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Rivera L.,Hospital Maternidad Nuestra Senora de la Altagracia | Saez-Llorens X.,University of Panama | Feris-Iglesias J.,Hospital Infantil Dr Robert Reid Cabral | Ip M.,Chinese University of Hong Kong | And 8 more authors.
BMC Pediatrics | Year: 2015

Background: Group B Streptococcus (GBS) is a leading cause of serious infection in very young infants. Robust incidence data from many geographic regions, including Latin America and Asia, are however lacking. Methods: A multicenter, hospital-based observational study was performed in Panama, Dominican Republic, Hong Kong and Bangladesh. All represented urban, tertiary referral hospitals, except Bangladesh. GBS cases (microbiological isolation from normally sterile sites in infants aged 0-89 days) were collected over 12 months. Results: At 2.35 (95 % CI: 1.74-3.18) cases per 1000 live births, the incidence of early onset GBS disease (EOD) was highest in the Dominican Republic, compared with 0.76 (95 % CI: 0.41-1.39) in Hong Kong and 0.77 (95 % CI: 0.44-1.35) in Panama, while no cases were identified in Bangladesh. Over 90 % of EOD cases occurred on the first day of life, with case fatality ratios ranging from 6.7 % to 40 %, varying by center, age of onset and clinical presentation. Overall, 90 % of GBS (EOD and late onset disease) was due to serotypes Ia, Ib and III. Conclusions: The incidence rate of early onset GBS infection reported in Dominican Republic was not dissimilar from that described in the United States prior to screening and intrapartum antibiotic prophylaxis, while the incidence in Hong Kong was higher than previously reported in the Asian region. The failure to identify GBS cases in Bangladesh highlights a need to better understand the contribution of population, healthcare and surveillance practice to variation in reported incidence. Overall, the identified disease burden and serotype distribution support the need for effective prevention methods in these populations, and the need for community based surveillance studies in rural areas where access to healthcare may be challenging. © 2015 Rivera et al. Source


Tanmoy A.M.,Child Health Research Foundation | Saha S.,University of Toronto | Darmstadt G.L.,Stanford University | Whitney C.G.,Centers for Disease Control and Prevention | And 2 more authors.
Journal of Clinical Microbiology | Year: 2016

Six multiplex-compatible PCR primers were designed to distinguish Streptococcus pneumoniae serotypes within serogroup 18 from culturable/nonculturable pneumococcal specimens, with no cross-reactivity with other serotypes and respiratory organisms. These primers will aid in the generation of better data on vaccine/nonvaccine serotypes in invasive and carriage pneumococcal surveillance and contribute to future vaccine formulation and impact studies. Copyright © 2016 David et al. Source


Darmstadt G.L.,Johns Hopkins University | Choi Y.,Johns Hopkins University | Arifeen S.E.,International Center for Diarrhoeal Disease Research | Bari S.,International Center for Diarrhoeal Disease Research | And 15 more authors.
PLoS ONE | Year: 2010

Background: To evaluate a delivery strategy for newborn interventions in rural Bangladesh. Methods: A cluster-randomized controlled trial was conducted in Mirzapur, Bangladesh. Twelve unions were randomized to intervention or comparison arm. All women of reproductive age were eligible to participate. In the intervention arm, community health workers identified pregnant women; made two antenatal home visits to promote birth and newborn care preparedness; made four postnatal home visits to negotiate preventive care practices and to assess newborns for illness; and referred sick neonates to a hospital and facilitated compliance. Primary outcome measures were antenatal and immediate newborn care behaviours, knowledge of danger signs, care seeking for neonatal complications, and neonatal mortality. Findings: A total of 4616 and 5241 live births were recorded from 9987 and 11153 participants in the intervention and comparison arm, respectively. High coverage of antenatal (91% visited twice) and postnatal (69% visited on days 0 or 1) home visitations was achieved. Indicators of care practices and knowledge of maternal and neonatal danger signs improved. Adjusted mortality hazard ratio in the intervention arm, compared to the comparison arm, was 1.02 (95% CI: 0.80-1.30) at baseline and 0.87 (95% CI: 0.68-1.12) at endline. Primary causes of death were birth asphyxia (49%) and prematurity (26%). No adverse events associated with interventions were reported. Conclusion: Lack of evidence for mortality impact despite high program coverage and quality assurance of implementation, and improvements in targeted newborn care practices suggests the intervention did not adequately address risk factors for mortality. The level and cause-structure of neonatal mortality in the local population must be considered in developing interventions. Programs must ensure skilled care during childbirth, including management of birth asphyxia and prematurity, and curative postnatal care during the first two days of life, in addition to essential newborn care and infection prevention and management. © 2010 Darmstadt et al. Source


Saha S.,Bangladesh Institute of Child Health | Modak J.K.,Bangladesh Institute of Child Health | Modak J.K.,Monash University | Naziat H.,Bangladesh Institute of Child Health | And 8 more authors.
Vaccine | Year: 2015

Detection of pneumococcal carriage by multiple co-colonizing serotypes is important in assessing the benefits of pneumococcal conjugate vaccine (PCV). Various methods differing in sensitivity, cost and technical complexity have been employed to detect multiple serotypes of pneumococcus in respiratory specimens. We have developed an algorithmic method to detect all known serotypes that preserves the relative abundance of specific serotypes by using Quellung-guided molecular techniques. The method involves culturing respiratory swabs followed by serotyping of 100 colonies by either capsular (10 colonies) or PCR (90 colonies) reactions on 96-well plates. The method was evaluated using 102 nasal swabs from children carrying pneumococcus. Multiple serotypes were detected in 22% of carriers, compared to 3% by World Health Organization (WHO)-recommended morphology-based selection of 1 to 3 colonies. Our method, with a processing cost of $87, could detect subdominant strains making up as low as 1% of the population. The method is affordable, practical, and capable of detecting all known serotypes without false positive reactions or change in the native distribution of multiple serotypes. © 2014 The Authors. Source


Islam M.,Mymensingh Medical College & Hospital | Chowdhury M.,Bangladesh Institute of Child Health | Siddika M.,CBMCB | Qurishi S.,Atomic Energy Center | And 3 more authors.
Indian Pediatrics | Year: 2010

Objective: To compare the effect of oral zinc supplementation on growth of preterm infants. Design: Randomized controlled trial. Setting: Dhaka Shisu Hospital (Tertiary care hospital). Subjects: 100 appropriate for date preterm infants weighing between 1000 to 2500g were randomized to receive zinc and multivitamin supplement (Group I; n=50) or only multivitamin supplement (Group II). Intervention: Zinc supplementation was given 2mg/kg/ day for 6 weeks along with multivitamin in Group I and only multivitamin to Group II. Primary outcome variable: Increment of weight and length. Results: At enrollment, serum zinc (62.1±12.4μg/dL in Group I and 63.1±14.6μg/dL in Group II) and hemoglobin levels (14.9±2.4g/dL in Group I and 14.4±1.7g/dL in Group II) were almost similar in both groups. Serum zinc levels were in lower limit of normal range. After supplementation, serum zinc and hemoglobin levels were significantlyhigher in Group I (105±16.5μg/dL) than Group II (82.2±17.4μg/dL) (P<0.05). Weight, length and head circumference were comparable in both groups at enrollment. Significant differences in weight gain and increment in length were found in first and second follow up between two groups but OFC increments were not significant (P>0.05). Reduction of morbidity was apparent in zinc supplemented group. No serious adverse effect was noted related to supplementation therapy.Conclusion: Zinc supplementation for preterm low birth weight babies is found effective to enhance the growth in early months of life. Source

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