The Experts below are selected from a list of 201 Experts worldwide ranked by ideXlab platform
Joy E Lawn - One of the best experts on this subject based on the ideXlab platform.
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effect on neonatal mortality of Newborn Infection management at health posts when referral is not possible a cluster randomized trial in rural ethiopia
Global health science and practice, 2017Co-Authors: Tedbabe Degefie Hailegebriel, Biruk Tensou, Brian Mulligan, Simon Cousens, Bereket Mathewos, Steve Wall, Abeba Bekele, Jeanne Russell, Deborah Sitrin, Joy E LawnAbstract:Background The World Health Organization recently provided guidelines for outpatient treatment of possible severe bacterial Infections (PSBI) in young infants, when referral to hospital is not feasible. This study evaluated Newborn Infection treatment at the most peripheral level of the health system in rural Ethiopia. Methods We performed a cluster-randomized trial in 22 geographical clusters (11 allocated to intervention, 11 to control). In both arms, volunteers and government-employed Health Extension Workers (HEWs) conducted home visits to pregnant and newly delivered mothers; assessed Newborns; and counseled caregivers on prevention of Newborn illness, danger signs, and care seeking. Volunteers referred sick Newborns to health posts for further assessment; HEWs referred Newborns with PSBI signs to health centers. In the intervention arm only, between July 2011 and June 2013, HEWs treated Newborns with PSBI with intramuscular gentamicin and oral amoxicillin for 7 days at health posts when referral to health centers was not possible or acceptable to caregivers. Intervention communities were informed of treatment availability at health posts to encourage care seeking. Masking was not feasible. The primary outcome was all-cause mortality of Newborns 2-27 days after birth, measured by household survey data. Baseline data were collected between June 2008 and May 2009; endline data, between February 2013 and June 2013. We sought to detect a 33% mortality reduction. Analysis was by intention to treat. (ClinicalTrials.gov registry: NCT00743691). Results Of 1,011 sick Newborns presenting at intervention health posts, 576 (57%) were identified by HEWs as having at least 1 PSBI sign; 90% refused referral and were treated at the health post, with at least 79% completing the antibiotic regimen. Estimated treatment coverage at health posts was in the region of 50%. Post-day 1 neonatal mortality declined more in the intervention arm (17.9 deaths per 1,000 live births at baseline vs. 9.4 per 1,000 at endline) than the comparison arm (14.4 per 1,000 vs. 11.2 per 1,000, respectively). After adjusting for baseline mortality and region, the estimated post-day 1 mortality risk ratio was 0.83, but the result was not statistically significant (95% confidence interval, 0.55 to 1.24; P=.33). Interpretation When referral to higher levels of care is not possible, HEWs can deliver outpatient antibiotic treatment of Newborns with PSBI, but estimated treatment coverage in a rural Ethiopian setting was only around 50%. While our data suggest a mortality reduction consistent with that which might be expected at this level of coverage, they do not provide conclusive results.
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Research priorities to reduce global mortality from Newborn Infections by 2015.
