent postnatal infections are associated with progressive white matter injury in premature infants. Pediatrics 2008 122 299 305 18676547
  30. van der Ree M Tanis JC Van Braeckel KN Bos AF Roze E Functional impairments at school age of preterm born children with late-onset sepsis. Early Hum Dev 2011 87 821 6 21752558
  31. Schlapbach LJ Aebischer M Adams M Swiss Neonatal Network and Follow-Up Group Impact of sepsis on neurodevelopmental outcome in a Swiss National Cohort of extremely premature infants. Pediatrics 2011 128 e348 57 21768312
  32. Soofi S Cousens S Imdad A Bhutto N Ali N Bhutta ZA Topical application of chlorhexidine to neonatal umbilical cords for prevention of omphalitis and neonatal mortality in a rural district of Pakistan: a community-based, cluster-randomised trial. Lancet 2012 379 1029 36 22322126
  33. Arifeen SE Mullany LC Shah R The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial. Lancet 2012 379 1022 8 22322124
  34. Edmond KM Zandoh C Quigley MA Amenga-Etego S Owusu-Agyei S Kirkwood BR Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 2006 117 e380 6 16510618
  35. Conde-Agudelo A Belizan JM Diaz-Rossello J Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2011 CD002771 21412879
  36. Darmstadt GL Saha SK Ahmed AS Effect of skin barrier therapy on neonatal mortality rates in preterm infants in Bangladesh: a randomized, controlled, clinical trial. Pediatrics 2008 121 522 9 18310201
  37. Seale AC Berkley JA Managing severe infection in infancy in resource poor settings. Early Hum Dev 2012 88 957 60 23031387 PMC3507620
  38. Bang AT Bang RA Baitule SB Reddy MH Deshmukh MD Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet 1999 354 1955 61 10622298
  39. Zaidi AK Tikmani SS Warraich HJ Community-based treatment of serious bacterial infections in newborns and young infants: a randomized controlled trial assessing three antibiotic regimens. Pediatr Infect Dis J 2012 31 667 72 22481421
  40. Zaidi AK Baqui AH Qazi SA Scientific rationale for study design of community-based simplified antibiotic therapy trials in newborns and young infants with clinically diagnosed severe infections or fast breathing in South Asia and sub-Saharan Africa. Pediatr Infect Dis J 2013 32 9 Suppl 1 S7 11 23945577 PMC3814626
  41. Downie L Armiento R Subhi R Kelly J Clifford V Duke T Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO's currently recommended antibiotics–systematic review and meta-analysis. Arch Dis Child 2013 98 146 54 23142784
  42. Aiken AM Mturi N Njuguna P Kilifi Bacteraemia Surveillance Group Risk and causes of paediatric hospital-acquired bacteraemia in Kilifi District Hospital, Kenya: a prospective cohort study. Lancet 2011 378 2021 7 22133536 PMC3242162
  43. Montgomery-Taylor S Emery F Anthony M Eighteen months of “matching Michigan” at a UK neonatal intensive care unit. Pediatr Infect Dis J 2013 32 565 7 23340554
  44. Schwab F Geffers C Bärwolff S Rüden H Gastmeier P Reducing neonatal nosocomial bloodstream infections through participation in a national surveillance system. J Hosp Infect 2007 65 319 25 17350730
  45. Schulman J Stricof R Stevens TP New York State Regional Perinatal Care Centers Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics 2011 127 436 44 21339265
  46. Manzoni P Stolfi I Pugni L Italian Task Force for the Study and Prevention of Neonatal Fungal Infections; Italian Society of Neonatology A multicenter, randomized trial of prophylactic fluconazole in preterm neonates. N Engl J Med 2007 356 2483 95 17568029
  47. Kaufman DA Fluconazole prophylaxis: can we eliminate invasive Candida infections in the neonatal ICU Curr Opin Pediatr 2008 20 332 40 18475105
