Research Priorities to Reduce Global Mortality From Newborn Infections by 2015
Research Priorities to Reduce Global Mortality From Newborn Infections by 2015
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DOI：
10.1097/inf.0b013e31819588d7
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发表时间：
2009-01-01
影响因子：
3.6
通讯作者：
Rudan, Igor
中科院分区：
文献类型：
--
作者：
Bahl, Rajiv;Martines, Jose;Rudan, Igor
背景：在全球每年估计的400万新生儿死亡中，约有三分之一是新生儿感染造成的。需要进行适当的针对性研究，以指导对有效干预措施的投资，特别是在低资源销售方面。为解决新生儿感染的研究确定全球优先事项是必要和紧迫的。方法：世界卫生组织（WHO/CAH）儿童和青少年健康与发展司采用儿童健康与营养研究倡议（CHNRI）确定重点的方法，确定和促进最有可能在2015年之前降低全球新生儿感染相关死亡率的研究。世卫组织/CAH邀请技术专家系统地列出研究问题，然后使用标准方法根据这些问题(i)以所有伦理方式回答的可能性，（ii）导致（或改进）有效干预措施的可能性，（iii）可交付、负担得起和可持续的可能性，（iv）最大限度地减少死亡负担，以及(v)对人口产生公平影响的可能性对其进行评分。然后根据来自全球研究优先设置网络的广泛利益相关者提供的价值对分数进行加权。研究发现：在100分制中，69个研究问题的最终优先级得分从39分到83分不等。在得分最高的15个研究问题中，大多数属于卫生系统和政策研究领域，以解决影响现有成本效益高的干预措施的障碍。优先问题的重点是促进预防新生儿感染的家庭护理做法，以及在保健设施和社区提高新生儿感染管理的覆盖面和质量的办法。虽然以社区为基础的干预研究目前正在得到一些投资，但对以设施为基础的干预和质量改进的研究几乎完全缺乏严格的评价和成本分析。解释：尽管存在有效的干预措施，但鉴于在改善新生儿生存方面缺乏进展，本文中排名靠前的研究重点大多数在卫生系统和政策研究领域也就不足为奇了。我们敦促供资机构和调查人员对这些研究重点进行投资，以加速减少新生儿死亡，特别是因感染造成的新生儿死亡。
Background: Newborn infections are responsible for approximately one-third of the estimated 4.0 million neonatal deaths that occur globally every year. Appropriately targeted research is required to guide investment in effective interventions, especially in low resource sellings. Setting global priorities for research to address neonatal infections is essential and urgent.Methods: The Department of Child and Adolescent Health and Development of the World Health Organization (WHO/CAH) applied the Child Health and Nutrition Research Initiative (CHNRI) priority-setting methodology to identify and stimulate research most likely to reduce global newborn infection-related mortality by 2015. Technical experts were invited by WHO/CAH to systematically list and then use standard methods to score research questions according to their likelihood to (i) be answered in all ethical way, (ii) lead to (Or improve) effective interventions, (iii) be deliverable, affordable, and sustainable, (iv) maximize death burden reduction, and (v) have an equitable effect in the population. The scores were then weighted according to the values provided by a wide group of stakeholders from the global research priority-setting network.Findings: On a 100-point scale, the final priority scores for 69 research questions ranged from 39 to 83. Most of the 15 research questions that received the highest scores were in the domain of health systems and policy research to address barriers affecting existing cost-effective interventions. The priority questions focused oil promotion of home care practices to prevent newborn infections and approaches to increase coverage and quality of management of newborn infections in health facilities as well as in the community. While community-based intervention research is receiving some current investment, rigorous evaluation and cost analysis is almost entirely lacking for research on facility-based interventions and quality improvement.Interpretation: Given the lack of progress in improving newborn survival despite the existence of effective interventions, it is not surprising that of the top ranked research priorities in this article the majority are in the domain of health systems and policy research. We urge funding agencies and investigators to invest in these research priorities to accelerate reduction of neonatal deaths, particularly those due to infections.