Trends in the incidence of possible severe bacterial infection and case fatality rates in rural communities in Sub-Saharan Africa, South Asia and Latin America, 2010-2013

A multicenter prospective cohort study

Patricia L. Hibberd, Nellie I. Hansen, Marie E. Wang, Shivaprasad S. Goudar, Omrana Pasha, Fabian Esamai, Elwyn Chomba, Ana Garces, Fernando Althabe, Richard J. Derman, Robert L. Goldenberg, Edward A. Liechty, Waldemar A. Carlo, K. Michael Hambidge, Nancy F. Krebs, Pierre Buekens, Elizabeth M. McClure, Marion Koso-Thomas, Archana B. Patel

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Possible severe bacterial infections (pSBI) continue to be a leading cause of global neonatal mortality annually. With the recent publications of simplified antibiotic regimens for treatment of pSBI where referral is not possible, it is important to know how and where to target these regimens, but data on the incidence and outcomes of pSBI are limited. Methods: We used data prospectively collected at 7 rural community-based sites in 6 low and middle income countries participating in the NICHD Global Network's Maternal and Newborn Health Registry, between January 1, 2010 and December 31, 2013. Participants included pregnant women and their live born neonates followed for 6 weeks after delivery and assessed for maternal and infant outcomes. Results: In a cohort of 248,539 infants born alive between 2010 and 2013, 32,088 (13 %) neonates met symptomatic criteria for pSBI. The incidence of pSBI during the first 6 weeks of life varied 10 fold from 3 % (Zambia) to 36 % (Pakistan), and overall case fatality rates varied 8 fold from 5 % (Kenya) to 42 % (Zambia). Significant variations in incidence of pSBI during the study period, with proportions decreasing in 3 sites (Argentina, Kenya and Nagpur, India), remaining stable in 3 sites (Zambia, Guatemala, Belgaum, India) and increasing in 1 site (Pakistan), cannot be explained solely by changing rates of facility deliveries. Case fatality rates did not vary over time. Conclusions: In a prospective population based registry with trained data collectors, there were wide variations in the incidence and case fatality of pSBI in rural communities and in trends over time. Regardless of these variations, the burden of pSBI is still high and strategies to implement timely diagnosis and treatment are still urgently needed to reduce neonatal mortality. Trial registration: The study was registered at ClinicalTrials.gov (NCT01073475).

Original languageEnglish (US)
Article number13
JournalReproductive Health
Volume13
Issue number1
DOIs
StatePublished - May 24 2016

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Latin America
South America
Africa South of the Sahara
Rural Population
Bacterial Infections
Cohort Studies
Prospective Studies
Mortality
Incidence
Zambia
Kenya
Pakistan
Infant Mortality
Registries
India
National Institute of Child Health and Human Development (U.S.)
Newborn Infant
Guatemala
Argentina
Pregnant Women

Keywords

  • Case fatality rates from neonatal sepsis
  • Global health
  • Incidence of neonatal sepsis
  • Low middle income countries
  • Neonatal sepsis
  • Possible severe bacterial infections

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Trends in the incidence of possible severe bacterial infection and case fatality rates in rural communities in Sub-Saharan Africa, South Asia and Latin America, 2010-2013 : A multicenter prospective cohort study. / Hibberd, Patricia L.; Hansen, Nellie I.; Wang, Marie E.; Goudar, Shivaprasad S.; Pasha, Omrana; Esamai, Fabian; Chomba, Elwyn; Garces, Ana; Althabe, Fernando; Derman, Richard J.; Goldenberg, Robert L.; Liechty, Edward A.; Carlo, Waldemar A.; Hambidge, K. Michael; Krebs, Nancy F.; Buekens, Pierre; McClure, Elizabeth M.; Koso-Thomas, Marion; Patel, Archana B.

In: Reproductive Health, Vol. 13, No. 1, 13, 24.05.2016.

Research output: Contribution to journalArticle

Hibberd, PL, Hansen, NI, Wang, ME, Goudar, SS, Pasha, O, Esamai, F, Chomba, E, Garces, A, Althabe, F, Derman, RJ, Goldenberg, RL, Liechty, EA, Carlo, WA, Hambidge, KM, Krebs, NF, Buekens, P, McClure, EM, Koso-Thomas, M & Patel, AB 2016, 'Trends in the incidence of possible severe bacterial infection and case fatality rates in rural communities in Sub-Saharan Africa, South Asia and Latin America, 2010-2013: A multicenter prospective cohort study', Reproductive Health, vol. 13, no. 1, 13. https://doi.org/10.1186/s12978-016-0177-1
Hibberd, Patricia L. ; Hansen, Nellie I. ; Wang, Marie E. ; Goudar, Shivaprasad S. ; Pasha, Omrana ; Esamai, Fabian ; Chomba, Elwyn ; Garces, Ana ; Althabe, Fernando ; Derman, Richard J. ; Goldenberg, Robert L. ; Liechty, Edward A. ; Carlo, Waldemar A. ; Hambidge, K. Michael ; Krebs, Nancy F. ; Buekens, Pierre ; McClure, Elizabeth M. ; Koso-Thomas, Marion ; Patel, Archana B. / Trends in the incidence of possible severe bacterial infection and case fatality rates in rural communities in Sub-Saharan Africa, South Asia and Latin America, 2010-2013 : A multicenter prospective cohort study. In: Reproductive Health. 2016 ; Vol. 13, No. 1.
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abstract = "Background: Possible severe bacterial infections (pSBI) continue to be a leading cause of global neonatal mortality annually. With the recent publications of simplified antibiotic regimens for treatment of pSBI where referral is not possible, it is important to know how and where to target these regimens, but data on the incidence and outcomes of pSBI are limited. Methods: We used data prospectively collected at 7 rural community-based sites in 6 low and middle income countries participating in the NICHD Global Network's Maternal and Newborn Health Registry, between January 1, 2010 and December 31, 2013. Participants included pregnant women and their live born neonates followed for 6 weeks after delivery and assessed for maternal and infant outcomes. Results: In a cohort of 248,539 infants born alive between 2010 and 2013, 32,088 (13 {\%}) neonates met symptomatic criteria for pSBI. The incidence of pSBI during the first 6 weeks of life varied 10 fold from 3 {\%} (Zambia) to 36 {\%} (Pakistan), and overall case fatality rates varied 8 fold from 5 {\%} (Kenya) to 42 {\%} (Zambia). Significant variations in incidence of pSBI during the study period, with proportions decreasing in 3 sites (Argentina, Kenya and Nagpur, India), remaining stable in 3 sites (Zambia, Guatemala, Belgaum, India) and increasing in 1 site (Pakistan), cannot be explained solely by changing rates of facility deliveries. Case fatality rates did not vary over time. Conclusions: In a prospective population based registry with trained data collectors, there were wide variations in the incidence and case fatality of pSBI in rural communities and in trends over time. Regardless of these variations, the burden of pSBI is still high and strategies to implement timely diagnosis and treatment are still urgently needed to reduce neonatal mortality. Trial registration: The study was registered at ClinicalTrials.gov (NCT01073475).",
keywords = "Case fatality rates from neonatal sepsis, Global health, Incidence of neonatal sepsis, Low middle income countries, Neonatal sepsis, Possible severe bacterial infections",
author = "Hibberd, {Patricia L.} and Hansen, {Nellie I.} and Wang, {Marie E.} and Goudar, {Shivaprasad S.} and Omrana Pasha and Fabian Esamai and Elwyn Chomba and Ana Garces and Fernando Althabe and Derman, {Richard J.} and Goldenberg, {Robert L.} and Liechty, {Edward A.} and Carlo, {Waldemar A.} and Hambidge, {K. Michael} and Krebs, {Nancy F.} and Pierre Buekens and McClure, {Elizabeth M.} and Marion Koso-Thomas and Patel, {Archana B.}",
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TY - JOUR

T1 - Trends in the incidence of possible severe bacterial infection and case fatality rates in rural communities in Sub-Saharan Africa, South Asia and Latin America, 2010-2013

T2 - A multicenter prospective cohort study

AU - Hibberd, Patricia L.

AU - Hansen, Nellie I.

AU - Wang, Marie E.

AU - Goudar, Shivaprasad S.

AU - Pasha, Omrana

AU - Esamai, Fabian

AU - Chomba, Elwyn

AU - Garces, Ana

AU - Althabe, Fernando

AU - Derman, Richard J.

AU - Goldenberg, Robert L.

AU - Liechty, Edward A.

AU - Carlo, Waldemar A.

AU - Hambidge, K. Michael

AU - Krebs, Nancy F.

AU - Buekens, Pierre

AU - McClure, Elizabeth M.

AU - Koso-Thomas, Marion

AU - Patel, Archana B.

PY - 2016/5/24

Y1 - 2016/5/24

N2 - Background: Possible severe bacterial infections (pSBI) continue to be a leading cause of global neonatal mortality annually. With the recent publications of simplified antibiotic regimens for treatment of pSBI where referral is not possible, it is important to know how and where to target these regimens, but data on the incidence and outcomes of pSBI are limited. Methods: We used data prospectively collected at 7 rural community-based sites in 6 low and middle income countries participating in the NICHD Global Network's Maternal and Newborn Health Registry, between January 1, 2010 and December 31, 2013. Participants included pregnant women and their live born neonates followed for 6 weeks after delivery and assessed for maternal and infant outcomes. Results: In a cohort of 248,539 infants born alive between 2010 and 2013, 32,088 (13 %) neonates met symptomatic criteria for pSBI. The incidence of pSBI during the first 6 weeks of life varied 10 fold from 3 % (Zambia) to 36 % (Pakistan), and overall case fatality rates varied 8 fold from 5 % (Kenya) to 42 % (Zambia). Significant variations in incidence of pSBI during the study period, with proportions decreasing in 3 sites (Argentina, Kenya and Nagpur, India), remaining stable in 3 sites (Zambia, Guatemala, Belgaum, India) and increasing in 1 site (Pakistan), cannot be explained solely by changing rates of facility deliveries. Case fatality rates did not vary over time. Conclusions: In a prospective population based registry with trained data collectors, there were wide variations in the incidence and case fatality of pSBI in rural communities and in trends over time. Regardless of these variations, the burden of pSBI is still high and strategies to implement timely diagnosis and treatment are still urgently needed to reduce neonatal mortality. Trial registration: The study was registered at ClinicalTrials.gov (NCT01073475).

AB - Background: Possible severe bacterial infections (pSBI) continue to be a leading cause of global neonatal mortality annually. With the recent publications of simplified antibiotic regimens for treatment of pSBI where referral is not possible, it is important to know how and where to target these regimens, but data on the incidence and outcomes of pSBI are limited. Methods: We used data prospectively collected at 7 rural community-based sites in 6 low and middle income countries participating in the NICHD Global Network's Maternal and Newborn Health Registry, between January 1, 2010 and December 31, 2013. Participants included pregnant women and their live born neonates followed for 6 weeks after delivery and assessed for maternal and infant outcomes. Results: In a cohort of 248,539 infants born alive between 2010 and 2013, 32,088 (13 %) neonates met symptomatic criteria for pSBI. The incidence of pSBI during the first 6 weeks of life varied 10 fold from 3 % (Zambia) to 36 % (Pakistan), and overall case fatality rates varied 8 fold from 5 % (Kenya) to 42 % (Zambia). Significant variations in incidence of pSBI during the study period, with proportions decreasing in 3 sites (Argentina, Kenya and Nagpur, India), remaining stable in 3 sites (Zambia, Guatemala, Belgaum, India) and increasing in 1 site (Pakistan), cannot be explained solely by changing rates of facility deliveries. Case fatality rates did not vary over time. Conclusions: In a prospective population based registry with trained data collectors, there were wide variations in the incidence and case fatality of pSBI in rural communities and in trends over time. Regardless of these variations, the burden of pSBI is still high and strategies to implement timely diagnosis and treatment are still urgently needed to reduce neonatal mortality. Trial registration: The study was registered at ClinicalTrials.gov (NCT01073475).

KW - Case fatality rates from neonatal sepsis

KW - Global health

KW - Incidence of neonatal sepsis

KW - Low middle income countries

KW - Neonatal sepsis

KW - Possible severe bacterial infections

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U2 - 10.1186/s12978-016-0177-1

DO - 10.1186/s12978-016-0177-1

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VL - 13

JO - Reproductive Health

JF - Reproductive Health

SN - 1742-4755

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