  48. Manzoni P Rinaldi M Cattani S Italian Task Force for the Study and Prevention of Neonatal Fungal Infections, Italian Society of Neonatology Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial. JAMA 2009 302 1421 8 19809023
  49. Marlow N Morris T Brocklehurst P A randomised trial of granulocyte-macrophage colony-stimulating factor for neonatal sepsis: outcomes at 2 years. Arch Dis Child Fetal Neonatal Ed 2013 98 F46 53 22542709 PMC3533400
  50. Cohen-Wolkowiez M Benjamin DK Jr Capparelli E Immunotherapy in neonatal sepsis: advances in treatment and prophylaxis. Curr Opin Pediatr 2009 21 177 81 19276977 PMC3319032
  51. Seale AC Mwaniki M Newton CR Berkley JA Maternal and early onset neonatal bacterial sepsis: burden and strategies for prevention in sub-Saharan Africa. Lancet Infect Dis 2009 9 428 38 19555902 PMC2856817
  52. Chiesa C Panero A Osborn JF Simonetti AF Pacifico L Diagnosis of neonatal sepsis: a clinical and laboratory challenge. Clin Chem 2004 50 279 87 14752012
  53. Rafael ME Taylor T Magill A Lim YW Girosi F Allan R Reducing the burden of childhood malaria in Africa: the role of improved. Nature 2006 444 Suppl 1 39 48 17159893
  54. Wilson ML Malaria rapid diagnostic tests. Clin Infect Dis 2012 54 1637 41 22550113
  55. Crede S Lawn J Woods D Wyatt J Pulse oximetry screening for critical congenital heart defects. Lancet 2012 380 1305; author reply 1306 23063277
  56. Gona JK Mung'ala-Odera V Newton CR Hartley S Caring for children with disabilities in Kilifi, Kenya: what is the carer's experience Child Care Health Dev 2011 37 175 83 20645990 PMC3072473
  57. Cousens S Blencowe H Stanton C National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis. Lancet 2011 377 1319 30 21496917
  58. Berkley JA Mwangi I Ngetsa CJ Diagnosis of acute bacterial meningitis in children at a district hospital in sub-Saharan Africa. Lancet 2001 357 1753 7 11403812
  59. Cherian T Mulholland EK Carlin JB Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies. Bull World Health Organ 2005 83 353 9 15976876 PMC2626240

Authors
; on behalf of the neonatal infections estimation team, Seale, A. C., Blencowe, H., Zaidi, A., Ganatra, H., Syed, S., Engmann, C., Newton, C. R., Vergnano, S., Stoll, B. J., Cousens, S. N., & Lawn, J. E.
Affiliations
  • Kenya Medical Research Institute (KE)
  • Aga Khan University (PK)
  • Gates Foundation (US)
  • St George's Hospital (GB)
  • Emory University (US)
  • London School of Hygiene & Tropical Medicine (GB)
Corresponding author
Seale, Anna C.
ORCID
Venue
Pediatric Research
Publisher
Springer Science and Business Media LLC
Published
2013-12
Volume
74
Issue
S1
Pages
73-85
ISSN
  • 0031-3998 (ISSN-L)
  • 1530-0447
DOI
10.1038/pr.2013.207
PMC
PMC3873707
OpenAlex
W2070383019
Cited by
159
References
69
Citations by year
2026: 5 · 2025: 2 · 2024: 18 · 2023: 7 · 2022: 18 · 2021: 14 · 2020: 17 · 2019: 10 · 2018: 11 · 2017: 16 · 2016: 12 · 2015: 18 · 2014: 8 · 2013: 3
FWCI
1.95
Type
journal article
Language
en
Open access
Licence
Locations
  • Pediatric Research (publishedVersion, cc-by-nc-sa)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Funders
  • Wellcome Trust (092654)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (UG1HD076461, U01HD058322, U10HD078439, U10HD076461)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
neonatal bacterial infection, neurodevelopmental impairment, neonatal sepsis, neonatal meningitis, neonatal pneumonia, neonatal tetanus, case fatality risk, post-infectious sequelae, South Asia, sub-Saharan Africa, Latin America, low-income countries, neonatal mortality, neonatal infection prevention
MeSH terms
Asia, Developmental Disabilities, Humans, Infant, Newborn, Latin America, Meningitis, Pneumonia, Models, Statistical, Africa South of the Sahara, Risk Assessment, Sepsis

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