Pediatric Infectious Disease Journal, 2009Co-Authors: Rajiv Bahl, Joy E Lawn, Jose Martines, Nabeela Ali, Maharaj K. Bhan, Wally Carlo, Kit Yee Chan, Gary L. Darmstadt, Davidson H. Hamer, Douglas McmillanAbstract:Background: Newborn Infections are responsible for approximately one-third of the estimated 4.0 million neonatal deaths that occur globally every year. Appropriately targeted research is required to guide investment in effective interventions, especially in low resource settings. Setting global priorities for research to address neonatal Infections is essential and urgent. Methods: The Department of Child and Adolescent Health and Development of the World Health Organization (WHO/CAH) applied the Child Health and Nutrition Research Initiative (CHNRI) priority-setting methodology to identify and stimulate research most likely to reduce global Newborn Infection-related mortality by 2015. Technical experts were invited by WHO/CAH to systematically list and then use standard methods to score research questions according to their likelihood to (i) be answered in an ethical way, (ii) lead to (or improve) effective interventions, (iii) be deliverable, affordable, and sustainable, (iv) maximize death burden reduction, and (v) have an equitable effect in the population. The scores were then weighted according to the values provided by a wide group of stakeholders from the global research priority-setting network. Findings: On a 100-point scale, the final priority scores for 69 research questions ranged from 39 to 83. Most of the 15 research questions that received the highest scores were in the domain of health systems and policy research to address barriers affecting existing cost-effective interventions. The priority questions focused on promotion of home care practices to prevent Newborn Infections and approaches to increase coverage and quality of management of Newborn Infections in health facilities as well as in the community. While community-based intervention research is receiving some current investment, rigorous evaluation and cost analysis is almost entirely lacking for research on facility-based interventions and quality improvement. Interpretation: Given the lack of progress in improving Newborn survival despite the existence of effective interventions, it is not surprising that of the top ranked research priorities in this article the majority are in the domain of health systems and policy research. We urge funding agencies and investigators to invest in these research priorities to accelerate reduction of neonatal deaths, particularly those due to Infections.
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Research priorities to reduce global mortality from Newborn Infections by 2015.
The Pediatric infectious disease journal, 2009Co-Authors: Rajiv Bahl, Joy E Lawn, Jose Martines, Nabeela Ali, Maharaj K. Bhan, Wally Carlo, Kit Yee Chan, Gary L. Darmstadt, Davidson H. Hamer, Douglas D McmillanAbstract:Newborn Infections are responsible for approximately one-third of the estimated 4.0 million neonatal deaths that occur globally every year. Appropriately targeted research is required to guide investment in effective interventions, especially in low resource settings. Setting global priorities for research to address neonatal Infections is essential and urgent. The Department of Child and Adolescent Health and Development of the World Health Organization (WHO/CAH) applied the Child Health and Nutrition Research Initiative (CHNRI) priority-setting methodology to identify and stimulate research most likely to reduce global Newborn Infection-related mortality by 2015. Technical experts were invited by WHO/CAH to systematically list and then use standard methods to score research questions according to their likelihood to (i) be answered in an ethical way, (ii) lead to (or improve) effective interventions, (iii) be deliverable, affordable, and sustainable, (iv) maximize death burden reduction, and (v) have an equitable effect in the population. The scores were then weighted according to the values provided by a wide group of stakeholders from the global research priority-setting network. On a 100-point scale, the final priority scores for 69 research questions ranged from 39 to 83. Most of the 15 research questions that received the highest scores were in the domain of health systems and policy research to address barriers affecting existing cost-effective interventions. The priority questions focused on promotion of home care practices to prevent Newborn Infections and approaches to increase coverage and quality of management of Newborn Infections in health facilities as well as in the community. While community-based intervention research is receiving some current investment, rigorous evaluation and cost analysis is almost entirely lacking for research on facility-based interventions and quality improvement. Given the lack of progress in improving Newborn survival despite the existence of effective interventions, it is not surprising that of the top ranked research priorities in this article the majority are in the domain of health systems and policy research. We urge funding agencies and investigators to invest in these research priorities to accelerate reduction of neonatal deaths, particularly those due to Infections.
Robert E. Black - One of the best experts on this subject based on the ideXlab platform.
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Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal Infection research.
The Lancet. Infectious diseases, 2016Co-Authors: Elizabeth J A Fitchett, Anna C Seale, Stefania Vergnano, Mike Sharland, Paul T. Heath, Samir K. Saha, Ramesh Agarwal, Adejumoke I. Ayede, Zulfiqar A Bhutta, Robert E. BlackAbstract:Neonatal Infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal Infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal Infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines.
Hassan Wehbeh - One of the best experts on this subject based on the ideXlab platform.
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The impact of prenatal exposure to cocaine on Newborn costs and length of stay.
