Tropical medicine & international health : TM & IH
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Trop. Med. Int. Health · Sep 2013
Early-onset neonatal sepsis in Dhaka, Bangladesh: risk associated with maternal bacterial colonisation and chorioamnionitis.
To estimate the risk of early-onset neonatal sepsis among newborns of mothers with chorioamnionitis and/or bacterial colonisation in Dhaka. ⋯ Newborns born to mothers with colonisation or chorioamnionitis developed sepsis faster and were at higher risk of developing sepsis in Dhaka.
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Trop. Med. Int. Health · Sep 2013
Cryptococcal antigen prevalence in HIV-infected Tanzanians: a cross-sectional study and evaluation of a point-of-care lateral flow assay.
Cryptococcal antigen (CRAG) screening at antiretroviral therapy (ART) initiation and pre-emptive antifungal treatment for those testing positive could prevent many cases of cryptococcal meningitis (CM). To investigate whether CRAG screening would be feasible in Tanzania, we conducted a cross-sectional study measuring CRAG prevalence in ART clinic patients and comparing the novel lateral flow assay (LFA) with the cryptococcal latex agglutination (LA) test. ⋯ Five percentage of ART clinic patients with CD4 cell counts ≤100 cells/µL in northern Tanzania had asymptomatic cryptococcal antigenaemia, suggesting that CRAG screening would be worthwhile in the Tanzanian ART programme. The LFA is a reliable, cheap and practical alternative to LA for detection of CRAG.
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Trop. Med. Int. Health · Aug 2013
Control of soil-transmitted helminthiasis in Myanmar: results of 7 years of deworming.
After a baseline survey in 2003 which showed an overall parasitological prevalence of soil-transmitted helminths of 69.7% in school children (prevalence of ascariasis 48.5%, prevalence of trichuriasis 57.5% and prevalence of hookworm infection 6.5), a national deworming programme was established. After 7 years of implementation, it had resulted in a significant reduction of STH prevalence (prevalence of any STH 21%, prevalence of ascariasis 5.8%, prevalence of trichuriasis 18.6% and prevalence of hookworm infection 0.3%) as well as a reduction of the infections of moderate-heavy intensity from 18.5% at baseline to less than 7%. The results are encouraging and a reduction of the frequency of deworming can be envisaged in two of four ecological areas of Myanmar.
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Trop. Med. Int. Health · Aug 2013
Randomized Controlled TrialPromoting skin-to-skin care for low birthweight babies: findings from the Ghana Newhints cluster-randomised trial.
To evaluate whether the Newhints home visits intervention increased the adoption of skin-to-skin care (SSC), in particular, among low birthweight (LBW) (<2.5 kg) babies. ⋯ Newhints successfully promoted the uptake of SSC in rural Ghana. Although findings are encouraging, promotion in rural community settings in sub-Saharan Africa is challenging. Lessons learned can help shape SSC promotion in efforts to increase adoption and save newborn lives.
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Trop. Med. Int. Health · Aug 2013
An ambulance referral network improves access to emergency obstetric and neonatal care in a district of rural Burundi with high maternal mortality.
In 2006, Médecins sans Frontières (MSF) established an emergency obstetric and neonatal care (EmONC) referral facility linked to an ambulance referral system for the transfer of women with obstetric complications from peripheral maternity units in Kabezi district, rural Burundi. This study aimed to (i) describe the communication and ambulance service together with the cost; (ii) examine the association between referral times and maternal and early neonatal deaths; and (iii) assess the impact of the referral service on coverage of complicated obstetric cases and caesarean sections. ⋯ This study demonstrates that it is possible to implement an effective communication and transport system to ensure access to EmONC and also highlights some of the important operational factors to consider, particularly in relation to minimising referral delays.