3 results on '"Bertin B"'
Search Results
2. Malaria in Refugee Children Resettled to a Holoendemic Area of Sub-Saharan Africa.
- Author
-
Hauser, Manuela, Kabuya, Jean-Bertin B, Mantus, Molly, Kamavu, Luc K, Sichivula, James L, Matende, Wycliffe M, Fritschi, Nora, Shields, Timothy, Curriero, Frank, Kvit, Anton, Chongwe, Gershom, Moss, William J, Ritz, Nicole, and Ippolito, Matthew M
- Subjects
- *
PUBLIC health surveillance , *PSYCHOLOGY of refugees , *EMIGRATION & immigration , *ACQUISITION of data , *REGRESSION analysis , *MALARIA , *SEVERITY of illness index , *MEDICAL records , *MEDICAL referrals , *DESCRIPTIVE statistics , *MALNUTRITION , *RESEARCH funding , *CHILDREN ,MALARIA transmission - Abstract
Background Malaria is a leading cause of morbidity and mortality in refugee children in high-transmission parts of Africa. Characterizing the clinical features of malaria in refugees can inform approaches to reduce its burden. Methods The study was conducted in a high-transmission region of northern Zambia hosting Congolese refugees. We analyzed surveillance data and hospital records of children with severe malaria from refugee and local sites using multivariable regression models and geospatial visualization. Results Malaria prevalence in the refugee settlement was similar to the highest burden areas in the district, consistent with the local ecology and leading to frequent rapid diagnostic test stockouts. We identified 2197 children hospitalized for severe malaria during the refugee crisis in 2017 and 2018. Refugee children referred from a refugee transit center (n = 63) experienced similar in-hospital mortality to local children and presented with less advanced infection. However, refugee children from a permanent refugee settlement (n = 110) had more than double the mortality of local children (P <.001), had lower referral rates, and presented more frequently with advanced infection and malnutrition. Distance from the hospital was an important mediator of the association between refugee status and mortality but did not account for all of the increased risk. Conclusions Malaria outcomes were more favorable in refugee children referred from a highly outfitted refugee transit center than those referred later from a permanent refugee settlement. Refugee children experienced higher in-hospital malaria mortality due in part to delayed presentation and higher rates of malnutrition. Interventions tailored to the refugee context are required to ensure capacity for rapid diagnosis and referral to reduce malaria mortality. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
3. Whole Blood Transfusion for Severe Malarial Anemia in a High Plasmodium falciparum Transmission Setting.
- Author
-
Ippolito, Matthew M, Kabuya, Jean-Bertin B, Hauser, Manuela, Kamavu, Luc K, Banda, Proscovia Miiye, Yanek, Lisa R, Malik, Rubab, Mulenga, Modest, Bailey, Jeffrey A, Chongwe, Gershom, Louis, Thomas A, Shapiro, Theresa A, Moss, William J, and Research, for the Southern and Central Africa International Centers of Excellence for Malaria
- Subjects
- *
ANEMIA treatment , *CONFIDENCE intervals , *BLOOD transfusion , *MORTALITY , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *THROMBOCYTOPENIA , *ODDS ratio , *LOGISTIC regression analysis , *LONGITUDINAL method , *HOSPITAL care of children ,MALARIA transmission - Abstract
Background Severe malaria resulting from Plasmodium falciparum infection is the leading parasitic cause of death in children worldwide, and severe malarial anemia (SMA) is the most common clinical presentation. The evidence in support of current blood transfusion guidelines for patients with SMA is limited. Methods We conducted a retrospective cohort study of 911 hospitalized children with SMA in a holoendemic region of Zambia to examine the association of whole blood transfusion with in-hospital survival. Data were analyzed in adjusted logistic regression models using multiple imputation for missing data. Results The median age of patients was 24 months (interquartile range, 16–30) and overall case fatality was 16%. Blood transfusion was associated with 35% reduced odds of death in children with SMA (odds ratio, 0.65; 95% confidence interval,.52–.81; P =.0002) corresponding to a number-needed-to-treat (NNT) of 14 patients. Children with SMA complicated by thrombocytopenia were more likely to benefit from transfusion than those without thrombocytopenia (NNT = 5). Longer storage time of whole blood was negatively associated with survival and with the posttransfusion rise in the platelet count but was not associated with the posttransfusion change in hemoglobin concentration. Conclusions Whole blood given to pediatric patients with SMA was associated with improved survival, mainly among those with thrombocytopenia who received whole blood stored for <4 weeks. These findings point to a potential use for incorporating thrombocytopenia into clinical decision making and management of severe malaria, which can be further assessed in prospective studies, and underline the importance of maintaining reliable blood donation networks in areas of high malaria transmission. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.