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

Anna C. Seale, Hannah Blencowe, Alexander A. Manu, Harish Nair, Rajiv Bahl, Shamim A. Qazi, Anita K. Zaidi, James A. Berkley, Simon N. Cousens, Joy E. Lawn, Dwi Agustian, Fernando Althabe, Eduardo Azziz-Baumgartner, Abdullah H. Baqui, Daniel G. Bausch, Jose M. Belizan, Zulfi Qar Bhutta, Robert E. Black, Shobha Broor, Nigel Bruce & 45 others Pierre Buekens, Harry Campbell, Waldemar A. Carlo, Elwyn Chomba, Anthony Costello, Richard J. Derman, Mukesh Dherani, Shams El-Arifeen, Cyril Engmann, Fabian Esamai, Hammad Ganatra, Ana Garcés, Bradford D. Gessner, Christopher Gill, Robert L. Goldenberg, Shivaprasad S. Goudar, K. Michael Hambidge, Davidson H. Hamer, Nellie I. Hansen, Patricia L. Hibberd, Sudhir Khanal, Betty Kirkwood, Patrick Kosgei, Marion Koso-Thomas, Edward A. Liechty, Elizabeth M. McClure, Dipak Mitra, Neema Mturi, Luke C. Mullany, Charles R. Newton, Francois Nosten, Shama Parveen, Archana Patel, Candice Romero, Naomi Saville, Katherine Semrau, Eric A F Simões, Sajid Soofi, Barbara J. Stoll, Shiyam Sunder, Sana Syed, James M. Tielsch, Yeny O. Tinoco, Claudia Turner, Stefania Vergnano

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Background: Bacterial 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. Methods: We 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≥1500 g) with livebirth denominator data, undertaking a systematic review and forming an investigator group to obtain unpublished data.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. Findings: We 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. Interpretation: The 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. Funding: The 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.

Original languageEnglish (US)
Pages (from-to)731-741
Number of pages11
JournalThe Lancet Infectious Diseases
Volume14
Issue number8
DOIs
StatePublished - 2014
Externally publishedYes

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Latin America
South America
Africa South of the Sahara
Bacterial Infections
Meta-Analysis
Newborn Infant
Research Personnel
Organized Financing
Incidence
Case Management
Uncertainty
Epidemiology

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

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. / Seale, Anna C.; Blencowe, Hannah; Manu, Alexander A.; Nair, Harish; Bahl, Rajiv; Qazi, Shamim A.; Zaidi, Anita K.; Berkley, James A.; Cousens, Simon N.; Lawn, Joy E.; Agustian, Dwi; Althabe, Fernando; Azziz-Baumgartner, Eduardo; Baqui, Abdullah H.; Bausch, Daniel G.; Belizan, Jose M.; Qar Bhutta, Zulfi; Black, Robert E.; Broor, Shobha; Bruce, Nigel; Buekens, Pierre; Campbell, Harry; Carlo, Waldemar A.; Chomba, Elwyn; Costello, Anthony; Derman, Richard J.; Dherani, Mukesh; El-Arifeen, Shams; Engmann, Cyril; Esamai, Fabian; Ganatra, Hammad; Garcés, Ana; Gessner, Bradford D.; Gill, Christopher; Goldenberg, Robert L.; Goudar, Shivaprasad S.; Hambidge, K. Michael; Hamer, Davidson H.; Hansen, Nellie I.; Hibberd, Patricia L.; Khanal, Sudhir; Kirkwood, Betty; Kosgei, Patrick; Koso-Thomas, Marion; Liechty, Edward A.; McClure, Elizabeth M.; Mitra, Dipak; Mturi, Neema; Mullany, Luke C.; Newton, Charles R.; Nosten, Francois; Parveen, Shama; Patel, Archana; Romero, Candice; Saville, Naomi; Semrau, Katherine; Simões, Eric A F; Soofi, Sajid; Stoll, Barbara J.; Sunder, Shiyam; Syed, Sana; Tielsch, James M.; Tinoco, Yeny O.; Turner, Claudia; Vergnano, Stefania.

In: The Lancet Infectious Diseases, Vol. 14, No. 8, 2014, p. 731-741.

