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2. Integrated Management of Childhood Illnesses strategy: compliance with referral and follow-up recommendations in Gezira State, Sudan

Author

Al Fadil Sumaia Mohammed, Abd Alrahman Samira Hamid, Cousens Simon, Bustreo Flavia, Shadoul Ahmed, Farhoud Suzanne, and El Hassan Samia Mohamed

Subjects
Child health services, Primary health care, Delivery of health care, Integrated, Referral and consultation, Patient compliance, Child, Family, Socioeconomic factors, Sudan, Public aspects of medicine, RA1-1270
Abstract

OBJECTIVES: To determine the extent to which families follow referral and follow-up recommendations given in accordance with the Integrated Management of Childhood Illnesses (IMCI) strategy and the factors that influence families' responses to such recommendations. METHODS: Children aged 2 months-5 years who presented to an IMCI-trained health worker in Massalamia Health Area, Sudan, were recruited. Children with an IMCI classification that indicated the need for referral or follow-up were traced to determine whether the family complied with the referral or follow-up recommendation. Caretakers were interviewed to find out why they had or had not complied. Focus group discussions were held with health workers, caretakers, and community members. FINDINGS: Overall, 5745 children were enrolled. Of these, 162 (3%) were considered to be in need of urgent referral: 53 (33%) attended a hospital on the day of the referral, with a further 37 (23%) visiting the hospital later than the day of referral. About half of families cited cost as the reason for not visiting a hospital. A total of 1197 (21%) children were classified as needing follow-up. Compliance with a follow-up recommendation was 44% (529 children). Almost 165 (90%) of caretakers who were aware of and did not comply with follow-up, said they had not done so because the child was better. Compliance increased with the caretaker's level of education, if drugs were provided during the first visit, and if the follow-up period was short (2 or 5 days). CONCLUSION: In Massalamia - a resource-constrained environment in which IMCI implementation was well received by the community - only about half of children judged to be in need of urgent referral were taken for that care within 24 hours. Most children in need of follow-up received their first treatment dose in the health facility. This aspect of IMCI was commented upon favourably by caretakers, and it may encourage them to return for follow-up. Rates of return might also improve if return visits for children currently asked to return after 14 or 30 days were scheduled earlier.

Published
2003

4. Efficacy of oral azithromycin versus topical tetracycline in mass treatment of endemic trachoma

Author

Fraser-Hurt Nicole, Bailey Robin L., Cousens Simon, Mabey Denise, Faal Hannah, and Mabey David C.W.

Subjects
Trachoma/drug therapy, Azithromycin/therapeutic use, Tetracycline/therapeutic use, Clinical trials, Comparative study, Gambia, Public aspects of medicine, RA1-1270
Abstract

OBJECTIVE: To compare the impact of mass treatment with oral azithromycin and topical tetracycline on the prevalence of active trachoma. METHODS: A total of 1803 inhabitants from 106 households of eight Gambian villages were randomized, in pairs, to receive either three doses of azithromycin at weekly intervals, or daily topical tetracycline over 6 weeks. Ocular examinations were conducted before treatment, and 2, 6 and 12 months after treatment. FINDINGS: Prior to treatment, 16% of the study participants had active trachoma. Two months after treatment, the prevalence of trachoma was 4.6% and 5.1% in the azithromycin and the tetracycline groups, respectively (adjusted odds ratio (OR) = 1.09; 95% confidence interval (CI) = 0.53, 2.02). Subsequently, the prevalence rose to 16% in the tetracycline group, while remaining at 7.7% in the azithromycin group (adjusted OR at 12 months = 0.52; 95% CI = 0.34, 0.80). At 12 months post-treatment, there were fewer new prevalent cases in the azithromycin group, and trachoma resolution was significantly better for this group (adjusted OR = 2.02; 95% CI = 1.42, 3.50). CONCLUSION: Oral azithromycin therefore appears to offer a means for controlling blinding trachoma. It is easy to administer and higher coverages may be possible than have been achieved hitherto.

Published
2001

5. Evidence of behaviour change following a hygiene promotion programme in Burkina Faso

Author

Curtis Valerie, Kanki Bernadette, Cousens Simon, Diallo Ibrahim, Kpozehouen Alphonse, Sangaré Morike, and Nikiema Michel

Subjects
Handwashing, Toilet facilities, Hygiene, Health promotion, Diarrhea/prevention and control, Data collection, Burkina Faso, Public aspects of medicine, RA1-1270
Abstract

OBJECTIVES: To determine whether a large, 3-year hygiene promotion programme in Bobo-Dioulasso, Burkina Faso, was effective in changing behaviours associated with the spread of diarrhoeal diseases. The programme was tailored to local customs, targeted specific types of behaviour, built on existing motivation for hygiene, and used locally appropriate channels of communication. METHODS: Two population surveys recorded the coverage of the programme among target audiences (mothers of children aged 0-35 months). Four surveys were carried out: three prior to the programme and one in 1998 (after the programme had been running for 3 years), using structured observation of hygiene behaviours in the participants? homes to document changes in target behaviours. FINDINGS: After the programme had run for 3 years, three-quarters of the mothers targeted had had contact with programme activities. Half could cite the two main messages of the programme correctly. Although the safe disposal of children?s stools changed little between 1995 and 1998 (80% pre-intervention, 84% post-intervention), hand-washing with soap after cleaning a child?s bottom rose from 13% to 31%. The proportion of mothers who washed their hands with soap after using the latrine increased from 1% to 17%. CONCLUSION: Hygiene promotion programmes can change behaviour and are more likely to be effective if they are built on local research and use locally appropriate channels of communication repeatedly and for an extended time.

Published
2001

6. Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect

Author

Blencowe Hannah, Cousens Simon, Mullany Luke C, Lee Anne CC, Kerber Kate, Wall Steve, Darmstadt Gary L, and Lawn Joy E

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Annually over 520,000 newborns die from neonatal sepsis, and 60,000 more from tetanus. Estimates of the effect of clean birth and postnatal care practices are required for evidence-based program planning. Objective To review the evidence for clean birth and postnatal care practices and estimate the effect on neonatal mortality from sepsis and tetanus for the Lives Saved Tool (LiST). Methods We conducted a systematic review of multiple databases. Data were abstracted into standard tables and assessed by GRADE criteria. Where appropriate, meta-analyses were undertaken. For interventions with low quality evidence but a strong GRADE recommendation, a Delphi process was conducted. Results Low quality evidence supports a reduction in all-cause neonatal mortality (19% (95% c.i. 1–34%)), cord infection (30% (95% c.i. 20–39%)) and neonatal tetanus (49% (95% c.i. 35–62%)) with birth attendant handwashing. Very low quality evidence supports a reduction in neonatal tetanus mortality with a clean birth surface (93% (95% c.i. 77-100%)) and no relationship between a clean perineum and tetanus. Low quality evidence supports a reduction of neonatal tetanus with facility birth (68% (95% c.i. 47-88%). No relationship was found between birth place and cord infections or sepsis mortality. For postnatal clean practices, all-cause mortality is reduced with chlorhexidine cord applications in the first 24 hours of life (34% (95% c.i. 5–54%, moderate quality evidence) and antimicrobial cord applications (63% (95% c.i. 41–86%, low quality evidence). One study of postnatal maternal handwashing reported reductions in all-cause mortality (44% (95% c.i. 18–62%)) and cord infection ((24% (95% c.i. 5-40%)). Given the low quality of evidence, a Delphi expert opinion process was undertaken. Thirty experts reached consensus regarding reduction of neonatal sepsis deaths by clean birth practices at home (15% (IQR 10–20)) or in a facility (27% IQR 24–36)), and by clean postnatal care practices (40% (IQR 25–50)). The panel estimated that neonatal tetanus mortality was reduced by clean birth practices at home (30% (IQR(20–30)), or in a facility (38% (IQR 34–40)), and by clean postnatal care practices (40% (IQR 30–50)). Conclusion According to expert opinion, clean birth and particularly postnatal care practices are effective in reducing neonatal mortality from sepsis and tetanus. Further research is required regarding optimal implementation strategies.

Published
2011
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7. Care during labor and birth for the prevention of intrapartum-related neonatal deaths: a systematic review and Delphi estimation of mortality effect

Author

Moran Neil F, Pattinson Robert, Blencowe Hannah, Darmstadt Gary L, Cousens Simon, Lee Anne CC, Hofmeyr G, Haws Rachel A, Bhutta Shereen, and Lawn Joy E

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Our objective was to estimate the effect of various childbirth care packages on neonatal mortality due to intrapartum-related events (“birth asphyxia”) in term babies for use in the Lives Saved Tool (LiST). Methods We conducted a systematic literature review to identify studies or reviews of childbirth care packages as defined by United Nations norms (basic and comprehensive emergency obstetric care, skilled care at birth). We also reviewed Traditional Birth Attendant (TBA) training. Data were abstracted into standard tables and quality assessed by adapted GRADE criteria. For interventions with low quality evidence, but strong GRADE recommendation for implementation, an expert Delphi consensus process was conducted to estimate cause-specific mortality effects. Results We identified evidence for the effect on perinatal/neonatal mortality of emergency obstetric care packages: 9 studies (8 observational, 1 quasi-experimental), and for skilled childbirth care: 10 studies (8 observational, 2 quasi-experimental). Studies were of low quality, but the GRADE recommendation for implementation is strong. Our Delphi process included 21 experts representing all WHO regions and achieved consensus on the reduction of intrapartum-related neonatal deaths by comprehensive emergency obstetric care (85%), basic emergency obstetric care (40%), and skilled birth care (25%). For TBA training we identified 2 meta-analyses and 9 studies reporting mortality effects (3 cRCT, 1 quasi-experimental, 5 observational). There was substantial between-study heterogeneity and the overall quality of evidence was low. Because the GRADE recommendation for TBA training is conditional on the context and region, the effect was not estimated through a Delphi or included in the LiST tool. Conclusion Evidence quality is rated low, partly because of challenges in undertaking RCTs for obstetric interventions, which are considered standard of care. Additional challenges for evidence interpretation include varying definitions of obstetric packages and inconsistent measurement of mortality outcomes. Thus, the LiST effect estimates for skilled birth and emergency obstetric care were based on expert opinion. Using LiST modelling, universal coverage of comprehensive obstetric care could avert 591,000 intrapartum-related neonatal deaths each year. Investment in childbirth care packages should be a priority and accompanied by implementation research and further evaluation of intervention impact and cost. Funding This work was supported by the Bill and Melinda Gates Foundation through a grant to the US Fund for UNICEF, and to Saving Newborn Lives Save the Children, through Save the Children US.

Published
2011
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8. Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect

Author

Carlo Waldemar A, Darmstadt Gary L, Niermeyer Susan, Wall Stephen N, Cousens Simon, Lee Anne CC, Keenan William J, Bhutta Zulfiqar A, Gill Christopher, and Lawn Joy E

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously “birth asphyxia”) and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published. Objective To estimate the mortality effect of immediate newborn assessment and stimulation, and basic resuscitation on neonatal deaths due to term intrapartum-related events or preterm birth, for facility and home births. Methods We conducted systematic reviews for studies reporting relevant mortality or morbidity outcomes. Evidence was assessed using GRADE criteria adapted to provide a systematic approach to mortality effect estimates for the Lives Saved Tool (LiST). Meta-analysis was performed if appropriate. For interventions with low quality evidence but strong recommendation for implementation, a Delphi panel was convened to estimate effect size. Results We identified 24 studies of neonatal resuscitation reporting mortality outcomes (20 observational, 2 quasi-experimental, 2 cluster randomized controlled trials), but none of immediate newborn assessment and stimulation alone. A meta-analysis of three facility-based studies examined the effect of resuscitation training on intrapartum-related neonatal deaths (RR= 0.70, 95%CI 0.59-0.84); this estimate was used for the effect of facility-based basic neonatal resuscitation (additional to stimulation). The evidence for preterm mortality effect was low quality and thus expert opinion was sought. In community-based studies, resuscitation training was part of packages with multiple concurrent interventions, and/or studies did not distinguish term intrapartum-related from preterm deaths, hence no meta-analysis was conducted. Our Delphi panel of 18 experts estimated that immediate newborn assessment and stimulation would reduce both intrapartum-related and preterm deaths by 10%, facility-based resuscitation would prevent a further 10% of preterm deaths, and community-based resuscitation would prevent further 20% of intrapartum-related and 5% of preterm deaths. Conclusion Neonatal resuscitation training in facilities reduces term intrapartum-related deaths by 30%. Yet, coverage of this intervention remains low in countries where most neonatal deaths occur and is a missed opportunity to save lives. Expert opinion supports smaller effects of neonatal resuscitation on preterm mortality in facilities and of basic resuscitation and newborn assessment and stimulation at community level. Further evaluation is required for impact, cost and implementation strategies in various contexts. Funding This work was supported by the Bill & Melinda Gates Foundation through a grant to the US Fund for UNICEF, and to the Saving Newborn Lives program of Save the Children, through Save the Children US.

Published
2011
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9. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality

Author

Berman Stuart, Kamb Mary, Cousens Simon, Blencowe Hannah, and Lawn Joy E

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity. Objectives This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4MU benzathine penicillin (or equivalent) on syphilis-related stillbirths and neonatal mortality. Methods We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken. Results Moderate quality evidence (3 studies) supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 – 98%) with detection and treatment of women with active syphilis in pregnancy with at least 2.4MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 – 90%) (8 studies), a 64% reduction in preterm delivery (95% c.i. 53 – 73%) (7 studies) and an 80% reduction in neonatal deaths (95% c.i. 68 – 87%) (5 studies). Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong. Conclusion Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required.

Published
2011
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10. Effect of case management on neonatal mortality due to sepsis and pneumonia

Author

Black Robert, Lee Anne CC, Cousens Simon, Syed Sana, Ganatra Hammad A, Zaidi Anita K M, Bhutta Zulfiqar A, and Lawn Joy E

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST). Methods We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. Results Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies) and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies). Two studies (1 RCT, 1 observational study), evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR= 0.56, 95% CI 0.41-0.77) and 34% (RR =0.66, 95% CI 0.47-0.93), but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents) effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were identified assessing effect of hospital management for neonatal infections and Delphi consensus suggested 80%, and 90% reductions for sepsis and pneumonia-specific mortality respectively. Conclusion Oral antibiotics administered in the community are effective for neonatal pneumonia mortality reduction based on a meta-analysis, but expert opinion suggests much higher impact from injectable antibiotics in the community or primary care level and even higher for facility-based care. Despite feasibility and low cost, these interventions are not widely available in many low income countries. Funding This work was supported by the Bill & Melinda Gates Foundation through a grant to the US Fund for UNICEF, and to Saving Newborn Lives Save the Children, through Save the Children US.

