Serious and life-threatening pregnancy-related infections: opportunities to reduce the global burden.
Ontology highlight
ABSTRACT:
SUBMITTER: Gravett CA
PROVIDER: S-EPMC3467240 | biostudies-literature | 2012
REPOSITORIES: biostudies-literature
Publications
Serious and life-threatening pregnancy-related infections: opportunities to reduce the global burden.
Gravett Courtney A CA Gravett Michael G MG Martin Emily T ET Bernson Jeffrey D JD Khan Sadaf S Boyle David S DS Lannon Sophia M R SM Patterson Janna J Rubens Craig E CE Steele Matthew S MS
PLoS medicine 20121009 10
Michael Gravett and colleagues review the burden of pregnancy-related infections, especially in low- and middle-income countries, and offer suggestions for a more effective intervention strategy. ...[more]
Similar Datasets
Project description:Sochi virus was recently identified as a new hantavirus genotype carried by the Black Sea field mouse, Apodemus ponticus. We evaluated 62 patients in Russia with Sochi virus infection. Most clinical cases were severe, and the case-fatality rate was as high as 14.5%.
| S-EPMC4672424 | biostudies-literature
Project description:BackgroundFungal disease is frequent in India, but its incidence and prevalence are unclear. This review aims at defining the frequency or burden of various fungal infections in India.MethodsA systematic review of the literature on the PubMed, Embase, and Web of Science (WOS) databases was conducted using appropriate search strings. Deterministic modeling determined annual incidence and prevalence estimates for multiple life- and sight-threatening infections with significant morbidity.ResultsLiterature searches yielded >2900 papers; 434 papers with incidence/prevalence/proportion data were analyzed. An estimated 57 251 328 of the 1 393 400 000 people in India (4.1%) suffer from a serious fungal disease. The prevalence (in millions) of recurrent vulvovaginal candidiasis is 24.3, allergic bronchopulmonary aspergillosis is 2.0, tinea capitis in school-age children is 25, severe asthma with fungal sensitization is 1.36, chronic pulmonary aspergillosis is 1.74, and chronic fungal rhinosinusitis is 1.52. The annual incidence rates of Pneumocystis pneumonia (58 400), invasive aspergillosis (250 900), mucormycosis (195 000), esophageal candidiasis in HIV (266 600), candidemia (188 000), fungal keratitis (1 017 100), and cryptococcal meningitis (11 500) were also determined. Histoplasmosis, talaromycosis, mycetoma, and chromoblastomycosis were less frequent.ConclusionsIndia's fungal burden is high and underappreciated in clinical practice.
| S-EPMC9792086 | biostudies-literature
Project description:BackgroundSexually transmitted infections (STI), such as chlamydial, gonorrheal, and trichomonal infections, are prevalent in pregnant women in many countries and are widely reported to be associated with increased risk of poor maternal and neonatal outcomes. Syndromic STI management is frequently used in pregnant women in low- and middle-income countries, yet its low specificity and sensitivity lead to both overtreatment and undertreatment. Etiologic screening for chlamydial, gonorrheal, and/or trichomonal infection in all pregnant women combined with targeted treatment might be an effective intervention. However, the evidence base is insufficient to support the development of global recommendations. We aimed to describe key considerations and knowledge gaps regarding chlamydial, gonorrheal, and trichomonal screening during pregnancy to inform future research needed for developing guidelines for low- and middle-income countries.MethodsWe conducted a narrative review based on PubMed and clinical trials registry searches through January 20, 2020, guidelines review, and expert opinion. We summarized our findings using the frameworks adopted by the World Health Organization for guideline development.ResultsAdverse maternal-child health outcomes of potential interest are wide-ranging and variably defined. No completed randomized controlled trials on etiologic screening and targeted treatment were identified. Evidence from observational studies was limited, and trials of presumptive STI treatment have shown mixed results. Subgroups that might benefit from specific recommendations were identified. Evidence on harms was limited. Cost-effectiveness was influenced by STI prevalence and availability of testing infrastructure and high-accuracy/low-cost tests. Preliminary data suggested high patient acceptability.DiscussionPreliminary data on harms, acceptability, and feasibility and the availability of emerging test technologies suggest that etiologic STI screening deserves further evaluation as a potential tool to improve maternal and neonatal health outcomes worldwide.
| S-EPMC7668326 | biostudies-literature
Project description:ObjectiveTo assess whether severe psychiatric reactions to trauma and other adversities are associated with subsequent risk of life threatening infections.DesignPopulation and sibling matched cohort study.SettingSwedish population.Participants144 919 individuals with stress related disorders (post-traumatic stress disorder (PTSD), acute stress reaction, adjustment disorder, and other stress reactions) identified from 1987 to 2013 compared with 184 612 full siblings of individuals with a diagnosed stress related disorder and 1 449 190 matched individuals without such a diagnosis from the general population.Main outcome measuresA first inpatient or outpatient visit with a primary diagnosis of severe infections with high mortality rates (ie, sepsis, endocarditis, and meningitis or other central nervous system infections) from the Swedish National Patient Register, and deaths from these infections or infections of any origin from the Cause of Death Register. After controlling for multiple confounders, Cox models were used to estimate hazard ratios of these life threatening infections.ResultsThe average age at diagnosis of a stress related disorder was 37 years (55 541, 38.3% men). During a mean follow-up of eight years, the incidence of life threatening infections per 1000 person years was 2.9 in individuals with a stress related disorder, 1.7 in siblings without a diagnosis, and 1.3 in matched individuals without a diagnosis. Compared with full siblings without a diagnosis of a stress related disorder, individuals with such a diagnosis were at increased risk of life threatening infections (hazard ratio for any stress related disorder was 1.47 (95% confidence intervals1.37 to 1.58) and for PTSD was 1.92 (1.46 to 2.52)). Corresponding estimates in the population based analysis were similar (1.58 (1.51 to 1.65) for any stress related disorder, P=0.09 for difference between sibling and population based comparison, and 1.95 (1.66 to 2.28) for PTSD, P=0.92 for difference). Stress related disorders were associated with all studied life threatening infections, with the highest relative risk observed for meningitis (sibling based analysis 1.63 (1.23 to 2.16)) and endocarditis (1.57 (1.08 to 2.30)). Younger age at diagnosis of a stress related disorder and the presence of psychiatric comorbidity, especially substance use disorders, were associated with higher hazard ratios, whereas use of selective serotonin reuptake inhibitors in the first year after diagnosis of a stress related disorder was associated with attenuated hazard ratios.ConclusionIn the Swedish population, stress related disorders were associated with a subsequent risk of life threatening infections, after controlling for familial background and physical or psychiatric comorbidities.
| S-EPMC6812608 | biostudies-literature
Project description:BackgroundLong-term exposure to fine particulate matter (PM2.5) may increase the risk of neonatal infections. To show the effects of PM2.5 on neonatal infections as well as the trends of the effect, we studied the burden measured by the age-standardized mortality rate (ASMR) and the age-standardized disability-adjusted life years rate (ASDR) and its trends with the socio-demographic index in 192 countries and regions from 1990 to 2019.MethodsThis is a retrospective study that uses the Global Burden of Disease Study 2019 database. The age-standardized mortality rate and age-standardized disability-adjusted life years rate are used to measure the burden of PM2.5-related neonatal infections in different countries and regions. The annual percentage changes and the average annual percentage changes are used to reflect the trends over the years (1990-2019) and are calculated using a Joinpoint model. The relationship of the socio-demographic index with the ASMR and ASDR is calculated and described using Gaussian process regression.ResultsWith the rapid increase in the global annual average of PM2.5, the global burden of PM2.5-related neonatal infections has increased since 1990, especially in early neonates, boys, and low-middle SDI regions. Globally, the ASMR and ASDR of PM2.5-related neonatal infections in 2019 were 0.21 (95% CI: 0.14, 0.31) and 19.06 (95% CI: 12.58, 27.52) per 100,000 people, respectively. From 1990 to 2019, the ASMR and ASDR increased by 72.58% and 73.30%, and their average annual percentage changes were 1.9 (95% CI: 1.3, 2.6) and 2.0 (95% CI: 1.3, 2.6), respectively. When the socio-demographic index was more than 0.60, it was negatively related to the burden of PM2.5-related neonatal infections. Surprisingly, the burden in low SDI regions was lower than it was in low-middle and middle SDI regions, while high-middle and high-SDI regions showed decreasing trends.InterpretationBoys bore a higher PM2.5-related neonatal burden, with male