Research output: Contribution to journalArticle

Seale, AC, Blencowe, H, Manu, AA, Nair, H, Bahl, R, Qazi, SA, Zaidi, AK, Berkley, JA, Cousens, SN, Lawn, JE, Agustian, D, Althabe, F, Azziz-Baumgartner, E, Baqui, AH, Bausch, DG, Belizan, JM, Qar Bhutta, Z, Black, RE, Broor, S, Bruce, N, Buekens, P, Campbell, H, Carlo, WA, Chomba, E, Costello, A, Derman, RJ, Dherani, M, El-Arifeen, S, Engmann, C, Esamai, F, Ganatra, H, Garcés, A, Gessner, BD, Gill, C, Goldenberg, RL, Goudar, SS, Hambidge, KM, Hamer, DH, Hansen, NI, Hibberd, PL, Khanal, S, Kirkwood, B, Kosgei, P, Koso-Thomas, M, Liechty, EA, McClure, EM, Mitra, D, Mturi, N, Mullany, LC, Newton, CR, Nosten, F, Parveen, S, Patel, A, Romero, C, Saville, N, Semrau, K, Simões, EAF, Soofi, S, Stoll, BJ, Sunder, S, Syed, S, Tielsch, JM, Tinoco, YO, Turner, C & Vergnano, S 2014, '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', The Lancet Infectious Diseases, vol. 14, no. 8, pp. 731-741. https://doi.org/10.1016/S1473-3099(14)70804-7
Seale, Anna C. ; Blencowe, Hannah ; Manu, Alexander A. ; Nair, Harish ; Bahl, Rajiv ; Qazi, Shamim A. ; Zaidi, Anita K. ; Berkley, James A. ; Cousens, Simon N. ; Lawn, Joy E. ; Agustian, Dwi ; Althabe, Fernando ; Azziz-Baumgartner, Eduardo ; Baqui, Abdullah H. ; Bausch, Daniel G. ; Belizan, Jose M. ; Qar Bhutta, Zulfi ; Black, Robert E. ; Broor, Shobha ; Bruce, Nigel ; Buekens, Pierre ; Campbell, Harry ; Carlo, Waldemar A. ; Chomba, Elwyn ; Costello, Anthony ; Derman, Richard J. ; Dherani, Mukesh ; El-Arifeen, Shams ; Engmann, Cyril ; Esamai, Fabian ; Ganatra, Hammad ; Garcés, Ana ; Gessner, Bradford D. ; Gill, Christopher ; Goldenberg, Robert L. ; Goudar, Shivaprasad S. ; Hambidge, K. Michael ; Hamer, Davidson H. ; Hansen, Nellie I. ; Hibberd, Patricia L. ; Khanal, Sudhir ; Kirkwood, Betty ; Kosgei, Patrick ; Koso-Thomas, Marion ; Liechty, Edward A. ; McClure, Elizabeth M. ; Mitra, Dipak ; Mturi, Neema ; Mullany, Luke C. ; Newton, Charles R. ; Nosten, Francois ; Parveen, Shama ; Patel, Archana ; Romero, Candice ; Saville, Naomi ; Semrau, Katherine ; Simões, Eric A F ; Soofi, Sajid ; Stoll, Barbara J. ; Sunder, Shiyam ; Syed, Sana ; Tielsch, James M. ; Tinoco, Yeny O. ; Turner, Claudia ; Vergnano, Stefania. / 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. In: The Lancet Infectious Diseases. 2014 ; Vol. 14, No. 8. pp. 731-741.
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title = "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 = "Background: Bacterial 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. Methods: We 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. Findings: We 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. Interpretation: The 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. Funding: The 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.",
author = "Seale, {Anna C.} and Hannah Blencowe and Manu, {Alexander A.} and Harish Nair and Rajiv Bahl and Qazi, {Shamim A.} and Zaidi, {Anita K.} and Berkley, {James A.} and Cousens, {Simon N.} and Lawn, {Joy E.} and Dwi Agustian and Fernando Althabe and Eduardo Azziz-Baumgartner and Baqui, {Abdullah H.} and Bausch, {Daniel G.} and Belizan, {Jose M.} and {Qar Bhutta}, Zulfi and Black, {Robert E.} and Shobha Broor and Nigel Bruce and Pierre Buekens and Harry Campbell and Carlo, {Waldemar A.} and Elwyn Chomba and Anthony Costello and Derman, {Richard J.} and Mukesh Dherani and Shams El-Arifeen and Cyril Engmann and Fabian Esamai and Hammad Ganatra and Ana Garc{\'e}s and Gessner, {Bradford D.} and Christopher Gill and Goldenberg, {Robert L.} and Goudar, {Shivaprasad S.} and Hambidge, {K. Michael} and Hamer, {Davidson H.} and Hansen, {Nellie I.} and Hibberd, {Patricia L.} and Sudhir Khanal and Betty Kirkwood and Patrick Kosgei and Marion Koso-Thomas and Liechty, {Edward A.} and McClure, {Elizabeth M.} and Dipak Mitra and Neema Mturi and Mullany, {Luke C.} and Newton, {Charles R.} and Francois Nosten and Shama Parveen and Archana Patel and Candice Romero and Naomi Saville and Katherine Semrau and Sim{\~o}es, {Eric A F} and Sajid Soofi and Stoll, {Barbara J.} and Shiyam Sunder and Sana Syed and Tielsch, {James M.} and Tinoco, {Yeny O.} and Claudia Turner and Stefania Vergnano",
year = "2014",
doi = "10.1016/S1473-3099(14)70804-7",
language = "English (US)",
volume = "14",
pages = "731--741",
journal = "The Lancet Infectious Diseases",
issn = "1473-3099",
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TY - JOUR

T1 - Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012

T2 - A systematic review and meta-analysis

AU - Seale, Anna C.

AU - Blencowe, Hannah

AU - Manu, Alexander A.

AU - Nair, Harish

AU - Bahl, Rajiv

AU - Qazi, Shamim A.

AU - Zaidi, Anita K.

AU - Berkley, James A.

AU - Cousens, Simon N.

AU - Lawn, Joy E.

AU - Agustian, Dwi

AU - Althabe, Fernando

AU - Azziz-Baumgartner, Eduardo

AU - Baqui, Abdullah H.

AU - Bausch, Daniel G.

AU - Belizan, Jose M.

AU - Qar Bhutta, Zulfi

AU - Black, Robert E.

AU - Broor, Shobha

AU - Bruce, Nigel

AU - Buekens, Pierre

AU - Campbell, Harry

AU - Carlo, Waldemar A.

AU - Chomba, Elwyn

AU - Costello, Anthony

AU - Derman, Richard J.

AU - Dherani, Mukesh

AU - El-Arifeen, Shams

AU - Engmann, Cyril

AU - Esamai, Fabian

AU - Ganatra, Hammad

AU - Garcés, Ana

AU - Gessner, Bradford D.

AU - Gill, Christopher

AU - Goldenberg, Robert L.

AU - Goudar, Shivaprasad S.

AU - Hambidge, K. Michael

AU - Hamer, Davidson H.

AU - Hansen, Nellie I.

AU - Hibberd, Patricia L.

AU - Khanal, Sudhir

AU - Kirkwood, Betty

AU - Kosgei, Patrick

AU - Koso-Thomas, Marion

AU - Liechty, Edward A.

AU - McClure, Elizabeth M.

AU - Mitra, Dipak

AU - Mturi, Neema

AU - Mullany, Luke C.

AU - Newton, Charles R.

AU - Nosten, Francois

AU - Parveen, Shama

AU - Patel, Archana

AU - Romero, Candice

AU - Saville, Naomi

AU - Semrau, Katherine

AU - Simões, Eric A F

AU - Soofi, Sajid

AU - Stoll, Barbara J.

AU - Sunder, Shiyam

AU - Syed, Sana

AU - Tielsch, James M.

AU - Tinoco, Yeny O.

AU - Turner, Claudia

AU - Vergnano, Stefania

PY - 2014

Y1 - 2014

N2 - Background: Bacterial 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. Methods: We 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. Findings: We 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. Interpretation: The 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. Funding: The 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.

AB - Background: Bacterial 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. Methods: We 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. Findings: We 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. Interpretation: The 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. Funding: The 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.

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