Prospective observational study of the challenges in diagnosing common neonatal conditions in Nigeria and Kenya.
Prospective observational study of the challenges in diagnosing common neonatal conditions in Nigeria and Kenya.
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DOI：
10.1136/bmjopen-2022-064575
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发表时间：
2022-12-06
期刊：
影响因子：
2.9
通讯作者：
behalf Neonatal Nutr Network NeoNuNet
中科院分区：
文献类型：
--
作者：
Staunton, Aimee P.;Nabwera, Helen M.;Allen, Stephen J.;Tongo, Olukemi O.;Akindolire, Abimbola E.;Abdulkadir, Isa;Ezeaka, Chinyere, V;Ezenwa, Beatrice N.;Fajolu, Iretiola B.;Imam, Zainab O.;Umoru, Dominic D.;Otieno, Walter;Nalwa, Grace M.;Olwala, Macrine;Talbert, Alison W.;Andang'o, Pauline E. A.;Mwangome, Martha K.;Abubakar, Ismaela;Embleton, Nicholas D.;behalf Neonatal Nutr Network NeoNuNet
准确和及时地诊断常见的新生儿疾病对于减少新生儿死亡至关重要。在资源有限的低收入/中等收入国家，关于如何进行新生儿诊断的信息很少。本研究的目的是描述尼日利亚和肯尼亚新生儿单位（NNUs）常见疾病的诊断标准。前瞻性观察性研究。疑似败血症、呼吸系统疾病、出生窒息和腹部疾病的标准病例报告表由新生儿营养网络（https：//www.lstmed.ac.uk/nnu）合作者共同开发。临床医生填写了所有NNUs入院表格。关键数据使用热图显示。尼日利亚的五个营养网和肯尼亚的两个营养网组成了新生儿营养网。2851例新生儿，包括6个月内7个NNU收治的所有新生儿。1230例（43.1%）新生儿疑似败血症，874例（30.6%）呼吸系统疾病，587例（20.6%）出生窒息和71例（2.5%）腹部疾病。对于所有条件和所有NNU，一致使用临床标准，很少使用实验室和放射学标准。我们的研究结果强调了对临床标准的依赖和对撒哈拉以南非洲NNU常见疾病诊断技术的极其有限的使用。这对新生儿疾病的管理有影响，新生儿疾病通常具有重叠的临床特征。需要实施诊断途径的战略，并投资于负担得起的和可持续的诊断，以改善对这些脆弱婴儿的护理。
Accurate and timely diagnosis of common neonatal conditions is crucial for reducing neonatal deaths. In low/middle-income countries with limited resources, there is sparse information on how neonatal diagnoses are made. The aim of this study was to describe the diagnostic criteria used for common conditions in neonatal units (NNUs) in Nigeria and Kenya. Prospective observational study. Standard case report forms for suspected sepsis, respiratory disorders, birth asphyxia and abdominal conditions were co-developed by the Neonatal Nutrition Network (https://www.lstmed.ac.uk/nnu) collaborators. Clinicians completed forms for all admissions to their NNUs. Key data were displayed using heatmaps. Five NNUs in Nigeria and two in Kenya comprising the Neonatal Nutrition Network. 2851 neonates, which included all neonates admitted to the seven NNUs over a 6-month period. 1230 (43.1%) neonates had suspected sepsis, 874 (30.6%) respiratory conditions, 587 (20.6%) birth asphyxia and 71 (2.5%) abdominal conditions. For all conditions and across all NNUs, clinical criteria were used consistently with sparse use of laboratory and radiological criteria. Our findings highlight the reliance on clinical criteria and extremely limited use of diagnostic technologies for common conditions in NNUs in sub-Saharan Africa. This has implications for the management of neonatal conditions which often have overlapping clinical features. Strategies for implementation of diagnostic pathways and investment in affordable and sustainable diagnostics are needed to improve care for these vulnerable infants.
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影响因子：
8.1
作者：
Engel N;Wachter K;Pai M;Gallarda J;Boehme C;Celentano I;Weintraub R
通讯作者：
Weintraub R
影响因子：
2.6
作者：
Camacho-Gonzalez, Andres;Spearman, Paul W.;Stoll, Barbara J.
通讯作者：
Stoll, Barbara J.
DOI：
10.1111/1471-0528.12312
发表时间：
2013-09-01
影响因子：
5.8
作者：
Bhutta, Z. A.;Giuliani, F.;Paul, V.
通讯作者：
Paul, V.
影响因子：
6.1
作者：
Majors CE;Smith CA;Natoli ME;Kundrod KA;Richards-Kortum R
通讯作者：
Richards-Kortum R
影响因子：
4.3
作者：
Ellington, Laura E.;Gilman, Robert H.;Checkley, William
通讯作者：
Checkley, William