Published
2011
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11. Microbiology testing capacity and antimicrobial drug resistance in surgical-site infections: a post-hoc, prospective, secondary analysis of the FALCON randomised trial in seven low-income and middle-income countries

Author

Aboderin, Aaron Oladipo, Amfoabegyi, Solomon, Awopeju, Abimbola Temitayo, Bahrami-Hessari, Michael, Garchie, Emmanuel Isaac Acquah, Gill, Martin, Karikari, Akosua, Kirby, Andrew, Makanjuola, Olufunmilola, Mutiu, Bamidele, Offiong, Anthony Bassey, Oshun, Philip Olayiwola, Osumanu, Hisham Alhassan, Owusu-Ofori, Alex, Varghese, Shereen Rachel, Adam-Zakariah, Leslie Issa, Adebanjo, Ademola Tolulope, Aguirre, Celina Cuellar, Akoto, Erica, Aminu, Aliyu, Armah, Ralph, Aruldas, Neerav David, Choudhrie, Ashish V, Coompson, Christian Larbi, Ekwunife, Okechukwu Hyginus, Fourtounas, Maria, Lawani, Souliath, Mathew, Arpit Jacob, Patel, Akhil, Ademuyiwa, Adesoji O, Hardy, Pollyanna, Runigamugabo, Emmy, Sodonougbo, Pierre, Behanzin, Hulrich, Kangni, Sosthène, Agboton, Gérard, Adagrah, Luke Aniakwo, Adjei-Acquah, Esther, Acquah, Ato Oppong, Ankomah, James, Acquah, Regina, Addo, Kwame Gyambibi, Acheampong, Dorcas Otuo, Adu-Aryee, Nii Armah, Abubakari, Fatao, Titigah, Abraham, Owusu, Frank, Adu-Brobbey, Raphael, Adobea, Vivian, Abantanga, Francis Atindaana, Gautham, Arun, Bhatti, Dimple, Jesudason, Esther Daniel Mark, Aggarwal, Manisha, Alexander, Philip, Dasari, Amos, Alpheus, Rahul, Kumar, Hemanth, Raul, Subrat, Bueno, Wenceslao Ángeles, Ortiz, Reyes Cervantes, Gomez, Isaac Baltazar, Cerdan, Claudia Caballero, Gallo, Mariana Barreto, Gamez, Rozana Reyes, Sánchez, Irani Durán, Abdullahi, Lawal, Adesanya, Opeoluwa, Abdulsalam, Moruf, Adeleye, Victoria, Egwuonwu, Ochomma, Adeleke, Akeem, Adebayo, Francis, Chiejina, Godwin, Abayomi, Olukayode, Abdur-Rahman, Lukman, Ede, Jude, Ezinne, Uba, Kanyarukiko, Salathiel, Dusabe, Moses, Hirwa, Aime Dieudonne, Bucyibaruta, Georges, Adams, Mary Augusta, Birtles, Cheryl, Ally, Zain, Adewunmi, Abdus-sami, Cook, Jonathan, Brown, Julia, Adisa, Adewale O, Ismail, Lawani, Bhangu, Aneel, Omar, Omar, Simoes, Joana FF, Li, Elizabeth, Chaudhry, Daoud, Saeed, Samerah, Spurring, Eleanor Margaret, Verjee, Azmina, Assouto, Pamphile, Seto, Djifid Morel, Kpangon, Cyrile, Ahossi, Rene, Alhassan, Bin Baaba Alhaji, Agyekum, Vera, Assah-Adjei, Frank, Asare, Christopher, Amoako, James, Akosa, Enoch Appiah, Acquaye, Jane, Adjei, Faisal, Ballu, Cletus, Bennin, Amos, Abdulai, Darling Ramatu, Hepzibah, Alice, Bhatti, William, Paul, Priyadarshini K, Dhamija, Parth, Thomas, Josy, Jacob, Priya, Choudhrie, Ashish, Peters, Nitin, Sharma, Rajeev, Camacho, Francisco Barbosa, Gonzalez, Gonzalo Hernandez, Solano, David Dominguez, Flores, Ana Cortes, Menindez, Roque Lincona, Vazquez, Diana Gonzalez, Ado, Khadija, Awonuga, David, Adeniran, Abimbola, Ademuyiwa, Adesoji, Ekwunife, Okechukwu, Adenikinju, Wilson, Aisuodionoe-Shadrach, Oseremen, Edet, Ekpo, Abdus-Salam, Rukiyat, Adeleke, Nurudeen, Ekenze, Sebastian, Francis, Matthew, Mukaneza, Francine, Izabiriza, Emelyne, Kabanda, Elysee, Bunogerane, Gisele Juru, Crawford, Richard, Ivy, Mathete, Jayne, David, Cousens, Simon, Chakrabortee, Sohini, Ghosh, Dhruva, Gyamfi, Frank Enoch, Brant, Felicity, Fiogbe, Michel, Tandje, Yannick, Akpla, Marcelin, Ngabo, Raoul Baderha, Amoako-Boateng, Mabel Pokuah, Agyemang, Eric, Asabre, Esther, Boakye, Anthony Appiah, Gakpetor, Delali Akosua, Appiah, Akosua Dwamena, Boakye, Percy, Adinku, Michael, Barimah, Charles Gyamfi, Labaran, Abdul-Hamid, Dankwah, Fred, Acquah, Daniel Kwesi, Mary, Grace, Bir, Karan, Madankumar, Latha, Gupta, Himani, Zechariah, Pradeep, Kurien, Elizabeth, Vakil, Rakesh, Hernández, Aldo Bernal, Krauss, Rosa Hernandez, Avendaño, Alejandro Cuevas, Garcia, Rafael Toriz, Ojeda, Alejandro Gonzalez, Peón, Alberto Navarrete, Lara, Maria Martínez, Aliyu, Mohammed, Fasiku, Olushola, Ajai, Olalekan, Adeniyi, Oluwafunmilayo, Modekwe, Victor, Adeniyi, Olumide, Akaba, Godwin, Inyang, Akan, Adebayo, Sikiru, Adesola, Muideen, Enemuo, Vincent, Ikechukwu, Iweha, Mukantibaziyaremye, Deborah, Maniraguha, Hope Lydia, Mbonimpaye, Salomee, Habumuremyi, Sosthene, Ede, Chikwendu Jeffrey, Mbavhalelo, Cynthia, Laurberg, Soren, Smart, Neil, de la Medina, Antonio Ramos, Brocklehurst, Peter, Koco, Houenoukpo, Chobli, Hugues Herve, Bisimwa, Nathan, Appiah, Anthony Baffour, Akesseh, Rebecca Adjeibah, Boateng, Ruby Acheampong, Fosu, Godfred, Gawu, Victoria Sena, Aseti, Mark, Agbedinu, Kwabena, Ametefe, Elikem, Boateng, Guy Casskey, Owusu, Junior Atta, Doe, Stanley, Ayingayure, Emmanuel, Singh, Deepak, Daniel, Swati, Mittal, Rohin, Kanna, Vinoth, Mathew, Arpit, Arellano, Ana Bogurin, Miguelena, Luis Hernández, Sansores, Luis Dominguez, Velasco, Monica Jimenez, Muñoz, Maria Paz, Perez-Maldonado, Laura Martinez, Anyanwu, Lofty-John, Ogo, Chidiebere, Akande, Olukemi, Akinajo, Opeyemi, Okoro, Chukwuemeka, Adepiti, Akinfolarin, Ameh, Lazarus, Isa, Mary, Ajao, Akinlabi, Afolabi, Rafiat, Eze, Matthew, Nnyonno, Okoi, Munyaneza, Aphrodis, Mpirimbanyi, Christophe, Mukakomite, Christine, Haragirimana, Jean de Dieu, Moore, Rachel, Metchinhoungbe, Serge, Kovohouande, Blaise, Kandokponou, Covalic Melic Bokossa, Asante-Asamani, Alvin, Amponsah-Manu, Forster, Koomson, Barbara, Serbeh, Godwin, Obbeng, Ambe, Banka, Charles, Gyamfi, Brian, Agbeko, Anita Eseenam, Amoako, Joachim Kwaku, Luri, Prosper Tonwisi, Kantanka, Ruth Sarfo, Osman, Imoro, Dhar, Tapasya, Nagomy, Ida, Kumar, Ashwani, Prakash, Danita, Torres, Edgar Cortes, Romero, Marco Hurtado, Mejia, Hector Ortiz, de la Fuente, Alejandra Nayen Sainz, Magashi, Mahmoud, Atobatele, Kazeem, Akinboyewa, David, Uche, Chisom, Aderounmu, Adewale, Mbajiekwe, Ndubuisi, Iseh, Faith, Amusat, Olanrewaju, Agodirin, Sulaiman, Ezomike, Uchechukwu, Okoro, Philemon, Ndegamiye, Gibert, Mutuyimana, Josiane, Muroruhirwe, Piolette, Imanishimwe, Alphonsine, Hyman, Gabriella, Ntirenganya, Faustin, Sogbo, Hodonou, Dokponou, Mireille, Boakye, Benedict, Ofosu-Akromah, Richard, Kusiwaa, Ataa, Gyan, Kofi Yeboah, Ofosuhene, Doris, Dadzie, Samuel, Kontor, Bismark Effah, Amankwa, Emmanuel Gyimah, Attepor, Godsway Solomon, Kobby, Ephraim, Kunfah, Sheba, Dhiman, Jyoti, Selvakumar, Rajesh, Singh, Gurtaj, Susan, Anju, Orozco, Clotilde Fuentes, del Campo, Laura Urdapilleta Gomez, de la Medina, Antonio Ramos De, Muhammad, Abubakar, Eke, Grace, Alasi, Iyabo, Ugwuanyi, Kenneth, Adesunkanmi, Abdulhafiz, Ogbo, Felix, Marwa, Adams, Ayandipo, Omobolaji, Aremu, Isiaka, Izuka, Emmanuel, Patrick, Igwe, Tubasiime, Ronald, Mwenedata, Olivier, Ingabire, JC Allen, Khan, Zafar, Harrison, Ewen, Tabiri, Stephen, Glasbey, James, Dossou, Francis Moïse, Debrah, Samuel A, Enti, Donald, Twerefour, Emmanuel Yaw, Nyarko, Isaac Omane, Osei-Poku, Dorcas, Essien, Derick, Kyeremeh, Christian, Amoah, Michael, Brown, George Darko, Larnyor, Kennedy Kofi Korankye-Hanson, Limann, Gbana, Shankar, Bharat, Varghese, Rose, de Rojas, Erick González García, Muhammad, Saminu, Faboya, Omolara, Alakaloko, Felix, Ugwunne, Chuka, Adisa, Adewale, Olori, Samson, Ogbeche, Sunday, Egbuchulem, Kelvin, Bello, Jibril, Mbadiwe, Okezie, Raphael, John, Rwagahirima, Elisee, Mukanyange, Violette, Kwati, Morapedi, Dzemta, Corinne, Ganiyu, Rahman Adebisi, Robertson, Zelda, Puozaa, Diana, Manu, Ruth, Amoah, George, Fenu, Benjamin, Osei, Edwin, Mohammed, Shamudeen Alhassan, Goyal, Sunita, Sivakumar, Moonish, Muideen, Bello, Imam, Zainab, Atoyebi, Oluwole, Ajekwu, Samuel, Osagie, Olabisi, Olory, Edima, Ekwuazi, Hyginus, Lawal, Saheed, Mbah, Ngozi, Vaduneme, Oriji, Uwizeyimana, Francine, Munyaneza, Emmanuel, Mathe, Mpho Nosipho, Haque, Parvez D, Gaou, Antoine, Koggoh, Patience, Tackie, Enoch, Hussey, Romeo, Mensah, Elijah, Appiah, Juliana, Kumassah, Philemon Kwame, Owusu, Prince Yeboah, Mohammed, Sheriff, Goyal, Ankush, Sridhar, Rajeevan, Ramírez, Bertha Guzmán, Takai, Idris, Momson, Esther, Balogun, Olanrewaju, Ajenjfuja, Olusegun, Sadiq, Abu, Udie, Gabriel, Elemile, Peter, Lawal, Abdulwahab, Victor, Abhulimen, Zirikana, Job, Mutabazi, Emmanuel, Heritage, Emily, Goudou, Roland, Kpankpari, Richard, Temitope, Arkorful Ebenezer, Kwarteng, Jemima, Solae, Friko Ibrahim, Arthur, Joshua, Olayiwola, David Olatayo, Sie-Broni, Clement Ayum, Musah, Yakubu, Thomas, Cecil, Valadez, Michel Hernández Valadez, Ukata, Onyekachi, Nwaenyi, Francisca, Belie, Orimisan, Akindojutimi, Jerrie, Sani, Samuel, Udosen, Joseph, Lawal, Taiwo, Raji, Hadijat, Ncogoza, Isaie, Nhlabathi, Ncamsile Anthea, Hedefoun, Emmanuel, Opandoh, Isabella Naa M., Sowah, Naa Anyekaa, Toffah, Gideon Kwasi, Ayim, Alex, Wordui, Theodore, Zume, Marshall, Ofori, Bernard, Hans, Monika, Titus, Devabalan, Acevedo, Diego Luna, Ogunyemi, Ayokunle, Bode, Christopher, Akinkuolie, Akinbolaji, Tabuanu, Nancy, Usang, Usang, Lawal, Olatunji, Sayomi, Olayinka, Nxumalo, Hlengiwe Samkelisiwe, Kroese, Karolin, Houtoukpe, Sunday, Manu, Meshach Agyemang, Yeboah, Grace, Ayodeji, Emmanuel Kafui, Agboadoh, Nelson, Owusu, Emmanuel Abem, Haque, Parvez, Galaviz, Rubén Morán, Oludara, Mobolaji, Ekwesianya, Andrew, Alatise, Olusegun, Uanikhoba, Martins, Olagunju, Solomon, Shittu, Asimiyu, Nyirahabimana, Jeannette, Pattinson, Paddy, Lillywhite, Rachel, Lapitan, Carmela, Kamga, Felix, Manu, Maison Patrick Opoku, Yeboah, Cynthia, Boakye-Yiadom, Jonathan, Saba, Abdul-Hafiz, Konda, Samuel, Flores, Oscar Olvera, Omisanjo, Olufunmilade, Elebute, Olumide, Allen, Olubukola, Osuala, Peter, Urimubabo, Christian, Sentholang, Nnosa, Kiki-Migan, Eric, Mensah, Samuel, Boateng, Edward Amoah, Seidu, Anwar Sadat, Luther, Anil, Navarro, José Pérez, Oshodi, Olabode, Ezenwankwo, Francis, Amosu, Lukmon, Suleman, Bamidele, Sethoana, Mmule Evelyn, Lissauer, David, Morna, Martin Tangnaa, Dally, Charles, Mahajan, Amit, Belmontes, Kevin Pintor, Oshodi, Yusuf, Fatuga, Adedeji, Archibong, Micheal, Takure, Augustine, Stassen, Maria Elizabeth, Magill, Laura, Lawani, Ismaïl, Nkrumah, John, Davor, Anthony, Yakubu, Mustapha, Makkar, Shalini, Marbello, Fernando Ramirez, Oyewole, Yemisi, Ihediwa, George, Arowolo, Olukayode, Thornley, Laura, Morton, Dion, Loko, René, Nortey, Michael, Gyasi-Sarpong, Christian Kofi, Yenli, Edwin Mwintiereh Ta-ang, Mandrelle, Kavita, Ramírez-González, Luis, Salami, Omotade, Jimoh, Adesola, Ayantona, Deborah, Wondoh, Paul, Nepogodiev, Dmitri, Mistry, Punam, Moutaïrou, Afissatou, Ofori, Emmanuel Owusu, Hamidu, Naabo Nuhu Noel, Michael, Vishal, Aguirre, Laura Reyes, Williams, Omolara, Kuku, Jubril, Ayinde, Ademola, Monahan, Mark, Ogouyemi, Pencome, Quartson, Elizaberth Mercy Quartson, Haruna, Iddrisu, Mukherjee, Partho, García, Ramona Rojas, Ladipo-Ajayi, Oluwaseun, Badejoko, Olusegun, Soumanou, Fouad, Kwarley, Naa, Rajappa, Reuben, Robles, Eduardo Valtierra, Makanjuola, Ayomide, Badmus, Tajudeen, Smith, Donna, Tamadaho, Pia, Lovi, Agbenya Kobla, Singh, Prashant, Mokwenyei, Olayanju, Etonyeaku, Amarachukwu, Zounon, Mack-Arthur, Nimako, Boateng, Suroy, Atul, Nwokocha, Samuel, Igbodike, Emeka, Nyadu, Bertina Beauty, Thind, Ravinder, Ogein, Olubunmi, Ijarotimi, Omotade, Opoku, Dominic, Thomas, Alen, Ojewola, Rufus, Lawal, Adedayo, Pinkney, Thomas, Osabutey, Anita, Tuli, Arti, Oladimeji, Abraham, Nana, Fayowole, Roberts, Tracy, Sagoe, Robert, Veetil, Sreejith, Olajide, Thomas, Oduanafolabi, Tunde, Tuffour, Samuel, Oluseye, Oluwaseun, Olasehinde, Olalekan, Tufour, Yaa, Seyi-Olajide, Justina, Olayemi, Olaniyi, Winkles, Neil, Yamoah, Francis Akwaw, Soibi-Harry, Adaiah, Omitinde, Stephen, Yefieye, Abiboye Cheduko, Ugwu, Aloy, Oni, Owolabi, Yorke, Joseph, Williams, Emmanuel, Onyeze, Chigozie, Orji, Ernest, Rotimi, Adewale, Salako, Abdulkadir, Solaja, Olufemi, Sowemimo, Oluwaseun, Talabi, Ademola, Tajudeen, Mohammed, and Wuraola, Funmilola

Published
2024
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12. Characteristics and birth outcomes of pregnant adolescents compared to older women: An analysis of individual level data from 140,000 mothers from 20 RCTs

Author

Akseer, Nadia, Keats, Emily Catherine, Thurairajah, Pravheen, Cousens, Simon, Bétran, Ana Pilar, Oaks, Brietta M, Osrin, David, Piwoz, Ellen, Gomo, Exnevia, Ahmed, Faruk, Friis, Henrik, Belizán, José, Dewey, Kathryn, West, Keith, Huybregts, Lieven, Zeng, Lingxia, Dibley, Michael J, Zagre, Noel, Christian, Parul, Kolsteren, Patrick Wilfried, Kaestel, Pernille, Black, Robert E, Arifeen, Shams El, Ashorn, Ulla, Fawzi, Wafaie, Bhutta, Zulfiqar Ahmed, and Group, The Global Young Women's Nutrition Investigators

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Paediatrics, Reproductive Medicine, Adolescent Sexual Activity, Preterm, Low Birth Weight and Health of the Newborn, Pediatric, Perinatal Period - Conditions Originating in Perinatal Period, Prevention, Infant Mortality, 3.3 Nutrition and chemoprevention, Prevention of disease and conditions, and promotion of well-being, Aetiology, 2.2 Factors relating to the physical environment, Reproductive health and childbirth, Good Health and Well Being, Adolescence, Age, Determinants, Pregnancy, Birth outcomes, Global Young Women's Nutrition Investigators Group, Clinical sciences, Health services and systems, Public health
Abstract

BackgroundAdolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10-19 years) compared to older mothers in low and middle-income countries.MethodsThis study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10-14 years, 15-17 years, 18-19 years, 20-29 years, 30-39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, prevalence and relative risks of pregnancy, nutrition and birth outcomes were estimated using multivariable linear and log-binomial regression models with 95% confidence intervals.FindingsAdolescent mothers comprised 31.6% of our data. Preterm birth, small-for-gestational age (SGA), low birthweight (LBW) and newborn mortality followed a U-shaped trend in which prevalence was highest among the youngest mothers (10-14 years) and then reduced gradually, but increased again for older mothers (40+ years). When compared to mothers aged 20-29 years, there was a 23% increased risk of preterm birth, a 60% increased risk of perinatal mortality, a 63% increased risk of neonatal mortality, a 28% increased risk of LBW, and a 22% increased risk of SGA among mothers 10-14 years. Mothers 40+ years experienced a 22% increased risk of preterm birth and a 103% increased risk of stillbirth when compared to the 20-29 year group.InterpretationThe youngest and oldest mothers suffer most from adverse pregnancy and birth outcomes. Policy and programming agendas should consider both biological and socioeconomic/environmental factors when targeting these populations.FundingBill and Melinda Gates Foundation (Grant No: OP1137750).

Published
2022

13. Multiple-micronutrient supplementation in pregnant adolescents in low- and middle-income countries: a systematic review and a meta-analysis of individual participant data

Author

Keats, Emily C, Akseer, Nadia, Thurairajah, Pravheen, Cousens, Simon, Bhutta, Zulfiqar A, Ali, Hasmot, Arifeen, Shams El, Ashorn, Ulla, Belizan, José, Black, Robert E, Christian, Parul, De-Regil, Luz Maria, Dewey, Kathryn, Dibley, Michael J, Fawzi, Wafaie, Friis, Henrik, Gomo, Exnevia, Huybregts, Lieven, Jayatissa, Renuka, Kaestel, Pernille, Khatry, Subarna K, Kolsteren, Patrick W, Labrique, Alain B, McCauley, Mary, Oaks, Brietta M, Piwoz, Ellen, Shaikh, Saijuddin, Soekarjo, Damayanti D, Sudfeld, Christopher R, Urassa, Willy, West, Keith, Wu, Lee Shu-Fune, Zagre, Noel, Zeng, Lingxia, and Zhu, Zhonghai

Subjects
Nutrition, Preterm, Low Birth Weight and Health of the Newborn, Infant Mortality, Prevention, Clinical Research, Perinatal Period - Conditions Originating in Perinatal Period, Clinical Trials and Supportive Activities, Pediatric, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, 3.3 Nutrition and chemoprevention, Prevention of disease and conditions, and promotion of well-being, Reproductive health and childbirth, Good Health and Well Being, Adolescent, Aged, Developing Countries, Dietary Supplements, Female, Humans, Infant, Newborn, Micronutrients, Pregnancy, Pregnant Women, Premature Birth, Global Young Women’s Nutrition Investigators’ Group, adolescent nutrition, antenatal care, individual participant data meta-analysis, multiple-micronutrient supplementation, Medical and Health Sciences, Psychology and Cognitive Sciences, Nutrition & Dietetics
Abstract

ContextApproximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy.ObjectiveThe aim of this systematic review and meta-analysis was to assess the following: (1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes, and mortality outcomes, (2) the effects of MMN supplementation in adolescents compared with the effects in adult women, and (3) the effect modification, if any, of MMN supplementation by baseline and geographic characteristics of adolescents.Data sourcesMEDLINE and Cochrane databases were searched, along with the reference lists of relevant reviews.Study selectionMultiple-micronutrient supplementation trials in pregnancy that were conducted in a low- or middle-income country and had included at least 100 adolescents (10-19 years of age) were eligible for inclusion. Two independent reviewers assessed study eligibility.Data extractionThirteen randomized controlled trials conducted in Africa and Asia were identified from 1792 reviews and 1578 original trials. Individual-level data was shared by study collaborators and was checked for completeness and extreme values. One- and two-stage individual participant data meta-analyses were conducted using data from randomized controlled trials of MMN supplementation.ResultsA total of 15 283 adolescents and 44 499 adult women with singleton births were included in the individual participant data meta-analyses of MMN supplementation vs IFA supplementation. In adolescents, MMN supplementation reduced low birth weight (1-stage OR = 0.87, 95%CI 0.77-0.97; 2-stage OR = 0.81; 95%CI 0.74-0.88), preterm birth (1-stage OR = 0.88, 95%CI 0.80-0.98; 2-stage OR = 0.86, 95%CI 0.79-0.95), and small-for-gestational-age births (1-stage OR = 0.90, 95%CI 0.81-1.00; 2-stage OR = 0.86, 95%CI 0.79-0.95) when compared with IFA supplementation. The effects of MMN supplementation did not differ between adolescents and older women, although a potentially greater reduction in small-for-gestational-age births was observed among adolescents. Effect modification by baseline characteristics and geographic region was inconclusive.ConclusionsMultiple-micronutrient supplementation can improve birth outcomes among pregnant adolescents in low- and middle-income countries. Policy related to antenatal care in these settings should prioritize MMN supplementation over the currently recommended IFA supplementation for all pregnant women, especially adolescents.

Published
2022

14. Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a model-based cost-effectiveness analysis of a pragmatic, cluster-randomised trial in seven low-income and middle-income countries

Author

Kachapila, Mwayi, Oppong, Raymond, Ademuyiwa, Adesoji O., Bhangu, Aneel, Dauda, Risikat, Ghosh, Dhruva N., Kamarajah, Sivesh K, Lawani, Ismail, Medina, Antonio Ramos-De la, Monahan, Mark, Morton, Dion G., Omar, Omar, Picciochi, Maria, Tabiri, Stephen, Roberts, Tracy E., Brocklehurst, Peter, Chakrabortee, Sohini, Glasbey, James, Hardy, Pollyanna, Harrison, Ewen, Lillywhite, Rachel, Magill, Laura, Nepogodiev, Dmitri, Simoes, Joana, Smith, Donna, Kadir, Bryar, Pinkney, Thomas, Brant, Felicity, Li, Elizabeth, Runigamugabo, Emmy, Bahrami-Hessari, Michael, Bywater, Edward, Martinez, Laura, Habumuremyi, Sosthene, Ntirenganya, Faustin, Williams, Emmanuel, Fourtounas, Maria, Melic, Bokossa K. Covalic, Suroy, Atul, Ahogni, Didier, Ahounou, Aristide, Boukari, K. Alassan, Gbehade, Oswald, Hessou, Thierry K, Nindopa, Sinama, Nontonwanou, M.J. Bienvenue, Guessou, Nafissatou Orou, Sambo, Arouna, Tchati, Sorekou Victoire, Tchogo, Affisatou, Tobome, Semevo Romaric, Yanto, Parfait, Gandaho, Isidore, Hadonou, Armel, Hinvo, Simplice, Hodonou, Montcho Adrien, Tamou, Sambo Bio, Lawani, Souliath, Dossou, Francis Moise, Gaou, Antoine, Goudou, Roland, Kouroumta, Marie-Claire, Malade, Enrif, Dikao, Anne stredy Mkoh, Nsilu, Joel Nzuwa, Ogouyemi, Pencome, Akpla, Marcelin, Mitima, Nathan Bisimwa, Kovohouande, Blaise, Loupeda, Stephane Laurent, Agbangla, Mamonde Victorin, Hedefoun, Sena Emmanuel, Mavoha, Thierry, Ngaguene, Juvenal, Rugendabanga, Janvier, Soton, Rish Romaric, Totin, Martin, Agbadebo, Mouhamed, Dewamon, Hubert, Akpo, Irene, Djeto, Martin, Hada, Aissatou, Hollo, Monsede, Houndji, Albert, Houndote, Anasthasie, Hounsa, Sylvestre, Kpatchassou, Expedit, Yome, Hugues, Alidou, Mohamed Moussa, Bara, Eric Jerry, Yovo, B.T. Bonheur Dossou, Guinnou, Robert, Hamadou, Souleymane, Kola, H.Pauline, Moussa, Nabil, Cakpo, Boniface, Etchisse, Lolyta, Hatangimana, Emery, Muhindo, Moise, Sanni, Katia, Yevide, Agossou Barthelemy, Agossou, Hermann, Musengo, Fiston Basirwa, Behanzin, Hulrich, Seto, Djifid Morel, Alia, Bill Armstrong, Alitonou, Arnaud, Mehounou, Y.Edith, Agbanda, Lucien, Attinon, Julien, Hounsou, Nounagnon Rene, Gbassi, Marcel, Adagrah, Aniakwo, Alhassan, Bin Baaba Alhaji, Amoako-Boateng, Mabel Pokuah, Appiah, Anthony Baffour, Asante-Asamani, Alvin, Boakye, Benedict, Debrah, Samuel A, Ganiyu, Rahman Adebisi, Enti, Donald, Koggoh, Patience, Kpankpari, Richard, Opandoh, Isanella Naa M., Manu, Meshach Agyemang, Manu, Maison Patrick Opoku, Mensah, Samuel, Morna, Martin Tangnaa, Nortey, Michael, Nkrumah, John, Ofori, Emmanuel Owusu, Quartson, Elizaberth Mercy, Acquah, Ato Oppong, Adam-Zakariah, Leslie Issa, Asabre, Esther, Boateng, Ruby Acheampong, Koomson, Barbara, Kusiwaa, Ataa, Twerefour, Emmanuel Yaw, Ankomah, James, Assah-Adjei, Frank, Boakye, Anthony Appiah, Fosu, Godfred, Serbeh, Godwin, Gyan, Kofi Yeboah, Nyarko, Isaac Omane, Robertson, Zelda, Acheampong, Dorcas O, Acquaye, Jane, Adinku, Michael, Agbedinu, Kwabena, Agbeko, Anita Eseenam, Amankwa, Emmanuel Gyimah, Amoah, Michael, Amoah, George, Appiah, Juliana, Arthur, Joshua, Ayim, Alex, Ayodeji, Emmanuel Kafui, Boakye-Yiadom, Jonathan, Boateng, Edward Amoah, Dally, Charles, Davor, Anthony, Gyasi-Sarpong, Christian Kofi, Hamidu, Naabo Nuhu Noel, Haruna, Iddrisu, Kwarley, Naa, Lovi, Agbenya Kobla, Nimako, Boateng, Nyadu, Bertina Beauty, Opoku, Dominic, Osabutey, Anita, Sagoe, Robert, Tuffour, Samuel, Tufour, Yaa, Yamoah, Francis Akwaw, Yefieye, Abiboye Cheduko, Yorke, Joseph, Addo, Kwame Gyambibi, Akosa, Enoch Appiah, Boakye, Percy, Coompson, Christian Larbi, Gyamfi, Brian, Kontor, Bismark Effah, Kyeremeh, Christian, Manu, Ruth, Mensah, Elijah, Solae, Friko Ibrahim, Toffah, Gideon Kwasi, Adu-Brobbey, Raphael, Labaran, Abdul-Hamid, Owusu, Junior Atta, Adobea, Vivian, Bennin, Amos, Dankwah, Fred, Doe, Stanley, Kantanka, Ruth Sarfo, Kobby, Ephraim, Larnyor, Hanson, Owusu, Prince Yeboah, Sie-Broni, Clement Ayum, Zume, Marshall, Abantanga, Francis Atindaana, Abdulai, Darling Ramatu, Acquah, Daniel Kwesi, Ayingayure, Emmanuel, Osman, Imoro, Kunfah, Sheba, Limann, Gbana, Mohammed, Shamudeen Ahhassan, Mohammed, Sheriff, Musah, Yakubu, Ofori, Bernard, Owusu, Emmanuel Abem, Saba, Abdul-Hafiz, Seidu, Anwar Sadat, Yakubu, Mustapha, Yenli, Edwin Mwintiereh Ta-ang, Bhatti, Kavita, Dhiman, Jyoti, Dhir, Karan, Hans, Monika, Haque, Parvez D, Jesudason, Esther Daniel Mark, Madankumar, Latha, Mittal, Rohin, Nagomy, Ida, Prasad, Soosan, Dasari, Amos, Jacob, Priya, Kurien, Elizabeth, Mathew, Arpit, Prakash, Danita, Susan, Anju, Varghese, Rose, Ortiz, Reyes Cervantes, Gonzalez, Gonzalo Hernandez, Krauss, Rosa Hernandez, Miguelena, Luis Hernández, Romero, Marco Hurtado, Gomez, Isaac Baltazar, Aguirre, Celina Cuellar, Avendaño, Alejandro Cuevas, Sansores, Luis Dominguez, Mejia, Hector Ortiz, Campo, Laura Urdapilleta Gomez del, Sánchez, Irani Durán, Vazquez, Diana Gonzalez, Lara, Maria Martínez, Maldonado, Laura Martinez Perez, Fuente, Alejandra Nayen Sainz de la, Medina, Antonio Ramos De la, Adeleye, Victoria, Adeniyi, Oluwafunmilayo, Akinajo, Opeyemi, Akinboyewa, David, Alasi, Iyabo, Alakaloko, Felix, Atoyebi, Oluwole, Balogun, Olanrewaju, Belie, Orimisan, Bode, Christopher, Ekwesianya, Andrew, Elebute, Olumide, Ezenwankwo, Francis, Fatuga, Adedeji, Ihediwa, George, Jimoh, Adesola, Kuku, Jubril, Ladipo-Ajayi, Oluwaseun, Makanjuola, Ayomide, Mokwenyei, Olayanju, Nwokocha, Samuel, Ogein, Olubunmi, Ojewola, Rufus, Oladimeji, Abraham, Olajide, Thomas, Oluseye, Oluwaseun, Seyi-Olajide, Justina, Soibi-Harry, Adaiah, Ugwu, Aloy, Abdur-Rahman, Lukman, Adeleke, Nurudeen, Adesola, Muideen, Afolabi, Rafiat, Agodirin, Sulaiman, Aremu, Isiaka, Bello, Jibril, Lawal, Saheed, Lawal, Abdulwahab, Raji, Hadijat, Sayomi, Olayinka, Shittu, Asimiyu, Acquah, Regina, Banka, Charles, Esssien, Derick, Hussey, Romeo, Mustapha, Yakubu, Nunoo-Ghartey, Kojo, Yeboah, Grace, Aniakwo, Luke A, Adjei, Margarey N M, Adofo-Asamoah, Yvonne, Agyapong, Meshach M, Agyen, Thomas, Alhassan, Baba A B, Amoako-Boateng, Mabel P, Ashong, Josephine, Awindaogo, Joseph K, Brimpong, Benjamin B, Dayie, Makafui S C J K, Ghansah, Wendy W, Gyamfi, Jude E, Kudoh, Vincent, Mensah, Philip, Opandoh, Isabella N Morkor, Morna, Martin T, Odame, Emelia, Ofori, Emmanuel O, Quaicoo, Sandra, Quartson, Elizabert M, Teye-Topey, Cynthia, Yigah, Makafui, Yussif, Safia, Adjei-Acquah, Esther, Agyekum-Gyimah, Vera O, Agyemang, Eric, AkotoAmpaw, Arko, Amponsah-Manu, Forster, Arkorful, Temitope E, Dokurugu, Moses A, Essel, Nanabanyin, Ijeoma, Aja, Obiri, Emmanuel L, Ofosu-Akromah, Richard, Quarchey, Karen N D, Adam-Zakariah, Leslie, Andoh, Aaron B, Boateng, Ruby A, Kusiwaa, Atta, Naah, Adeline, Oppon-Acquah, Ato, Oppong, Benjamin A, Agbowada, Emma A, Akosua, Ameley, Armah, Ralph, Asare, Christopher, Awere-Kyere, Lawrence K B, Bruce-Adjei, Amanda, Christian, Nana Ama, Gakpetor, Delali A, Kennedy, Korankye K, Mends-Odro, Jacqueline, Obbeng, Ambe, Ofosuhene, Doris, Osei-Poku, Dorcas, Ciociano, Maria Chávez Jonathan M Chejfec, Valle, Carlos J Zuloaga Fernández del, Aziz, Hafsa I Ahmed Gowhar, Calvillo, Marijose De Cristo Gonzalez, Iriarte, David Giovanny I Morales, Namur, Luz del Carmen M, Mustapha, Bilkisu K Lawal Aisha, Utumatwishima, Athanasie Mukasine Jean N, Abdul-Aziz, Iddrisu I A, Anasara, Gilbert A G, Ogudi, David K D, Quansah, Jonathan I K, Kumar, Nivesh Agrawal Uttkarsh, Mehraj, Imtiyaz Mantoo Asif, Nayak, Sonia Mathai Pragyanmai, Díaz, Kriscia V Ascencio, Herrera, Victor J Avalos, Camacho, Francisco J Barbosa, Pérez, Irma V Brancaccio, Llamas, Miguel A Calderón, Cardona, Guillermo A Cervantes, Andrade, Luis R Cifuentes, Flores, Ana O Cortés, Torres, Edgar J Cortes, Valadez, Tania A Cueto, Valadez, Andrea E Cueto, Cardoza, Jose A Flores, González, Luis A García, Bojorquez, Jaime L González, Ponce, Fanny Y González, Ramírez, Cristhian S Guerrero, Barba, José A Guzmán, Ramírez, Bertha G Guzmán, Ruvalcaba, Mario J Guzmán, Alva, Daniel A Hérnandez, Camargo, Silvia A Ibarra, Peña, Juan C Ibarrola, Pérez, Zayra M Lara, Tellez, Mel P Mellado, Ackerman, Roberto C Miranda, Vallejo, Luis R Pacheco, Bocanegra, Víctor H Pérez, Navarro, Jose V Pérez, Posada, Francisco J Plascencia, Hernández, María A Quirarte, Gonzalez, Luis R Ramirez, Elizalde, Emilio A Reyes, Ascencio, Evelia V Romo, Velasco, Carlos B Ruiz, Martínez, José A Sánchez, Pulido, José I Sandoval, García, Alejandro G Serrano, Carreón, Luis O Suárez, Ávila, Juan J Tijerina, Gastelum, Jesus O Vega, Ramirez, Melissa L Vicencio, Casas, Maria F Zarate, Mata, Jesus Antonion Aguilar, Vanegas, Miguel Antonio Calderon, Arias, Rocio Guadalupe Cano, Barajas, Brenda Vanessa Enriquez, Angeles, Laura Olivia Montano, Lomeli, Angelo Fernando Mortola, Navarro, Jose Esteban Orozco, Baolboa, Laura Gabriela Pena, Dominguez, Ana Camille G, Morales, Jesus Flavio M, Pesquera, Jose Alberto A, Fonseca, Roland Kevin Cethorth, Hernandez, Edgard Efren Lozada, Ramirez, Jairo Arturo Rodriguez, Moscoso, Mitzi R Becerra, Duniya, Sharon A N, Adeleye, Gbadebo T C, Bakare, Tajudeen I B, Ohemu, Alexander A, Habumuremyi, Divine Umuhoza Sosthene, Seneza, Gabriel Ntwari Celestin, Haragirimana, Jean de Dieu, Ingabire, Allen J C, Ekwunife, Okechukwu Hyginus, Gyamfi, Frank E, Nyadu, Bertina B, Adu-Aryee, Nii A, Amoako, Joachim K, Aperkor, Nicholas T, Asman, Wilfred K, Attepor, Godsway S, Bediako-Bowan, Antoinette A, Brown, George D, Etwire, Victor K, Fenu, Benjamin S, Kumassah, Philemon K, Larbi-Siaw, Linda A, Olatola, David O, Tsatsu, Sandra E, Barimah, Charles G, Boateng, Guy C, Kwabena, Ponala W, Kwarteng, Seidu M, Luri, Prosper T, Acquah, Daniel K, Adams, Shamsudeen M, Alhassan, Mohammed S, Asirifi, Samuel A, Dery, Mathias K, Ofori, Bernard A, Sam, Napoleon Bellua, Seidu, Anwar S, Acquah, Emmanuel Kojo, Coompson, Christian L, Gyambibi, Addo K, Kontor, Bismark E, Poonia, Dharma R, Rathod, Kirti K, Rodha, Mahaveer S, Soni, Subhash C, Varsheney, Vaibhav K, Vishnoi, Jeevan R, Garnaik, Deepak K, Lokavarapu, Manoj J, Seenivasagam, Rajkumar K, Kalyanapu, Jeffery A, Gautham, Arun K, Singh, Deepak S, Abraham, Eunice S, Gold, Chinta S, Joseph, Jeremiah N, Kurien, Elizabeth N, Mathew, Arpit J, Mathew, Amy E, Prakash, Danita D, Hans, Monika A, Sam, Vivin Daniel, Thind, Ravinder Singh, Veetil, Sreejith K, Daniel, Esther R, Jacob, Smitha E, Jesudason, Mark R, Samuel, Vasanth Mark, Sivakumar, Moonish V, Saluja, Sundeep S, Attri, Ashok K, Pai, Murlidhar V, Prabhu, P S, T, Sundeep P, Alexander, Philip V, Ismavel, Vijay A, Solomi, Carolin V, Alpheus, Rahul A, Choudhrie, Ashish Victor, Gunny, Rashmi Jacob, Malik, Muneer A, Peters, Nitin J, Chowdri, Nisar A, Dar, Rayees A, Parray, Fazl Q, Shah, Zamir A, Wani, Rauf A, Villaseñor, S Alvarez, Hernández, Aldo Bernal, Ahumada, Elyoenai Bonilla, Cardiel, Guadalupe Castillo, Guevara, Gabino Cervantes, Perez, Enrique Cervantes, Martinez, Esteban Cueva, Barradas, Paulina Domínguez, Estrada, Isaac Esparza, Becerril, Paola Flores, Orozco, Clotilde Fuentes, Reyna, Benjamín García, Sánchez, Eduardo Gómez, Espinoza, Eduardo González, Ojeda, Alejandro González, Torres, Martin Islas, Tornero, Jorge Jiménez, País, Roberto Mares, Santana, Damián Mora, Villela, Gilberto Morgan, Hinojosa, Rodrigo Nájar, Escobar, Cesar Nuño, Rodríguez, Itzel Ochoa, Flores, Oscar Olvera, Barreiro, Angelica Ortega, Rubio, Jacqueline Osuna, Bravo, Cornelio Ruelas, Villaseñor, Guillermo Sanchez, Tinajero, Carlos Colunga, Samano, Fernanda Diaz, Banuelos, Gerardo Gallardo, Ortiz, Francisco Ibanez, Ramirez, Maryzela Lazo, Arroyo, Gerardo Lopez, Perez, Jaime Orozco, Ramirez, Damaris Orozco, Lozano, Jesus Pizarro, Reyes, Guillermo Yanowsky, Castillo, Monica N, Mellado, Dorihela H, Bozada-Gutierrez, Katya, Casado-Zarate, Ana Florencia, Delano-Alonso, Roberto, Herrera-Esquivel, Jose, Moreno-Portillo, Mucio, Trejo-Avila, Mario, Quiros, Bruno Crocco, Ambriz-González, Gabriela, Cabrera-Lozano, Ishtar, Calderón-Alvarado, Ana B, León-Frutos, Francisco J, Villanueva-Martínez, Erick E, Aliyu, Mohammed S, Balogun, Abigail Olajumoke, Francis, Abantanga Atindaana, Duromola, Kehinde Michael, Gana, Stephen G, George, Mukoro Duke, Iji, Lambert Onahi, Jimoh, Aminat O, Koledade, Afolabi K, Lawal, Ahmad T, Nwabuoku, Stanley Emeka, Ogunsua, Oluseyi O, Okafor, Ifeanyi Fidelis, Okorie, Ethos Ike, Saidu, Ibrahim A, Sholadoye, Tunde T, Abdulkarim, Abdulhafiz A, Abdullahi, Lawal Barau, Tolani, Musliu Adetola, Tukur, Aliyu Muhammad, Umar, Ahmad Shehu, Umar, Aminatu M, Yusuf, Salisu Abeku, Ado, Khadija A, Aliyu, Nura U, Anyanwu, Lofty-John Chukwuemeka, Daneji, Sulaiman M, Magashi, Mahmoud Kawu, Mohammad, Mohammad A, Muhammad, Abubakar Bala, Muhammad, Saminu S, Muideen, Bello Abodunde, Nwachukwu, Calistus U, Sallau, Suleiman B, Sheshe, Abdulrahman A, Takai, Idris Usman, Umar, Garzali I, Adze, Joel A, Airede, Lydia R, Bature, Stephen B, Galadima, Moses C, Hamza, Babatunde K, Kache, Stephen A, Kagomi, Williams Y, Kene, Ifeanyi A, Makama, Jerry G, Mohammed-Durosinlorun, Amina A, Taingson, Mathew C, Odunafolabi, Tunde A, Okereke, Chukwuma E, Oladele, Oluwafemi O, Olaleye, Oluwaseun H, Olubayo, Oyetunde O, Abiola, Olukayode P, Abiyere, Henry O, Adebara, Idowu O, Adeniyi, Adebayo A, Adewara, Olumide E, Adeyemo, Olabisi T, Adeyeye, Ademola A, Ariyibi, Abimbola L, Awoyinka, Babatunde S, Ayankunle, Olumide M, Babalola, Olakunle F, Banjo, Oluseyi O, Egharevba, Peter A, Fatudimu, Oluwafemi S, Obateru, John A, Odesanya, Oluremi J, Ojo, Owolabi D, Okunlola, Abiodun I, Okunlola, Cecilia K, Olajide, Adewale T, Orewole, Tesleem O, Salawu, Adedayo I, Abdulsalam, Moruf A, Adelaja, Aderinsola T, Ajai, Olalekan T, Atobatele, Kazeem M, Bakare, Oludayo Oluwaseyi, Faboya, Omolara M, Imam, Zainab O, Nwaenyi, Francisca C, Ogunyemi, Ayokunle A, Oludara, Mobolaji A, Omisanjo, Olufunmilade A, Onyeka, Chinonso U, Oshodi, Olabode A, Oshodi, Yusuf A, Salami, Omotade S, Williams, Omolara M, Adeyeye, Victoria Ibukunoluwa, Agbulu, Moses Vincent, Akinajo, Opeyemi Rebecca, Akinboyewa, David O, Alakaloko, Felix M, Alasi, Iyabo O, Atoyebi, Oluwole A, Balogun, Olanrewaju S, Bode, Christopher O, Busari, Maryam Oluwatobi, Duru, Nnamdi Jonathan, Edet, Glory Bassey, Elebute, Olumide A, Ezenwankwo, Francis Chinonso, Fatuga, Adedeji L, Ihediwa, George C, Inyang, Emmanuel Sylvester, Jimoh, Adesola I, Kuku, Jubril Oladayo, Ladipo-Ajayi, Oluwaseun A, Lawal, Abdulrazzaq O, Makwe, Christian Chigoze, Mgbemena, Chinelo Victoria, Nwokocha, Samuel U, Ogunjimi, Moses Adebisi, Ohazurike, Ephraim Okwudiri, Ojewola, Rufus W, Badedale, Moyosoluwa Eunice, Okeke, Chike J, Okunowo, Adeyemi A, Oladimeji, Abraham T, Olajide, Thomas O, Oluseye, Oluwaseun O, Orowale, Adeola Ayoola, Osinowo, Adedapo Olumide, Oyegbola, Christianah Bidemi, Seyi-Olajide, Justina O, Soibi-Harry, Adaiah P, Timo, Manuella Talla, Ugwu, Aloy Okechukwu, Williams, Emmanuel Ojo, Duruewuru, Innocent O, Egwuonwu, Ochonma A, Emeka, James J, Modekwe, Victor Ifeanyichukwu, Nwosu, Chimdiebele Daisy, Obiechina, Sylvester O, Obiesie, Ahuizechukwu E, Okafor, Celestine I, Okonoboh, Theophilus O, Okoye, Odili A, Onu, Onyekachi A, Onyejiaka, Chukwudubem C, Uche, Chisom Faith, Ugboajah, Joseph O, Ugwu, Jideofor Okechukwu, Adeleke, Akeem A, Adepiti, Akinfolarin C, Aderounmu, Adewale A, Adesunkanmi, Abdulhafiz O, Adisa, Adewale O, Ajekwu, Samuel C, Ajenifuja, Olusegun K, Alatise, Olusegun I, Badmus, Tajudeen A, Mohammed, Tajudeen O, Salako, Abdulkadir A, Sowande, Oludayo A, Talabi, Ademola O, Wuraola, Funmilola O, Adegoke, Paul Aderemi, Eseile, Ideyonbe Samuel, Ogundoyin, Olakayode Olaolu, Olulana, Dare Isaac, Adumah, Collins C, Ajagbe, Adewale O, Akintunde, Olugbenga P, Asafa, Opeyemi Q, Eziyi, Amogu K, Fasanu, Adeniyi O, Ojewuyi, Olufemi O, Ojewuyi, Abiodun R, Oyedele, Abisola E, Taiwo, Oluwaseun A, Abdullahi, Habiba I, Adewole, Nathaniel D, Agida, Teddy E, Ailunia, Eunice E, Akaba, Godwin O, Bawa, Kehinde G, Chinda, John Y, Daluk, Esther B, Eniola, Sefiu B, Ezenwa, Augusta O, Garba, Stephen E, Mshelbwala, Philip M, Ndukwe, Ngozi O, Ogolekwu, Idoko P, Osagie, Olabisi O, Sani, Samuel A, Tabuanu, Nancy O, Umar, Aminu M, Agbonrofo, Peter I, Arekhandia, Alexander I, Edena, Morrison E, Eghonghon, Raymond A, Enaholo, Joel E, Ideh, Stanley N, Iribhogbe, Oseihie I, Irowa, Omorodion O, Isikhuemen, Maradona E, Odutola, Oluwatomi R, Okoduwa, Kester O, Omorogbe, Scott O, Osagie, Osasumwen T, Abdus-Salam, Rukiyat A, Adebayo, Sikiru Adekola, Ajagbe, Oluwasanmi A, Ajao, Akinlabi E, Ayandipo, Omobolaji O, Egbuchulem, Kelvin I, Ekwuazi, Hyginus O, Idowu, Oluwasegun C, Irabor, David O, Lawal, Taiwo A, Lawal, Olatunji O, Ogundoyin, Olakayode O, Sanusi, Akinsola T, Takure, Augustine O, Abdur-Rahman, Lukman Olajide, Adebisi, Mary Oluwadamilola, Adeleke, Nurudeen Abiola, Afolabi, Rafiat Tinuola, Aremu, Isiaka Ishola, Bello, Jibril Oyekunle, Lawal, Saheed Abolade, Raji, Hadijat Olaide, Igwe, Patrick O, Iweha, Ikechukwu Enyinnaya, John, Raphael E, Okoro, Philemon E, Oriji, Vaduneme Kingsley, Oweredaba, Ibiene T, Majyabere, Jean Paul, Habiyakare, Jean Aimable, Nabada, Marie Gloriose, Masengesho, Jean pierre, Niyomuremyi, Jean Paul, Uwimana, Jean Claude, Maniraguha, Hope Lydia, Urimubabo, Christian Jean, Shyirakera, Jean Yves, Adams, Mary Augusta, Ede, Chikwendu Jeffrey, Mathe, Mpho Nosipho, Nhlabathi, Ncamsile Anthea, Nxumalo, Hlengiwe Samkelisiwe, Sethoana, Mmule Evelyn, Abdulai, Samira, Agboadoh, Nelson, Akoto, Erica, Boakye-Yiadom, Kwaku, Dedey, Florence, Nsaful, Josephine, Wordui, Theodore, Abubakari, Fatao, Akunyam, Johnson, Ballu, Cletus, Ngaaso, Kennedy, Kyeremeh, Collins, Osei, Edwin, Owusu, Frank, Sie-Broni, Clement, Abdul-Hafiz, Saba, Amadu, Munira, Awe, Martin, Azanlerigu, Millicent, Edwin, Yenli, Maalekuu, Aloysius, Malechi, Hawa, Mohammed, Ibrahim, Mumuni, Kareem, Yahaya, Shekira, Alhassan, Jaabir, Jeffery-Felix, Ametepe, Naah, Gifty, Noufuentes, Carmen, Sakyi, Abraham, Chaudhary, Ramkaran, Misra, Sanjeev, Pareek, Puneet, Pathak, Manish, Sharma, Naveen, Sharma, Nivedita, Huda, Farhanul, Mishra, Neha, Ranjan, Rohit, Singh, Shanky, Solanki, Pratik, Verma, Raunak, Yhoshu, Enono, John, Suzan, Kutma, Ananta, Philips, Sanish, Hepzibah, Alice, Mary, Grace, Chetana, Chetana, Dummala, Prashant, Jacob, Jurgen, Mary, Priya, Samuel, Oliver, Sukumar, Ashwin, Syam, Niyah, Bhatt, Alisha, Bhatti, William, Dhar, Tapasya, Goyal, Ankush, Goyal, Sunita, Jain, Deepak, Jain, Rita, Kaur, Savleen, Kumar, Karan, Luther, Anil, Mahajan, Amit, Mandrelle, Kavita, Michael, Vishal, Mukherjee, Partho, Rajappa, Reuben, Singh, Prashant, Williams, Rahul, D, Sreekar, Kumari, Pushplatha, Shankar, Bharat, Sharma, Srujan, Surendran, Suraj, Thomas, Anita, Trinity, Paul, Kanchodu, Sudheer, Leshiini, K, Bansal, Ishan, Gupta, Sanjay, Gureh, Monika, Kapoor, Simran, Aggarwal, Manisha, Kanna, Vinoth, Kaur, Harmanjot, Kumar, Ashwani, Singh, Simrandeep, Singh, Gurtaj, John, Viju, Adnan, Mohammed, Kumar, Pardeep, S, Abhishek, Sehrawat, Vikram, Singla, Deepak, Thami, Gaurav, Kumar, Vijay, Mathew, Stanley, Akhtar, Naseem, Chaturvedi, Arun, Gupta, Sameer, Prakash, Puneet, Rajan, Shiv, Singh, Mohit, Tripathi, Abhilasha, Thomas, Josy, Zechariah, Pradeep, Kichu, Moloti, Joseph, Susan, Pundir, Neha, Samujh, Ram, Kour, Robindera, Saqib, Najmus, Raul, Subrat, Rautela, Komal, Sharma, Rajeev, Singh, Nishu, Vakil, Rakesh, Chowdhury, Priyanka, Chowdhury, Sona, Roy, Bipradas, Abdullahi, Aisha, Abubakar, Maimuna, Awaisu, Mudi, Bakari, Fadimatu, Bashir, Mohammed, Bello, Ahmad, Daniyan, Muhammad, Gimba, Justina, Gundu, Isaac, Oyelowo, Nasir, Sufyan, Ibrahim, Umaru-Sule, Hajara, Usman, Mohammed, Yahya, Anisah, Yakubu, Alfa, Abdullahi, Muzzammil, Soladoye, Abdulmajeed, Yahaya, Abubakar, Abdulrasheed, Lubabatu, Aminu, Bashiru, Bello-Tukur, Firdaws, Chinyio, Damai, Joshua, Samaila, Lawal, Jamila, Mohammed, Caleb, Nuwam, Deborah, Sale, Danjuma, Sani, Abdulrasheed, Tabara, Salome, Usam, Emmanuel, Yakubu, Josiah, Adegoke, Folasade, Ige, Oluwasuyi, Bakare, Adewumi, Akande, Olukemi, Anyanwu, Noble, Eke, Grace, Oyewole, Yemisi, Abunimye, Esther, Adeoluwa, Adebunmi, Adesiyakan, Adedotun, Amao, Michael, Ashley-Osuzoka, Christiana, Gbenga-Oke, Christianah, Olanrewaju, Olabisi, Olayioye, Olawunmi, Olutola, Stephen, Onyekachi, Kenneth, Osariemen, Emili, Osunwusi, Benedetto, Owie, Emmanuel, Okoro, Chukwuemeka, Ugwuanyi, Kenneth, Ugwunne, Chuka, Olasehinde, Olalekan, Akinloye, Abidemi, Akinniyi, Ayodeji, Ejimogu, Joseph, Okedare, Amos, Omotola, Omolara, Sanwo, Francis, Awodele, Kehinde, Aisuodionoe-Shadrach, Oseremen, Alfred, Janet, Atim, Terkaa, Mbajiekwe, Ndubuisi, Olori, amson, Suleiman, Salisu, Sunday, Helen, Ida, Genesis, Oruade, David, Osemwegie, Osarenkhoe, Ajibola, Gboyega, Elemile, Peter, Fakoya, Adegbolahan, Ojediran, Oluwabukade, Olagunju, Naomi, Bello, Robiat, Ojajuni, Adeolu, Oyewale, Sabur, Abhulimen, Victor, Okoi, Nnyonno, Mizero, Japhet, Mutimamwiza, Immaculee, Nirere, Francoise, Niyongombwa, Irenee, Byaruhanga, Anastase, Dukuzimana, Rongin, Uwizeye, Marcel, Ruhosha, Mathias, Igiraneza, joselyne, Ingabire, Faustine, Karekezi, Aloys, Mpirimbanyi, Christophe, Mukamazera, Lydia, Mukangabo, Clemence, Imanishimwe, Alphonsine, Kanyarukiko, Salathiel, Mukaneza, Francine, Mukantibaziyaremye, Deborah, Munyaneza, Aphrodis, Ndegamiye, Gibert, Nyirangeri, Pierrine, Tubasiime, Ronald, Dusabe, Moses, Izabiriza, Emelyne, Mutuyimana, Josiane, Mwenedata, Olivier, Rwagahirima, Elisee, Zirikana, Job, Sibomana, Isaie, Rubanguka, Desire, Umuhoza, Josine, Uwayezu, Roda, Uzikwambara, Leoncie, Dieudonne, Aime, Kabanda, Elysee, Mbonimpaye, Salomee, Mukakomite, Christine, Muroruhirwe, Piolette, Butana, Herbert, Dusabeyezu, Moise, Batangana, Mediatrice, Bucyibaruta, Georges, Mukanyange, Violette, Munyaneza, Emmanuel, Mutabazi, Emmanuel, Mwungura, Espoir, Ncogoza, Isaie, Nyirahabimana, Jeannette, Nyirasebura, Dancilla, Dusabimana, Anaclet, Kanyesigye, Sam, Munyaneza, Robert, Hyman, Gabriella, Moore, Rachel, Sentholang, Nnosa, Wondoh, Paul, Ally, Zain, Domingo, Aimee, Munda, Philip, Nyatsambo, Chido, Ojo, Victor, Pswarayi, Rudo, Cook, Jonathan, Jayne, David, Laurberg, Soeren, Brown, Julia, Smart, Neil, and Cousens, Simon

Published
2024
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15. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

Author

Diallo Abdoulaye, Meda Nicolas, Sommerfelt Halvor, Traore Germain S, Cousens Simon, and Tylleskar Thorkild

Subjects
Infant mortality, Risk factors, Rural areas, Burkina Faso, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Infant mortality rates (IMR) remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. Methods A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150) in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Results Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143). Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88). Infections (35%) and preterm births complications (23%) were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. Conclusions We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

Published
2012
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16. Impact of long-term treatment of onchocerciasis with ivermectin in Kaduna State, Nigeria: first evidence of the potential for elimination in the operational area of the African Programme for Onchocerciasis Control

Author

Tekle Afework, Elhassan Elizabeth, Isiyaku Sunday, Amazigo Uche V, Bush Simon, Noma Mounkaila, Cousens Simon, Abiose Adenike, and Remme Jan H

Subjects
Onchocerciasis, elimination, APOC, epidemiological evaluation, Kaduna Nigeria, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Onchocerciasis can be effectively controlled as a public health problem by annual mass drug administration of ivermectin, but it was not known if ivermectin treatment in the long term would be able to achieve elimination of onchocerciasis infection and interruption of transmission in endemic areas in Africa. A recent study in Mali and Senegal has provided the first evidence of elimination after 15-17 years of treatment. Following this finding, the African Programme for Onchocerciasis Control (APOC) has started a systematic evaluation of the long-term impact of ivermectin treatment projects and the feasibility of elimination in APOC supported countries. This paper reports the first results for two onchocerciasis foci in Kaduna, Nigeria. Methods In 2008, an epidemiological evaluation using skin snip parasitological diagnostic method was carried out in two onchocerciasis foci, in Birnin Gwari Local Government Area (LGA), and in the Kauru and Lere LGAs of Kaduna State, Nigeria. The survey was undertaken in 26 villages and examined 3,703 people above the age of one year. The result was compared with the baseline survey undertaken in 1987. Results The communities had received 15 to 17 years of ivermectin treatment with more than 75% reported coverage. For each surveyed community, comparable baseline data were available. Before treatment, the community prevalence of O. volvulus microfilaria in the skin ranged from 23.1% to 84.9%, with a median prevalence of 52.0%. After 15 to 17 years of treatment, the prevalence had fallen to 0% in all communities and all 3,703 examined individuals were skin snip negative. Conclusions The results of the surveys confirm the finding in Senegal and Mali that ivermectin treatment alone can eliminate onchocerciasis infection and probably disease transmission in endemic foci in Africa. It is the first of such evidence for the APOC operational area.

Published
2012
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17. How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

Author

Cousens Simon, Campbell Oona MR, Merialdi Mario, Requejo Jennifer, Magoma Moke, and Filippi Veronique

Subjects
Gynecology and obstetrics, RG1-991
Abstract

Abstract Background Many women in Sub-Saharan African countries do not receive key recommended interventions during routine antenatal care (ANC) including information on pregnancy, related complications, and importance of skilled delivery attendance. We undertook a process evaluation of a successful cluster randomized trial testing the effectiveness of birth plans in increasing utilization of skilled delivery and postnatal care in Ngorongoro district, rural Tanzania, to document the time spent by health care providers on providing the recommended components of ANC. Methods The study was conducted in 16 health units (eight units in each arm of the trial). We observed, timed, and audio-recorded ANC consultations to assess the total time providers spent with each woman and the time spent for the delivery of each component of care. T-test statistics were used to compare the total time and time spent for the various components of ANC in the two arms of the trial. We also identified the topics discussed during the counselling and health education sessions, and examined the quality of the provider-woman interaction. Results The mean total duration for initial ANC consultations was 40.1 minutes (range 33-47) in the intervention arm versus 19.9 (range 12-32) in the control arm p < 0.0001. Except for drug administration, which was the same in both arms of the trial, the time spent on each component of care was also greater in the intervention health units. Similar trends were observed for subsequent ANC consultations. Birth plans were always discussed in the intervention health units. Counselling on HIV/AIDS was also prioritized, especially in the control health units. Most other recommended topics (e.g. danger signs during pregnancy) were rarely discussed. Conclusion Although the implementation of birth plans in the intervention health units improved provider-women dialogue on skilled delivery attendance, most recommended topics critical to improving maternal and newborn survival were rarely covered.

Published
2011
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18. Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

Author

Diallo Abdoulaye, Meda Nicolas, Zabsonré Emmanuel, Sommerfelt Halvor, Cousens Simon, and Tylleskär Thorkild

Subjects
Gynecology and obstetrics, RG1-991
Abstract

Abstract Background There is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso. Study objectives To measure the perinatal mortality rate (PNMR) in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death. Methods We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR) and early neonatal mortality rate (ENMR). We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death. Results 895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99), 54 per 1000 (95% CI: 38-69) and 27 per 1000 (95% CI: 9-44), respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0), primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9), twins (RR = 4.0, 95% CI: 2.3-6.9) and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3) were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre Conclusion Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.

Published
2010
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19. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention

Author

Cousens Simon, Campbell Oona MR, Requejo Jennifer, Magoma Moke, and Filippi Veronique

Subjects
Gynecology and obstetrics, RG1-991
Abstract

Abstract Background In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors underlying this divergent pattern of high use of antenatal services and low use of skilled delivery care. Specifically, the study examined beliefs and behaviors related to antenatal, labor, delivery and postnatal care among the Maasai and Watemi ethnic groups. The perspectives of health care providers and traditional birth attendants on childbirth and the factors determining where women deliver were also investigated. Methods Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed. Results The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis. Conclusions Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care Package in Ngorongoro depends upon improved training and monitoring of health care providers, and greater family participation in antenatal care visits.

Published
2010
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20. Satisfactory safety and immunogenicity of MSP3 malaria vaccine candidate in Tanzanian children aged 12–24 months

Author

Segeja Method D, Minja Daniel, Rutta Acleus, Sembuche Samwel, Seth Misago, Lemnge Martha, Francis Filbert, Msham Salum, Gesase Samwel, Lusingu John PA, Bosomprah Samuel, Cousens Simon, Noor Ramadhani, Chilengi Roma, and Druilhe Pierre

Subjects
Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Development and deployment of an effective malaria vaccine would complement existing malaria control measures. A blood stage malaria vaccine candidate, Merozoite Surface Protein-3 (MSP3), produced as a long synthetic peptide, has been shown to be safe in non-immune and semi-immune adults. A phase Ib dose-escalating study was conducted to assess the vaccine's safety and immunogenicity in children aged 12 to 24 months in Korogwe, Tanzania (ClinicalTrials.gov number: NCT00469651). Methods This was a double-blind, randomized, controlled, dose escalation phase Ib trial, in which children were given one of two different doses of the MSP3 antigen (15 μg or 30 μg) or a control vaccine (Engerix B). Children were randomly allocated either to the MSP3 candidate malaria vaccine or the control vaccine administered at a schedule of 0, 1, and 2 months. Immunization with lower and higher doses was staggered for safety reasons starting with the lower dose. The primary endpoint was safety and reactogenicity within 28 days post-vaccination. Blood samples were obtained at different time points to measure immunological responses. Results are presented up to 84 days post-vaccination. Results A total of 45 children were enrolled, 15 in each of the two MSP3 dose groups and 15 in the Engerix B group. There were no important differences in reactogenicity between the two MSP3 groups and Engerix B. Grade 3 adverse events were infrequent; only five were detected throughout the study, all of which were transient and resolved without sequelae. No serious adverse event reported was considered to be related to MSP3 vaccine. Both MSP3 dose regimens elicited strong cytophilic IgG responses (subclasses IgG1 and IgG3), the isotypes involved in the monocyte-dependant mechanism of Plasmodium falciparum parasite-killing. The titers reached are similar to those from African adults having reached a state of premunition. Furthermore, vaccination induced seroconversion in all vaccinees. Conclusion The MSP3 malaria vaccine candidate was safe, well tolerated and immunogenic in children aged 12–24 months living in a malaria endemic community. Given the vaccine's safety and its induction of cytophilic IgG responses, its efficacy against P. falciparum infection and disease needs to be evaluated in Phase 2 studies.

Published
2009
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22. Effectiveness of artemisinin-based combination therapy used in the context of home management of malaria: A report from three study sites in sub-Saharan Africa

Author

Mugittu Kefas, Boateng Samuel, Yusuf Bidemi, Gbotosho Grace O, Falade Catherine O, Happi Christian, Yar Denis, Bateganya Fred, Browne Edmund N, Ajayi Ikeoluwapo O, Cousens Simon, Nanyunja Miriam, and Pagnoni Franco

Subjects
Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background The use of artemisinin-based combination therapy (ACT) at the community level has been advocated as a means to increase access to effective antimalarial medicines by high risk groups living in underserved areas, mainly in sub-Saharan Africa. This strategy has been shown to be feasible and acceptable to the community. However, the parasitological effectiveness of ACT when dispensed by community medicine distributors (CMDs) within the context of home management of malaria (HMM) and used unsupervised by caregivers at home has not been evaluated. Methods In a sub-set of villages participating in a large-scale study on feasibility and acceptability of ACT use in areas of high malaria transmission in Ghana, Nigeria and Uganda, thick blood smears and blood spotted filter paper were prepared from finger prick blood samples collected from febrile children between six and 59 months of age reporting to trained CMDs for microscopy and PCR analysis. Presumptive antimalarial treatment with ACT (artesunate-amodiaquine in Ghana, artemether-lumefantrine in Nigeria and Uganda) was then initiated. Repeat finger prick blood samples were obtained 28 days later for children who were parasitaemic at baseline. For children who were parasitaemic at follow-up, PCR analyses were undertaken to distinguish recrudescence from re-infection. The extent to which ACTs had been correctly administered was assessed through separate household interviews with caregivers having had a child with fever in the previous two weeks. Results Over a period of 12 months, a total of 1,740 children presenting with fever were enrolled across the study sites. Patent parasitaemia at baseline was present in 1,189 children (68.3%) and varied from 60.1% in Uganda to 71.1% in Ghana. A total of 606 children (51% of infected children) reported for a repeat test 28 days after treatment. The crude parasitological failure rate varied from 3.7% in Uganda (C.I. 1.2%–6.2%) to 41.8% in Nigeria (C.I. 35%–49%). The PCR adjusted parasitological cure rate was greater than 90% in all sites, varying from 90.9% in Nigeria (C.I. 86%–95%) to 97.2% in Uganda (C.I. 95%–99%). Reported adherence to correct treatment in terms of dose and duration varied from 81% in Uganda (C.I. 67%–95%) to 97% in Ghana (C.I. 95%–99%) with an average of 94% (C.I. 91%–97%). Conclusion While follow-up rates were low, this study provides encouraging data on parasitological outcomes of children treated with ACT in the context of HMM and adds to the evidence base for HMM as a public health strategy as well as for scaling-up implementation of HMM with ACTs.

Published
2008
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23. Feasibility and acceptability of artemisinin-based combination therapy for the home management of malaria in four African sites

Author

Munguti Kaendi, Balyeku Andrew, Doamekpor Leticia, Agyei-Baffour Peter, Yusuf Bidemi, Bateganya Fred, Garshong Bertha, Browne Edmund N, Ajayi Ikeoluwapo O, Cousens Simon, and Pagnoni Franco

Subjects
Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background The Home Management of Malaria (HMM) strategy was developed using chloroquine, a now obsolete drug, which has been replaced by artemisinin-based combination therapy (ACT) in health facility settings. Incorporation of ACT in HMM would greatly expand access to effective antimalarial therapy by the populations living in underserved areas in malaria endemic countries. The feasibility and acceptability of incorporating ACT in HMM needs to be evaluated. Methods A multi-country study was performed in four district-size sites in Ghana (two sites), Nigeria and Uganda, with populations ranging between 38,000 and 60,000. Community medicine distributors (CMDs) were trained in each village to dispense pre-packaged ACT to febrile children aged 6–59 months, after exclusion of danger signs. A community mobilization campaign accompanied the programme. Artesunate-amodiaquine (AA) was used in Ghana and artemether-lumefantrine (AL) in Nigeria and Uganda. Harmonized qualitative and quantitative data collection methods were used to evaluate CMD performance, caregiver adherence and treatment coverage of febrile children with ACTs obtained from CMDs. Results Some 20,000 fever episodes in young children were treated with ACT by CMDs across the four study sites. Cross-sectional surveys identified 2,190 children with fever in the two preceding weeks, of whom 1,289 (59%) were reported to have received ACT from a CMD. Coverage varied from 52% in Nigeria to 75% in Ho District, Ghana. Coverage rates did not appear to vary greatly with the age of the child or with the educational level of the caregiver. A very high proportion of children were reported to have received the first dose on the day of onset or the next day in all four sites (range 86–97%, average 90%). The proportion of children correctly treated in terms of dose and duration was also high (range 74–97%, average 85%). Overall, the proportion of febrile children who received prompt treatment and the correct dose for the assigned duration of treatment ranged from 71% to 87% (average 77%). Almost all caregivers perceived ACT to be effective, and no severe adverse events were reported. Conclusion ACTs can be successfully integrated into the HMM strategy.

Published
2008
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24. Crowding: risk factor or protective factor for lower respiratory disease in young children?

Author

Cardoso Maria, Cousens Simon, de Góes Siqueira Luiz, Alves Fátima, and D'Angelo Luiz

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background To study the effects of household crowding upon the respiratory health of young children living in the city of São Paulo, Brazil. Methods Case-control study with children aged from 2 to 59 months living within the boundaries of the city of São Paulo. Cases were children recruited from 5 public hospitals in central São Paulo with an acute episode of lower respiratory disease. Children were classified into the following diagnostic categories: acute bronchitis, acute bronchiolitis, pneumonia, asthma, post-bronchiolitis wheezing and wheezing of uncertain aetiology. One control, crudely matched to each case with regard to age ( All buildings were surveyed for the presence of environmental contaminants, type of construction and building material. Plans of all homes, including measurements of floor area, height of walls, windows and solar orientation, was performed. Data were analysed using conditional logistic regression. Results A total of 313 pairs of children were studied. Over 70% of the cases had a primary or an associated diagnosis of a wheezing illness. Compared with controls, cases tended to live in smaller houses with less adequate sewage disposal. Cases and controls were similar with respect to the number of people and the number of children under five living in the household, as well the number of people sharing the child's bedroom. After controlling for potential confounders, no evidence of an association between number of persons sharing the child's bedroom and lower respiratory disease was identified when all cases were compared with their controls. However, when two categories of cases were distinguished (infections, asthma) and each category compared separately with their controls, crowding appeared to be associated with a 60% reduction in the incidence of asthma but with 2 1/2-fold increase in the incidence of lower respiratory tract infections (p = 0.001). Conclusion Our findings suggest that household crowding places young children at risk of acute lower respiratory infection but may protect against asthma. This result is consistent with the hygiene hypothesis.

Published
2004
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25. Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania

Author

Penzias, Rebecca E., Bohne, Christine, Gicheha, Edith, Molyneux, Elizabeth M., Gathara, David, Ngwala, Samuel K., Zimba, Evelyn, Rashid, Ekran, Odedere, Opeyemi, Dosunmu, Olabisi, Tillya, Robert, Shabani, Josephine, Cross, James H., Ochieng, Christian, Webster, Harriet H., Chiume, Msandeni, Dube, Queen, Wainaina, John, Kassim, Irabi, Irimu, Grace, Adudans, Steve, James, Femi, Tongo, Olukemi, Ezeaka, Veronica Chinyere, Salim, Nahya, Masanja, Honorati, Oden, Maria, Richards-Kortum, Rebecca, Hailegabriel, Tedbabe, Gupta, Gagan, Cousens, Simon, Lawn, Joy E., and Ohuma, Eric O.

Published
2023
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27. Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low- and middle-income countries.

Author

Bourassa, Megan W, Osendarp, Saskia JM, Adu-Afarwuah, Seth, Ahmed, Saima, Ajello, Clayton, Bergeron, Gilles, Black, Robert, Christian, Parul, Cousens, Simon, de Pee, Saskia, Dewey, Kathryn G, Arifeen, Shams El, Engle-Stone, Reina, Fleet, Alison, Gernand, Alison D, Hoddinott, John, Klemm, Rolf, Kraemer, Klaus, Kupka, Roland, McLean, Erin, Moore, Sophie E, Neufeld, Lynnette M, Persson, Lars-Åke, Rasmussen, Kathleen M, Shankar, Anuraj H, Smith, Emily, Sudfeld, Christopher R, Udomkesmalee, Emorn, and Vosti, Stephen A

Subjects
Humans, Micronutrients, Pregnancy Outcome, Pregnancy, Developing Countries, Dietary Supplements, Infant, Newborn, Female, LMICs, micronutrient, pregnancy, supplements, General Science & Technology
Abstract

Inadequate micronutrient intakes are relatively common in low- and middle-income countries (LMICs), especially among pregnant women, who have increased micronutrient requirements. This can lead to an increase in adverse pregnancy and birth outcomes. This review presents the conclusions of a task force that set out to assess the prevalence of inadequate micronutrient intakes and adverse birth outcomes in LMICs; the data from trials comparing multiple micronutrient supplements (MMS) that contain iron and folic acid (IFA) with IFA supplements alone; the risks of reaching the upper intake levels with MMS; and the cost-effectiveness of MMS compared with IFA. Recent meta-analyses demonstrate that MMS can reduce the risks of preterm birth, low birth weight, and small for gestational age in comparison with IFA alone. An individual-participant data meta-analysis also revealed even greater benefits for anemic and underweight women and female infants. Importantly, there was no increased risk of harm for the pregnant women or their infants with MMS. These data suggest that countries with inadequate micronutrient intakes should consider supplementing pregnant women with MMS as a cost-effective method to reduce the risk of adverse birth outcomes.

Published
2019

28. Epidemiology of SARS-CoV-2 infection among staff and students in a cohort of English primary and secondary schools during 2020–2021

Author

Abramsky, Tanya, Ahmad, Shazaad, Aiano, Felicity, Baawuah, Frances, Bankiewicz, Urszula, Batt, Sarah, Beckmann, Joanne, Bhavsar, Ami, Brent, Bernadette, Brent, Andrew, Brouwer, Simon, Brown, Kevin, Browne, Richard, Childs, Kevin, Cook, Sarah, Cousens, Simon, Day, Ieuan, Felton, Antonio, Fine, Paul, Foster, David, Garstang, Joanna, Gates, David, Grant, Claire, Griffiths-Tong, Bethany, Hele, Claire, Hemsi, Rowan, Jones, Pete, Jordan, Helena, Kucharski, Adam, Lacey, Andrea, Leeson, Rebecca, Lelii, Ffion, Lovely, Philip, Lunskey, Madeleine, McLanachan, Chris, Munday, James, Okike, Ifeanyichukwu, O'Reilly, Kathleen, Parker, Penelope, Powell, Annabel, Proud, Sarah, Ramsay, Mary, Rudd, Lee, Russell, Timothy, Shute, Justin, Tilouche, Nerissa, Virgin, Charmaine, Wyatt, Sian-Elin, YEO, KELLY, Hargreaves, James R., Langan, Sinéad M., Oswald, William E., Halliday, Katherine E., Sturgess, Joanna, Phelan, Jody, Nguipdop-Djomo, Patrick, Ford, Benjamin, Allen, Elizabeth, Sundaram, Neisha, Ireland, Georgina, Poh, John, Ijaz, Samreen, Diamond, Ian, Rourke, Emma, Dawe, Fiona, Judd, Alison, Warren-Gash, Charlotte, Clark, Taane G., Glynn, Judith R., Edmunds, W. John, Bonell, Chris, Mangtani, Punam, and Ladhani, Shamez N.

Published
2022
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29. Health and development from preconception to 20 years of age and human capital

Author

Black, Robert E, Liu, Li, Hartwig, Fernando P, Villavicencio, Francisco, Rodriguez-Martinez, Andrea, Vidaletti, Luis P, Perin, Jamie, Black, Maureen M, Blencowe, Hannah, You, Danzhen, Hug, Lucia, Masquelier, Bruno, Cousens, Simon, Gove, Amber, Vaivada, Tyler, Yeung, Diana, Behrman, Jere, Martorell, Reynaldo, Osmond, Clive, Stein, Aryeh D, Adair, Linda S, Fall, Caroline H D, Horta, Bernardo, Menezes, Ana M B, Ramirez-Zea, Manuel, Richter, Linda M, Patton, George C, Bendavid, Eran, Ezzati, Majid, Bhutta, Zulfiqar A, Lawn, Joy E, and Victora, Cesar G

Published
2022
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31. Patterns of antibiotic use, pathogens, and prediction of mortality in hospitalized neonates and young infants with sepsis: A global neonatal sepsis observational cohort study (NeoOBS)

Author

Russell, Neal J., Stöhr, Wolfgang, Plakkal, Nishad, Cook, Aislinn, Berkley, James A., Adhisivam, Bethou, Agarwal, Ramesh, Ahmed, Nawshad Uddin, Balasegaram, Manica, Ballot, Daynia, Bekker, Adrie, Berezin, Eitan Naaman, Bilardi, Davide, Boonkasidecha, Suppawat, Carvalheiro, Cristina G., Chami, Neema, Chaurasia, Suman, Chiurchiu, Sara, Colas, Viviane Rinaldi Favarin, Cousens, Simon, Cressey, Tim R., de Assis, Ana Carolina Dantas, Dien, Tran Minh, Ding, Yijun, Dung, Nguyen Trong, Dong, Han, Dramowski, Angela, DS, Madhusudhan, Dudeja, Ajay, Feng, Jinxing, Glupczynski, Youri, Goel, Srishti, Goossens, Herman, Hao, Doan Thi Huong, Khan, Mahmudul Islam, Huertas, Tatiana Munera, Islam, Mohammad Shahidul, Jarovsky, Daniel, Khavessian, Nathalie, Khorana, Meera, Kontou, Angeliki, Kostyanev, Tomislav, Laoyookhon, Premsak, Lochindarat, Sorasak, Larsson, Mattias, Luca, Maia De, Malhotra-Kumar, Surbhi, Mondal, Nivedita, Mundhra, Nitu, Musoke, Philippa, Mussi-Pinhata, Marisa M., Nanavati, Ruchi, Nakwa, Firdose, Nangia, Sushma, Nankunda, Jolly, Nardone, Alessandra, Nyaoke, Borna, Obiero, Christina W., Owor, Maxensia, Ping, Wang, Preedisripipat, Kanchana, Qazi, Shamim, Qi, Lifeng, Ramdin, Tanusha, Riddell, Amy, Romani, Lorenza, Roysuwan, Praewpan, Saggers, Robin, Roilides, Emmanuel, Saha, Samir K., Sarafidis, Kosmas, Tusubira, Valerie, Thomas, Reenu, Velaphi, Sithembiso, Vilken, Tuba, Wang, Xiaojiao, Wang, Yajuan, Yang, Yonghong, Zunjie, Liu, Ellis, Sally, Bielicki, Julia A., Walker, A. Sarah, Heath, Paul T., and Sharland, Mike

Subjects
Diagnosis, Care and treatment, Prevention, Dosage and administration, Forecasts and trends, Market trend/market analysis, Infant mortality -- Forecasts and trends -- Prevention, Hospital patients -- Care and treatment, Antibiotics -- Dosage and administration, Sepsis -- Diagnosis -- Care and treatment, Infants -- Patient outcomes
Abstract

Author(s): Neal J. Russell 1,*, Wolfgang Stöhr 2, Nishad Plakkal 3, Aislinn Cook 1, James A. Berkley 4,5,6, Bethou Adhisivam 3, Ramesh Agarwal 7, Nawshad Uddin Ahmed 8, Manica Balasegaram [...], Background There is limited data on antibiotic treatment in hospitalized neonates in low- and middle-income countries (LMICs). We aimed to describe patterns of antibiotic use, pathogens, and clinical outcomes, and to develop a severity score predicting mortality in neonatal sepsis to inform future clinical trial design. Methods and findings Hospitalized infants A total of 3,204 infants were enrolled, with median birth weight of 2,500 g (IQR 1,400 to 3,000) and postnatal age of 5 days (IQR 1 to 15). 206 different empiric antibiotic combinations were started in 3,141 infants, which were structured into 5 groups based on the World Health Organization (WHO) AWaRe classification. Approximately 25.9% (n = 814) of infants started WHO first line regimens (Group 1-Access) and 13.8% (n = 432) started WHO second-line cephalosporins (cefotaxime/ceftriaxone) (Group 2-"Low" Watch). The largest group (34.0%, n = 1,068) started a regimen providing partial extended-spectrum beta-lactamase (ESBL)/pseudomonal coverage (piperacillin-tazobactam, ceftazidime, or fluoroquinolone-based) (Group 3-"Medium" Watch), 18.0% (n = 566) started a carbapenem (Group 4-"High" Watch), and 1.8% (n = 57) a Reserve antibiotic (Group 5, largely colistin-based), and 728/2,880 (25.3%) of initial regimens in Groups 1 to 4 were escalated, mainly to carbapenems, usually for clinical deterioration (n = 480; 65.9%). A total of 564/3,195 infants (17.7%) were blood culture pathogen positive, of whom 62.9% (n = 355) had a gram-negative organism, predominantly Klebsiella pneumoniae (n = 132) or Acinetobacter spp. (n = 72). Both were commonly resistant to WHO-recommended regimens and to carbapenems in 43 (32.6%) and 50 (71.4%) of cases, respectively. MRSA accounted for 33 (61.1%) of 54 Staphylococcus aureus isolates. Overall, 350/3,204 infants died (11.3%; 95% CI 10.2% to 12.5%), 17.7% if blood cultures were positive for pathogens (95% CI 14.7% to 21.1%, n = 99/564). A baseline NeoSep Severity Score had a C-index of 0.76 (0.69 to 0.82) in the validation sample, with mortality of 1.6% (3/189; 95% CI: 0.5% to 4.6%), 11.0% (27/245; 7.7% to 15.6%), and 27.3% (12/44; 16.3% to 41.8%) in low (score 0 to 4), medium (5 to 8), and high (9 to 16) risk groups, respectively, with similar performance across subgroups. A related NeoSep Recovery Score had an area under the receiver operating curve for predicting death the next day between 0.8 and 0.9 over the first week. There was significant variation in outcomes between sites and external validation would strengthen score applicability. Conclusion Antibiotic regimens used in neonatal sepsis commonly diverge from WHO guidelines, and trials of novel empiric regimens are urgently needed in the context of increasing antimicrobial resistance (AMR). The baseline NeoSep Severity Score identifies high mortality risk criteria for trial entry, while the NeoSep Recovery Score can help guide decisions on regimen change. NeoOBS data informed the NeoSep1 antibiotic trial (ISRCTN48721236), which aims to identify novel first- and second-line empiric antibiotic regimens for neonatal sepsis. Trial registration ClinicalTrials.gov, (NCT03721302).