Health services research, 1995Co-Authors: Theodore Joyce, Andrew D. Racine, Sandra Mccalla, Hassan WehbehAbstract:OBJECTIVE: Our intention is to determine Newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit drugs. DATA SOURCES AND STUDY SETTING: All parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992. STUDY DESIGN: A cross-sectional analysis used multivariate, loglinear regressions to analyze differences in costs and length of stay between infants exposed and unexposed prenatally to cocaine and other illicit drugs, adjusting for maternal race, age, prenatal care, tobacco, parity, type of delivery, birth weight, prematurity, and Newborn Infection. DATA COLLECTION/EXTRACTION METHODS: Urine specimens, with linked obstetric sheets and discharge abstracts, provided information on exposure, prenatal behaviors, costs, length of stay, and discharge disposition. PRINCIPAL FINDINGS: Infants exposed to cocaine or some other illicit drug stay approximately seven days longer at a cost of $7,731 more than infants unexposed. Approximately 60 percent of these costs are indirect, the result of adverse birth outcomes and Newborn Infection. Hospital screening as recorded on discharge abstracts substantially underestimates prevalence at delivery, but overestimates its impact on costs.
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The Impact of Prenatal Exposure to Cocaine on Newborn Costs and Length of Stay
1994Co-Authors: Theodore Joyce, Andrew D. Racine, Sandra Mccalla, Hassan WehbehAbstract:This paper determines Newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit drugs, using as a data source all parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992. We performed a cross-sectional analysis in which multivariate, loglinear regressions were used to analyze differences in costs and length of stay between infants exposed and unexposed prenatally to cocaine and other illicit drugs adjusting for maternal race, age, prenatal care, tobacco, parity, type of delivery, birth weight, prematurity, and Newborn Infection. Urine specimens, with linked obstetric sheets and discharge abstracts provided information on exposure, prenatal behaviors, costs, length of stay and discharge disposition. Our principal findings show that infants exposed to cocaine and some other illicit drug stay approximately 7 days longer at a cost of $7,731 more than infants unexposed. Approximately 60 percent of these costs are indirect, the result of adverse birth outcomes and Newborn Infection. Hospital screening as recorded on discharge abstracts substantially underestimates prevalence at delivery, but overestimates its impact on costs.
Mike Sharland - One of the best experts on this subject based on the ideXlab platform.
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Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal Infection research.
The Lancet. Infectious diseases, 2016Co-Authors: Elizabeth J A Fitchett, Anna C Seale, Stefania Vergnano, Mike Sharland, Paul T. Heath, Samir K. Saha, Ramesh Agarwal, Adejumoke I. Ayede, Zulfiqar A Bhutta, Robert E. BlackAbstract:Neonatal Infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal Infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal Infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines.
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Advances in the antiviral therapy of herpes virus Infection in children
Expert review of anti-infective therapy, 2006Co-Authors: Suzanne Luck, Mike Sharland, Paul D. Griffiths, Sian M JenkinsAbstract:Herpes viruses are ubiquitous, and primary Infection with many of these viruses is common during childhood. In general, children tolerate primary Infection well, with only mild symptoms, but in the immunocompromised, including the Newborn, Infection can be associated with serious morbidity and mortality. Drug treatment for many of the herpes Infections is available but is often associated with serious side effects. In the pediatric age group, treatment is further hindered by a lack of information on suitable dosing regimes, unavailability of oral solutions and a lack of clinical trials specifically investigating response to treatment in this group of patients. This article will review current evidence regarding the pharmacokinetics and dosing of the most commonly used antiherpetic agents and will look specifically at the treatment of the more common herpes virus Infections in children.
Elizabeth J A Fitchett - One of the best experts on this subject based on the ideXlab platform.
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Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal Infection research.
The Lancet. Infectious diseases, 2016Co-Authors: Elizabeth J A Fitchett, Anna C Seale, Stefania Vergnano, Mike Sharland, Paul T. Heath, Samir K. Saha, Ramesh Agarwal, Adejumoke I. Ayede, Zulfiqar A Bhutta, Robert E. BlackAbstract:Neonatal Infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal Infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal Infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines.