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
Identifieur interne : 001E40 ( Main/Merge ); précédent : 001E39; suivant : 001E41Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: a systematic review and meta-analysis
Auteurs : Anna C. Seale [Royaume-Uni, Kenya] ; Hannah Blencowe [Royaume-Uni] ; Alexander A. Manu [Royaume-Uni] ; Harish Nair [Royaume-Uni, Inde] ; Rajiv Bahl [Suisse] ; Shamim A. Qazi [Suisse] ; Anita K. Zaidi [Pakistan] ; James A. Berkley [Royaume-Uni, Kenya] ; Simon N. Cousens [Royaume-Uni] ; Joy E. Lawn [Royaume-Uni, États-Unis]Source :
- The Lancet. Infectious Diseases [ 1473-3099 ] ; 2014.
Abstract
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.
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≥1500 g) with livebirth denominator data, undertaking a systematic review and forming an investigator group to obtain unpublished data.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.
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.
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.
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.
Url:
DOI: 10.1016/S1473-3099(14)70804-7
PubMed: 24974250
PubMed Central: 4123782
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Seale</name><affiliation wicri:level="4"><nlm:aff id="aff1">Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">KEMRI-Wellcome Trust Centre for Geographic Medicine and Research–Coast, Kilifi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Centre for Geographic Medicine and Research–Coast, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Blencowe, Hannah" sort="Blencowe, Hannah" uniqKey="Blencowe H" first="Hannah" last="Blencowe">Hannah Blencowe</name><affiliation wicri:level="3"><nlm:aff id="aff3">Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Manu, Alexander A" sort="Manu, Alexander A" uniqKey="Manu A" first="Alexander A" last="Manu">Alexander A. 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Zaidi</name><affiliation wicri:level="1"><nlm:aff id="aff8">Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Department of Paediatrics and Child Health, Aga Khan University, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Berkley, James A" sort="Berkley, James A" uniqKey="Berkley J" first="James A" last="Berkley">James A. 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Seale</name><affiliation wicri:level="4"><nlm:aff id="aff1">Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">KEMRI-Wellcome Trust Centre for Geographic Medicine and Research–Coast, Kilifi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Centre for Geographic Medicine and Research–Coast, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Blencowe, Hannah" sort="Blencowe, Hannah" uniqKey="Blencowe H" first="Hannah" last="Blencowe">Hannah Blencowe</name><affiliation wicri:level="3"><nlm:aff id="aff3">Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Manu, Alexander A" sort="Manu, Alexander A" uniqKey="Manu A" first="Alexander A" last="Manu">Alexander A. Manu</name><affiliation wicri:level="3"><nlm:aff id="aff3">Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Nair, Harish" sort="Nair, Harish" uniqKey="Nair H" first="Harish" last="Nair">Harish Nair</name><affiliation wicri:level="4"><nlm:aff id="aff5">Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Population Health Sciences, University of Edinburgh, Edinburgh</wicri:regionArea><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6">Public Health Foundation of India, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Public Health Foundation of India, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author><author><name sortKey="Bahl, Rajiv" sort="Bahl, Rajiv" uniqKey="Bahl R" first="Rajiv" last="Bahl">Rajiv Bahl</name><affiliation wicri:level="1"><nlm:aff id="aff7">Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Qazi, Shamim A" sort="Qazi, Shamim A" uniqKey="Qazi S" first="Shamim A" last="Qazi">Shamim A. Qazi</name><affiliation wicri:level="1"><nlm:aff id="aff7">Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Zaidi, Anita K" sort="Zaidi, Anita K" uniqKey="Zaidi A" first="Anita K" last="Zaidi">Anita K. Zaidi</name><affiliation wicri:level="1"><nlm:aff id="aff8">Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Department of Paediatrics and Child Health, Aga Khan University, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Berkley, James A" sort="Berkley, James A" uniqKey="Berkley J" first="James A" last="Berkley">James A. Berkley</name><affiliation wicri:level="4"><nlm:aff id="aff1">Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">KEMRI-Wellcome Trust Centre for Geographic Medicine and Research–Coast, Kilifi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>KEMRI-Wellcome Trust Centre for Geographic Medicine and Research–Coast, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Cousens, Simon N" sort="Cousens, Simon N" uniqKey="Cousens S" first="Simon N" last="Cousens">Simon N. Cousens</name><affiliation wicri:level="3"><nlm:aff id="aff3">Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Lawn, Joy E" sort="Lawn, Joy E" uniqKey="Lawn J" first="Joy E" last="Lawn">Joy E. Lawn</name><affiliation wicri:level="3"><nlm:aff id="aff3">Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Epidemiology and Population Health UK, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff4">Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff9">Saving Newborn Lives/Save the Children, Washington, DC, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Saving Newborn Lives/Save the Children, Washington, DC</wicri:regionArea><placeName><region type="state">District de Columbia</region></placeName></affiliation></author></analytic><series><title level="j">The Lancet. Infectious Diseases</title><idno type="ISSN">1473-3099</idno><idno type="eISSN">1474-4457</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Findings</title><p>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.</p></sec><sec><title>Interpretation</title><p>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.</p></sec><sec><title>Funding</title><p>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.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Murray, Cj" uniqKey="Murray C">CJ Murray</name></author><author><name sortKey="Vos, T" uniqKey="Vos T">T Vos</name></author><author><name sortKey="Lozano, R" uniqKey="Lozano R">R Lozano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blencowe, H" uniqKey="Blencowe H">H Blencowe</name></author><author><name sortKey="Vos, T" uniqKey="Vos T">T Vos</name></author><author><name sortKey="Lee, Ac" uniqKey="Lee A">AC Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, L" uniqKey="Liu L">L 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Baqui</name></author><author><name sortKey="Ahmed, S" uniqKey="Ahmed S">S Ahmed</name></author><author><name sortKey="El Arifeen, S" uniqKey="El Arifeen S">S El Arifeen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zaidi, Akm" uniqKey="Zaidi A">AKM Zaidi</name></author><author><name sortKey="Baqui, Ah" uniqKey="Baqui A">AH Baqui</name></author><author><name sortKey="Qazi, Sa" uniqKey="Qazi S">SA Qazi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mullany, Lc" uniqKey="Mullany L">LC Mullany</name></author><author><name sortKey="Katz, J" uniqKey="Katz J">J Katz</name></author><author><name sortKey="Khatry, Sk" uniqKey="Khatry S">SK Khatry</name></author><author><name sortKey="Leclerq, Sc" uniqKey="Leclerq S">SC Leclerq</name></author><author><name sortKey="Darmstadt, Gl" uniqKey="Darmstadt G">GL Darmstadt</name></author><author><name sortKey="Tielsch, Jm" uniqKey="Tielsch J">JM Tielsch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Darmstadt, Gl" uniqKey="Darmstadt G">GL Darmstadt</name></author><author><name sortKey="Kinney, M" uniqKey="Kinney M">M Kinney</name></author><author><name sortKey="Chopra, M" uniqKey="Chopra M">M Chopra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dickson, Ke" uniqKey="Dickson K">KE Dickson</name></author><author><name sortKey="Simien Kapeu, A" uniqKey="Simien Kapeu A">A Simien-Kapeu</name></author><author><name sortKey="Kinney, M" uniqKey="Kinney M">M Kinney</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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