Published
2023
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32. Reducing surgical site infections in low-income and middle-income countries (FALCON): a pragmatic, multicentre, stratified, randomised controlled trial

Author

Ademuyiwa, Adesoji O, Hardy, Pollyanna, Runigamugabo, Emmy, Sodonougbo, Pierre, Behanzin, Hulrich, Kangni, Sosthène, Agboton, Gérard, Adagrah, Luke Aniakwo, Adjei-Acquah, Esther, Acquah, Ato Oppong, Ankomah, James, Armah, Ralph, Acquah, Regina, Addo, Kwame Gyambibi, Acheampong, Dorcas Otuo, Adu-Aryee, Nii Armah, Abubakari, Fatao, Titigah, Abraham, Owusu, Frank, Adu-Brobbey, Raphael, Adobea, Vivian, Abantanga, Francis Atindaana, Gautham, Arun, Bhatti, Dimple, Jesudason, Esther Daniel Mark, Aggarwal, Manisha, Alexander, Philip, Dasari, Amos, Alpheus, Rahul, Kumar, Hemanth, Raul, Subrat, Bueno, Wenceslao Ángeles, Ortiz, Reyes Cervantes, Gomez, Isaac Baltazar, Cerdan, Claudia Caballero, Gallo, Mariana Barreto, Gamez, Rozana Reyes, Sánchez, Irani Durán, Abdullahi, Lawal, Adesanya, Opeoluwa, Abdulsalam, Moruf, Adeleye, Victoria, Egwuonwu, Ochomma, Adeleke, Akeem, Adebayo, Francis, Chiejina, Godwin, Abayomi, Olukayode, Abdur-Rahman, Lukman, Ede, Jude, Ezinne, Uba, Kanyarukiko, Salathiel, Dusabe, Moses, Hirwa, Aime Dieudonne, Bucyibaruta, Georges, Adams, Mary Augusta, Birtles, Cheryl, Ally, Zain, Adewunmi, Abdus-sami, Cook, Jonathan, Brown, Julia, Adisa, Adewale O, Ismail, Lawani, Bhangu, Aneel, Omar, Omar, Simoes, Joana FF, Li, Elizabeth, Verjee, Azmina, Assouto, Pamphile, Seto, Djifid Morel, Kpangon, Cyrile, Ahossi, Rene, Alhassan, Bin Baaba Alhaji, Agyekum, Vera, Adam-Zakariah, Leslie Issa, Assah-Adjei, Frank, Asare, Christopher, Amoako, James, Akosa, Enoch Appiah, Acquaye, Jane, Adjei, Faisal, Ballu, Cletus, Coompson, Christian Larbi, Bennin, Amos, Abdulai, Darling Ramatu, Hepzibah, Alice, Bhatti, William, Paul, Priyadarshini K, Dhamija, Parth, Thomas, Josy, Jacob, Priya, Choudhrie, Ashish, Peters, Nitin, Sharma, Rajeev, Camacho, Francisco Barbosa, Gonzalez, Gonzalo Hernandez, Aguirre, Celina Cuellar, Solano, David Dominguez, Flores, Ana Cortes, Menindez, Roque Lincona, Vazquez, Diana Gonzalez, Ado, Khadija, Awonuga, David, Adeniran, Abimbola, Ademuyiwa, Adesoji, Ekwunife, Okechukwu, Adenikinju, Wilson, Aisuodionoe-Shadrach, Oseremen, Edet, Ekpo, Abdus-Salam, Rukiyat, Adeleke, Nurudeen, Ekenze, Sebastian, Francis, Matthew, Mukaneza, Francine, Izabiriza, Emelyne, Kabanda, Elysee, Bunogerane, Gisele Juru, Crawford, Richard, Ivy, Mathete, Jayne, David, Cousens, Simon, Chakrabortee, Sohini, Ghosh, Dhruva, Gyamfi, Frank Enoch, Brant, Felicity, Fiogbe, Michel, Tandje, Yannick, Akpla, Marcelin, Ngabo, Raoul Baderha, Amoako-Boateng, Mabel Pokuah, Agyemang, Eric, Asabre, Esther, Boakye, Anthony Appiah, Gakpetor, Delali Akosua, Appiah, Akosua Dwamena, Boakye, Percy, Adinku, Michael, Akoto, Erica, Barimah, Charles Gyamfi, Labaran, Abdul-Hamid, Dankwah, Fred, Acquah, Daniel Kwesi, Mary, Grace, Bir, Karan, Madankumar, Latha, Gupta, Himani, Zechariah, Pradeep, Kurien, Elizabeth, Vakil, Rakesh, Hernández, Aldo Bernal, Krauss, Rosa Hernandez, Avendaño, Alejandro Cuevas, Garcia, Rafael Toriz, Ojeda, Alejandro Gonzalez, Peón, Alberto Navarrete, Lara, Maria Martínez, Aliyu, Mohammed, Fasiku, Olushola, Ajai, Olalekan, Adeniyi, Oluwafunmilayo, Modekwe, Victor, Adeniyi, Olumide, Akaba, Godwin, Inyang, Akan, Adebayo, Sikiru, Adesola, Muideen, Enemuo, Vincent, Ikechukwu, Iweha, Mukantibaziyaremye, Deborah, Maniraguha, Hope Lydia, Mbonimpaye, Salomee, Habumuremyi, Sosthene, Ede, Chikwendu Jeffrey, Mbavhalelo, Cynthia, Laurberg, Soren, Smart, Neil, de la Medina, Antonio Ramos, Brocklehurst, Peter, Koco, Houenoukpo, Chobli, Hugues Herve, Bisimwa, Nathan, Appiah, Anthony Baffour, Akesseh, Rebecca Adjeibah, Boateng, Ruby Acheampong, Fosu, Godfred, Gawu, Victoria Sena, Aseti, Mark, Agbedinu, Kwabena, Ametefe, Elikem, Boateng, Guy Casskey, Owusu, Junior Atta, Doe, Stanley, Ayingayure, Emmanuel, Singh, Deepak, Daniel, Swati, Mittal, Rohin, Kanna, Vinoth, Mathew, Arpit, Arellano, Ana Bogurin, Miguelena, Luis Hernández, Sansores, Luis Dominguez, Velasco, Monica Jimenez, Muñoz, Maria Paz, Perez-Maldonado, Laura Martinez, Anyanwu, Lofty-John, Ogo, Chidiebere, Akande, Olukemi, Akinajo, Opeyemi, Okoro, Chukwuemeka, Adepiti, Akinfolarin, Ameh, Lazarus, Isa, Mary, Ajao, Akinlabi, Afolabi, Rafiat, Eze, Matthew, Nnyonno, Okoi, Munyaneza, Aphrodis, Mpirimbanyi, Christophe, Mukakomite, Christine, Haragirimana, Jean de Dieu, Fourtounas, Maria, Moore, Rachel, Metchinhoungbe, Serge, Kovohouande, Blaise, Kandokponou, Covalic Melic Bokossa, Asante-Asamani, Alvin, Amponsah-Manu, Forster, Koomson, Barbara, Serbeh, Godwin, Obbeng, Ambe, Banka, Charles, Gyamfi, Brian, Agbeko, Anita Eseenam, Amoako, Joachim Kwaku, Luri, Prosper Tonwisi, Kantanka, Ruth Sarfo, Osman, Imoro, Dhar, Tapasya, Nagomy, Ida, Kumar, Ashwani, Prakash, Danita, Torres, Edgar Cortes, Romero, Marco Hurtado, Mejia, Hector Ortiz, de la Fuente, Alejandra Nayen Sainz, Magashi, Mahmoud, Atobatele, Kazeem, Akinboyewa, David, Uche, Chisom, Aderounmu, Adewale, Mbajiekwe, Ndubuisi, Iseh, Faith, Amusat, Olanrewaju, Agodirin, Sulaiman, Ezomike, Uchechukwu, Okoro, Philemon, Ndegamiye, Gibert, Mutuyimana, Josiane, Muroruhirwe, Piolette, Imanishimwe, Alphonsine, Hyman, Gabriella, Ntirenganya, Faustin, Sogbo, Hodonou, Dokponou, Mireille, Boakye, Benedict, Ofosu-Akromah, Richard, Kusiwaa, Ataa, Gyan, Kofi Yeboah, Ofosuhene, Doris, Dadzie, Samuel, Kontor, Bismark Effah, Amankwa, Emmanuel Gyimah, Attepor, Godsway Solomon, Kobby, Ephraim, Kunfah, Sheba, Dhiman, Jyoti, Selvakumar, Rajesh, Singh, Gurtaj, Susan, Anju, Orozco, Clotilde Fuentes, del Campo, Laura Urdapilleta Gomez, de la Medina, Antonio Ramos De, Muhammad, Abubakar, Eke, Grace, Alasi, Iyabo, Ugwuanyi, Kenneth, Adesunkanmi, Abdulhafiz, Ogbo, Felix, Marwa, Adams, Ayandipo, Omobolaji, Aremu, Isiaka, Izuka, Emmanuel, Patrick, Igwe, Tubasiime, Ronald, Mwenedata, Olivier, Ingabire, JC Allen, Khan, Zafar, Harrison, Ewen, Tabiri, Stephen, Glasbey, James, Dossou, Francis Moïse, Debrah, Samuel A, Enti, Donald, Twerefour, Emmanuel Yaw, Nyarko, Isaac Omane, Osei-Poku, Dorcas, Essien, Derick, Kyeremeh, Christian, Amoah, Michael, Brown, George Darko, Larnyor, Kennedy Kofi Korankye-Hanson, Limann, Gbana, Shankar, Bharat, Varghese, Rose, de Rojas, Erick González García, Muhammad, Saminu, Faboya, Omolara, Alakaloko, Felix, Ugwunne, Chuka, Adisa, Adewale, Olori, Samson, Ogbeche, Sunday, Egbuchulem, Kelvin, Bello, Jibril, Mbadiwe, Okezie, Raphael, John, Rwagahirima, Elisee, Mukanyange, Violette, Kwati, Morapedi, Dzemta, Corinne, Ganiyu, Rahman Adebisi, Robertson, Zelda, Puozaa, Diana, Manu, Ruth, Amoah, George, Fenu, Benjamin, Osei, Edwin, Mohammed, Shamudeen Alhassan, Goyal, Sunita, Sivakumar, Moonish, Muideen, Bello, Imam, Zainab, Atoyebi, Oluwole, Ajekwu, Samuel, Osagie, Olabisi, Olory, Edima, Ekwuazi, Hyginus, Lawal, Saheed, Mbah, Ngozi, Vaduneme, Oriji, Uwizeyimana, Francine, Munyaneza, Emmanuel, Mathe, Mpho Nosipho, Haque, Parvez D, Gaou, Antoine, Koggoh, Patience, Tackie, Enoch, Hussey, Romeo, Mensah, Elijah, Appiah, Juliana, Kumassah, Philemon Kwame, Owusu, Prince Yeboah, Mohammed, Sheriff, Goyal, Ankush, Sridhar, Rajeevan, Ramírez, Bertha Guzmán, Takai, Idris, Momson, Esther, Balogun, Olanrewaju, Ajenjfuja, Olusegun, Sadiq, Abu, Udie, Gabriel, Elemile, Peter, Lawal, Abdulwahab, Victor, Abhulimen, Zirikana, Job, Mutabazi, Emmanuel, Heritage, Emily, Goudou, Roland, Kpankpari, Richard, Temitope, Arkorful Ebenezer, Kwarteng, Jemima, Solae, Friko Ibrahim, Arthur, Joshua, Olayiwola, David Olatayo, Sie-Broni, Clement Ayum, Musah, Yakubu, Thomas, Cecil, Valadez, Michel Hernández Valadez, Ukata, Onyekachi, Nwaenyi, Francisca, Belie, Orimisan, Akindojutimi, Jerrie, Sani, Samuel, Udosen, Joseph, Lawal, Taiwo, Raji, Hadijat, Ncogoza, Isaie, Nhlabathi, Ncamsile Anthea, Hedefoun, Emmanuel, Opandoh, Isabella Naa M., Sowah, Naa Anyekaa, Toffah, Gideon Kwasi, Ayim, Alex, Wordui, Theodore, Zume, Marshall, Ofori, Bernard, Hans, Monika, Titus, Devabalan, Acevedo, Diego Luna, Ogunyemi, Ayokunle, Bode, Christopher, Akinkuolie, Akinbolaji, Tabuanu, Nancy, Usang, Usang, Lawal, Olatunji, Sayomi, Olayinka, Nxumalo, Hlengiwe Samkelisiwe, Kroese, Karolin, Houtoukpe, Sunday, Manu, Meshach Agyemang, Yeboah, Grace, Ayodeji, Emmanuel Kafui, Agboadoh, Nelson, Owusu, Emmanuel Abem, Haque, Parvez, Galaviz, Rubén Morán, Oludara, Mobolaji, Ekwesianya, Andrew, Alatise, Olusegun, Uanikhoba, Martins, Olagunju, Solomon, Shittu, Asimiyu, Nyirahabimana, Jeannette, Pattinson, Paddy, Lillywhite, Rachel, Lapitan, Carmela, Kamga, Felix, Manu, Maison Patrick Opoku, Yeboah, Cynthia, Boakye-Yiadom, Jonathan, Saba, Abdul-Hafiz, Konda, Samuel, Flores, Oscar Olvera, Omisanjo, Olufunmilade, Elebute, Olumide, Allen, Olubukola, Osuala, Peter, Urimubabo, Christian, Sentholang, Nnosa, Kiki-Migan, Eric, Mensah, Samuel, Boateng, Edward Amoah, Seidu, Anwar Sadat, Luther, Anil, Navarro, José Pérez, Oshodi, Olabode, Ezenwankwo, Francis, Amosu, Lukmon, Suleman, Bamidele, Sethoana, Mmule Evelyn, Lissauer, David, Lawani, Souliath, Morna, Martin Tangnaa, Dally, Charles, Mahajan, Amit, Belmontes, Kevin Pintor, Oshodi, Yusuf, Fatuga, Adedeji, Archibong, Micheal, Takure, Augustine, Stassen, Maria Elizabeth, Magill, Laura, Lawani, Ismaïl, Nkrumah, John, Davor, Anthony, Yakubu, Mustapha, Makkar, Shalini, Marbello, Fernando Ramirez, Oyewole, Yemisi, Ihediwa, George, Arowolo, Olukayode, Thornley, Laura, Morton, Dion, Loko, René, Nortey, Michael, Gyasi-Sarpong, Christian Kofi, Yenli, Edwin Mwintiereh Ta-ang, Mandrelle, Kavita, Ramírez-González, Luis, Salami, Omotade, Jimoh, Adesola, Ayantona, Deborah, Wondoh, Paul, Nepogodiev, Dmitri, Mistry, Punam, Moutaïrou, Afissatou, Ofori, Emmanuel Owusu, Hamidu, Naabo Nuhu Noel, Michael, Vishal, Aguirre, Laura Reyes, Williams, Omolara, Kuku, Jubril, Ayinde, Ademola, Monahan, Mark, Ogouyemi, Pencome, Quartson, Elizaberth Mercy Quartson, Haruna, Iddrisu, Mukherjee, Partho, García, Ramona Rojas, Ladipo-Ajayi, Oluwaseun, Badejoko, Olusegun, Soumanou, Fouad, Kwarley, Naa, Rajappa, Reuben, Robles, Eduardo Valtierra, Makanjuola, Ayomide, Badmus, Tajudeen, Smith, Donna, Tamadaho, Pia, Lovi, Agbenya Kobla, Singh, Prashant, Mokwenyei, Olayanju, Etonyeaku, Amarachukwu, Zounon, Mack-Arthur, Nimako, Boateng, Suroy, Atul, Nwokocha, Samuel, Igbodike, Emeka, Nyadu, Bertina Beauty, Thind, Ravinder, Ogein, Olubunmi, Ijarotimi, Omotade, Opoku, Dominic, Thomas, Alen, Ojewola, Rufus, Lawal, Adedayo, Pinkney, Thomas, Osabutey, Anita, Tuli, Arti, Oladimeji, Abraham, Nana, Fayowole, Roberts, Tracy, Sagoe, Robert, Veetil, Sreejith, Olajide, Thomas, Oduanafolabi, Tunde, Tuffour, Samuel, Oluseye, Oluwaseun, Olasehinde, Olalekan, Tufour, Yaa, Seyi-Olajide, Justina, Olayemi, Olaniyi, Winkles, Neil, Yamoah, Francis Akwaw, Soibi-Harry, Adaiah, Omitinde, Stephen, Yefieye, Abiboye Cheduko, Ugwu, Aloy, Oni, Owolabi, Yorke, Joseph, Williams, Emmanuel, Onyeze, Chigozie, Orji, Ernest, Rotimi, Adewale, Salako, Abdulkadir, Solaja, Olufemi, Sowemimo, Oluwaseun, Talabi, Ademola, Tajudeen, Mohammed, and Wuraola, Funmilola

Published
2021
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34. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment

Author

Hug, Lucia, You, Danzhen, Blencowe, Hannah, Mishra, Anu, Wang, Zhengfan, Fix, Miranda J, Wakefield, Jon, Moran, Allisyn C, Gaigbe-Togbe, Victor, Suzuki, Emi, Blau, Dianna M, Cousens, Simon, Creanga, Andreea, Croft, Trevor, Hill, Kenneth, Joseph, K S, Maswime, Salome, McClure, Elizabeth M, Pattinson, Robert, Pedersen, Jon, Smith, Lucy K, Zeitlin, Jennifer, and Alkema, Leontine

Published
2021
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36. Assessment of the validity of the measurement of newborn and maternal health-care coverage in hospitals (EN-BIRTH): an observational study

Author

Serbanescu, Florina, Amouzou, Agbessi, Sæbø, Johan Ivar, Mathai, Matthews, Rawlins, Barbara, Azim, Tariq, Vaz, Lara, Monet, Jean-Pierre, Jackson, Debra, Requejo, Jennifer, Ram, Pavani K, Moran, Allisyn C, Kabuteni, Theopista John, Mazumder, Tapas, Rahman, Hafizur, Shaikh, Ziaul Haque, Talha, Taqbir Us Samad, Haider, Rajib, Siddika, Aysha, Sumi, Taslima Akter, Khan, Jasmin, Biswas, Bilkish, Mannan, M A, Hasanuzzaman, Abu, Ali, Ayub, Jahan, Rowshan Hosne, Hossain, Amir, Jahan, Ishrat, Gurung, Rejina, Sunny, Avinash K, Thakur, Nishant, Ghimire, Jagat Jeevan, Joshi, Elisha, Shrestha, Parashu Ram, Shrestha, Shree Krishna, Singh, Dela, Rana, Nisha, Mrisho, Mwifadhi, Manzi, Fatuma, Hanson, Claudia, Kija, Edward, Pembe, Andrea, Kisenge, Rodrick, Manji, Karim, Mkopi, Namala, Assenga, Evelyne, Blencowe, Hannah, Moxon, Sarah G, KC, Naresh P, Day, Louise Tina, Sadeq-ur Rahman, Qazi, Ehsanur Rahman, Ahmed, Salim, Nahya, KC, Ashish, Ruysen, Harriet, Tahsina, Tazeen, Masanja, Honorati, Basnet, Omkar, Gore-Langton, Georgia R, Zaman, Sojib Bin, Shabani, Josephine, Jha, Anjani Kumar, Gordeev, Vladimir Sergeevich, Ameen, Shafiqul, Shamba, Donat, Jha, Bijay, Boggs, Dorothy, Hossain, Tanvir, Shirima, Kizito, Bastola, Ram Chandra, Peven, Kimberly, Siddique, Abu Bakkar, Mbaruku, Godfrey, Paudel, Rajendra, Baschieri, Angela, Hossain, Aniqa Tasnim, Kong, Stefanie, Paudel, Asmita, Ahmed, Anisuddin, Cousens, Simon, El Arifeen, Shams, and Lawn, Joy E

Published
2021
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37. Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study

Author

Ayele, Tadesse Awoke, Bisetegn, Telake Bisetegn, Delwar, Nafisa, Gezie, Lemma Derseh, Gyezaho, Collins, Kaija, Judith, Machiyama, Kazuyo, Manu, Grace, Manu, Alexander A, Martins, Justiniano SD, Melese, Tesfahun, Alam, Sayed S, Nareeba, Tryphena, Hardy, Victoria Ponce, Zandoh, Charles, Arnold, Fred, Byass, Peter, Croft, Trevor, Herbst, Kobus, Kishor, Sunita Kishor, Serbanescu, Florina, Akuze, Joseph, Blencowe, Hannah, Waiswa, Peter, Baschieri, Angela, Gordeev, Vladimir S, Kwesiga, Doris, Fisker, Ane B, Thysen, Sanne M, Rodrigues, Amabelia, Biks, Gashaw A, Abebe, Solomon M, Gelaye, Kassahun A, Mengistu, Mezgebu Y, Geremew, Bisrat M, Delele, Tadesse G, Tesega, Adane K, Yitayew, Temesgen A, Kasasa, Simon, Galiwango, Edward, Natukwatsa, Davis, Kajungu, Dan, Enuameh, Yeetey AK, Nettey, Obed E, Dzabeng, Francis, Amenga-Etego, Seeba, Newton, Sam K, Tawiah, Charlotte, Asante, Kwaku P, Owusu-Agyei, Seth, Alam, Nurul, Haider, Moinuddin M, Imam, Ali, Mahmud, Kaiser, Cousens, Simon, and Lawn, Joy E

Published
2020
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38. Setting research priorities to improve global newborn health and prevent stillbirths by 2025.

Author

Yoshida, Sachiyo, Martines, José, Lawn, Joy E, Wall, Stephen, Souza, Joăo Paulo, Rudan, Igor, Cousens, Simon, neonatal health research priority setting group, Aaby, Peter, Adam, Ishag, Adhikari, Ramesh Kant, Ambalavanan, Namasivayam, Arifeen, Shams Ei, Aryal, Dhana Raj, Asiruddin, Sk, Baqui, Abdullah, Barros, Aluisio Jd, Benn, Christine S, Bhandari, Vineet, Bhatnagar, Shinjini, Bhattacharya, Sohinee, Bhutta, Zulfiqar A, Black, Robert E, Blencowe, Hannah, Bose, Carl, Brown, Justin, Bührer, Christoph, Carlo, Wally, Cecatti, Jose Guilherme, Cheung, Po-Yin, Clark, Robert, Colbourn, Tim, Conde-Agudelo, Agustin, Corbett, Erica, Czeizel, Andrew E, Das, Abhik, Day, Louise Tina, Deal, Carolyn, Deorari, Ashok, Dilmen, Uğur, English, Mike, Engmann, Cyril, Esamai, Fabian, Fall, Caroline, Ferriero, Donna M, Gisore, Peter, Hazir, Tabish, Higgins, Rosemary D, Homer, Caroline Se, Hoque, DE, Irgens, Lorentz, Islam, MT, de Graft-Johnson, Joseph, Joshua, Martias Alice, Keenan, William, Khatoon, Soofia, Kieler, Helle, Kramer, Michael S, Lackritz, Eve M, Lavender, Tina, Lawintono, Laurensia, Luhanga, Richard, Marsh, David, McMillan, Douglas, McNamara, Patrick J, Mol, Ben Willem J, Molyneux, Elizabeth, Mukasa, GK, Mutabazi, Miriam, Nacul, Luis Carlos, Nakakeeto, Margaret, Narayanan, Indira, Olusanya, Bolajoko, Osrin, David, Paul, Vinod, Poets, Christian, Reddy, Uma M, Santosham, Mathuram, Sayed, Rubayet, Schlabritz-Loutsevitch, Natalia E, Singhal, Nalini, Smith, Mary Alice, Smith, Peter G, Soofi, Sajid, Spong, Catherine Y, Sultana, Shahin, Tshefu, Antoinette, van Bel, Frank, Gray, Lauren Vestewig, Waiswa, Peter, Wang, Wei, Williams, Sarah LA, Wright, Linda, Zaidi, Anita, Zhang, Yanfeng, Zhong, Nanbert, Zuniga, Isabel, and Bahl, Rajiv

Subjects
neonatal health research priority setting group, Public Health and Health Services
Abstract

BackgroundIn 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs) in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013-2025.MethodsWe used adapted Child Health and Nutrition Research Initiative (CHNRI) methods for this prioritization exercise. We identified and approached the 200 most productive researchers and 400 program experts, and 132 of them submitted research questions online. These were collated into a set of 205 research questions, sent for scoring to the 600 identified experts, and were assessed and scored by 91 experts.ResultsNine out of top ten identified priorities were in the domain of research on improving delivery of known interventions, with simplified neonatal resuscitation program and clinical algorithms and improved skills of community health workers leading the list. The top 10 priorities in the domain of development were led by ideas on improved Kangaroo Mother Care at community level, how to improve the accuracy of diagnosis by community health workers, and perinatal audits. The 10 leading priorities for discovery research focused on stable surfactant with novel modes of administration for preterm babies, ability to diagnose fetal distress and novel tocolytic agents to delay or stop preterm labour.ConclusionThese findings will assist both donors and researchers in supporting and conducting research to close the knowledge gaps for reducing neonatal mortality, morbidity and long term impairment. WHO, SNL and other partners will work to generate interest among key national stakeholders, governments, NGOs, and research institutes in these priorities, while encouraging research funders to support them. We will track research funding, relevant requests for proposals and trial registers to monitor if the priorities identified by this exercise are being addressed.

Published
2016

39. Cause-of-death estimates for the early and late neonatal periods for 194 countries from 2000-2013

Author

Oza, Shefali, Lawn, Joy E, Hogan, Daniel R, Mathers, Colin, and Cousens, Simon

Subjects
Statistics - Applications
Abstract

Objective: Cause-of-death distributions are important for prioritising interventions. We estimated proportions, risks, and numbers of deaths (with uncertainty) for programme-relevant causes of neonatal death for 194 countries for 2000-2013, differentiating between the early (days 0-6) and late (days 7-27) neonatal periods. Methods: For 65 high-quality VR countries, we used the observed early and late neonatal proportional cause distributions. For the remaining 129 countries, we used multinomial logistic models to estimate the early and late proportional cause distributions. We used separate models, with different inputs, for low and high neonatal mortality countries. We applied these cause-specific proportions to neonatal death estimates from the United Nations by country/year to estimate cause-specific risks and numbers of deaths. Findings: Of the 2.76 million neonatal deaths in 2013, 0.99 (uncertainty: 0.70-1.31) million (35.7%) were estimated to be from preterm complications, 0.64 (uncertainty: 0.46-0.84) million (23.4%) from intrapartum-related complications, and 0.43 (0.22-0.66) million (15.6%) from sepsis. Preterm (40.8%) and intrapartum-related (27.0%) complications accounted for the majority of early neonatal deaths while infections caused nearly half of late neonatal deaths. In every region, preterm was the leading cause of neonatal death, with the highest risks in Southern Asia (11.9 per 1000 livebirths) and Sub-Saharan Africa (9.5). Conclusion: The neonatal cause-of-death distribution differs between the early and late periods, and varies with NMR level and over time. To reduce neonatal deaths, this knowledge must be incorporated into policy decisions. The Every Newborn Action Plan provides stimulus for countries to update national strategies and include high-impact interventions to address these causes., Comment: 123 pages (18 pages of main paper, 105 pages of appendix), in press with Bulletin of the World Health Organization

Published
2014

40. Setting research priorities to improve global newborn health and prevent stillbirths by 2025

Author

Yoshida, Sachiyo, Martines, José, Lawn, Joy E, Wall, Stephen, Souza, Joăo Paulo, Rudan, Igor, Cousens, Simon, Aaby, Peter, Adam, Ishag, Adhikari, Ramesh Kant, Ambalavanan, Namasivayam, Arifeen, Shams EI, Aryal, Dhana Raj, Asiruddin, Sk, Baqui, Abdullah, Barros, Aluisio JD, Benn, Christine S, Bhandari, Vineet, Bhatnagar, Shinjini, Bhattacharya, Sohinee, Bhutta, Zulfiqar A, Black, Robert E, Blencowe, Hannah, Bose, Carl, Brown, Justin, Bührer, Christoph, Carlo, Wally, Cecatti, Jose Guilherme, Cheung, Po–Yin, Clark, Robert, Colbourn, Tim, Conde–Agudelo, Agustin, Corbett, Erica, Czeizel, Andrew E, Das, Abhik, Day, Louise Tina, Deal, Carolyn, Deorari, Ashok, Dilmen, Uğur, English, Mike, Engmann, Cyril, Esamai, Fabian, Fall, Caroline, Ferriero, Donna M, Gisore, Peter, Hazir, Tabish, Higgins, Rosemary D, Homer, Caroline SE, Hoque, DE, Irgens, Lorentz, Islam, MT, de Graft–Johnson, Joseph, Joshua, Martias Alice, Keenan, William, Khatoon, Soofia, Kieler, Helle, Kramer, Michael S, Lackritz, Eve M, Lavender, Tina, Lawintono, Laurensia, Luhanga, Richard, Marsh, David, McMillan, Douglas, McNamara, Patrick J, Mol, Ben Willem J, Molyneux, Elizabeth, Mukasa, GK, Mutabazi, Miriam, Nacul, Luis Carlos, Nakakeeto, Margaret, Narayanan, Indira, Olusanya, Bolajoko, Osrin, David, Paul, Vinod, Poets, Christian, Reddy, Uma M, Santosham, Mathuram, Sayed, Rubayet, Schlabritz–Loutsevitch, Natalia E, Singhal, Nalini, Smith, Mary Alice, Smith, Peter G, Soofi, Sajid, Spong, Catherine Y, Sultana, Shahin, Tshefu, Antoinette, van Bel, Frank, Gray, Lauren Vestewig, Waiswa, Peter, Wang, Wei, Williams, Sarah LA, Wright, Linda, Zaidi, Anita, Zhang, Yanfeng, Zhong, Nanbert, Zuniga, Isabel, and Bahl, Rajiv

Subjects
Public Health, Health Sciences, Infant Mortality, Preterm, Low Birth Weight and Health of the Newborn, Pediatric, Prevention, Perinatal Period - Conditions Originating in Perinatal Period, Reproductive health and childbirth, Good Health and Well Being, neonatal health research priority setting group, Public Health and Health Services, Public health
Abstract

BackgroundIn 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs) in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013-2025.MethodsWe used adapted Child Health and Nutrition Research Initiative (CHNRI) methods for this prioritization exercise. We identified and approached the 200 most productive researchers and 400 program experts, and 132 of them submitted research questions online. These were collated into a set of 205 research questions, sent for scoring to the 600 identified experts, and were assessed and scored by 91 experts.ResultsNine out of top ten identified priorities were in the domain of research on improving delivery of known interventions, with simplified neonatal resuscitation program and clinical algorithms and improved skills of community health workers leading the list. The top 10 priorities in the domain of development were led by ideas on improved Kangaroo Mother Care at community level, how to improve the accuracy of diagnosis by community health workers, and perinatal audits. The 10 leading priorities for discovery research focused on stable surfactant with novel modes of administration for preterm babies, ability to diagnose fetal distress and novel tocolytic agents to delay or stop preterm labour.ConclusionThese findings will assist both donors and researchers in supporting and conducting research to close the knowledge gaps for reducing neonatal mortality, morbidity and long term impairment. WHO, SNL and other partners will work to generate interest among key national stakeholders, governments, NGOs, and research institutes in these priorities, while encouraging research funders to support them. We will track research funding, relevant requests for proposals and trial registers to monitor if the priorities identified by this exercise are being addressed.

Published
2015

46. National, regional, and state-level all-cause and cause-specific under-5 mortality in India in 2000–15: a systematic analysis with implications for the Sustainable Development Goals

Author

Liu, Li, Chu, Yue, Oza, Shefali, Hogan, Dan, Perin, Jamie, Bassani, Diego G, Ram, Usha, Fadel, Shaza A, Pandey, Arvind, Dhingra, Neeraj, Sahu, Damodar, Kumar, Pradeep, Cibulskis, Richard, Wahl, Brian, Shet, Anita, Mathers, Colin, Lawn, Joy, Jha, Prabhat, Kumar, Rakesh, Black, Robert E, and Cousens, Simon

Published
2019
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48. Global, Regional, and National Estimates and Trends in Stillbirths From 2000 to 2019: A Systematic Assessment

Author

Hug, Lucia, You, Danzhen, Blencowe, Hannah, Mishra, Anu, Wang, Zhengfan, Fix, Miranda J., Wakefield, Jon, Moran, Allisyn C., Gaigbe-Togbe, Victor, Suzuki, Emi, Blau, Dianna M., Cousens, Simon, Creanga, Andreea, Croft, Trevor, Hill, Kenneth, Joseph, K. S., Maswime, Salome, McClure, Elizabeth M., Pattinson, Robert, Pedersen, Jon, Smith, Lucy K., Zeitlin, Jennifer, and Alkema, Leontine

Published
2022
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50. Persistence of Anti-SE36 Antibodies Induced by the Malaria Vaccine Candidate BK-SE36/CpG in 5–10-Year-Old Burkinabe Children Naturally Exposed to Malaria

Author

Nebie, Issa, primary, Palacpac, Nirianne Marie Q., additional, Bougouma, Edith Christiane, additional, Diarra, Amidou, additional, Ouédraogo, Alphonse, additional, D’Alessio, Flavia, additional, Houard, Sophie, additional, Tiono, Alfred B., additional, Cousens, Simon, additional, Horii, Toshihiro, additional, and Sirima, Sodiomon B., additional

Published
2024
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