fetuses being more likely to be affected by prenatal exposure to PM2.5 and having less of a biological survival advantage. Poverty was the root cause of the burden. Higher SDI countries devoted more resources to improving air quality, the coverage of medical services, the accessibility of institutional delivery, and timely referral to reduce the disease burden. The burden in low SDI regions was lower than that in low-middle and middle SDI regions. One reason was that the benefits of medical services were lower than the harm to health caused by environmental pollution in low-middle and middle SDI regions. Moreover, the underreporting of data is more serious in low SDI countries.ConclusionsIn the past 30 years, the global burden of PM2.5-related neonatal infections has increased, especially in early neonates, boys, and low-middle SDI regions. The huge difference compared to higher SDI countries means that lower SDI countries have a long way to go to reduce the disease burden. Policy makers should appropriately allocate medical resources to boys and early newborns and pay more attention to data under-reporting in low SDI countries. In addition, it is very necessary to promulgate policies to prevent and control air pollution in countries with large and increasing exposure to PM2.5 pollution.
| S-EPMC9105282 | biostudies-literature
Project description: Not available
| S-EPMC1123835 | biostudies-literature
Project description:BackgroundSerious life-threatening and life-limiting illnesses place an enormous burden on society and health systems. Understanding how this burden will evolve in the future is essential to inform policies that alleviate suffering and prevent health system weakening. We aimed to project the global burden of serious health-related suffering requiring palliative care until 2060 by world regions, age groups, and health conditions.MethodsWe projected the future burden of serious health-related suffering as defined by the Lancet Commission on Palliative Care and Pain Relief, by combining WHO mortality projections (2016-60) with estimates of physical and psychological symptom prevalence in 20 conditions most often associated with symptoms requiring palliative care. Projections were described in terms of absolute numbers and proportional change compared with the 2016 baseline data. Results were stratified by World Bank income regions and WHO geographical regions.FindingsBy 2060, an estimated 48 million people (47% of all deaths globally) will die with serious health-related suffering, which represents an 87% increase from 26 million people in 2016. 83% of these deaths will occur in low-income and middle-income countries. Serious health-related suffering will increase in all regions, with the largest proportional rise in low-income countries (155% increase between 2016 and 2060). Globally, serious health-related suffering will increase most rapidly among people aged 70 years or older (183% increase between 2016 and 2060). In absolute terms, it will be driven by rises in cancer deaths (16 million people, 109% increase between 2016 and 2060). The condition with the highest proportional increase in serious-related suffering will be dementia (6 million people, 264% increase between 2016 and 2060).InterpretationThe burden of serious health-related suffering will almost double by 2060, with the fastest increases occurring in low-income countries, among older people, and people with dementia. Immediate global action to integrate palliative care into health systems is an ethical and economic imperative.FundingResearch Challenge Fund, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London.
| S-EPMC6560023 | biostudies-literature
Project description:Background:The limited availability of microbiology services in sub-Saharan Africa impedes accurate diagnosis of bacterial pathogens and understanding of trends in prevalence and antibiotic sensitivities. We aimed to characterize bacteremia among hospitalized children in The Gambia and to identify factors associated with bacteremia and mortality. Methods:We prospectively studied children presenting with suspected severe infection to 2 urban hospitals in The Gambia, between January 2013 and September 2015. Demographic and anthropometric data, clinical features, management, and blood culture results were documented. Urine screens for antibiotic activity were performed in a subset of participants. Results:Of 411 children enrolled (median age, 29 months; interquartile range, 11-82), 79.5% (325 of 409) reported prehospital antibiotic use. Antimicrobial activity by urinary screen for antibiotic activity was detected in 70.8% (n = 80 of 113). Sixty-six bacterial pathogens were identified in 65 (15.8%) participants and Staphylococcus aureus predominated. Gram-positive organisms were more commonly identified than Gram-negative (P < .01). Antibiotic resistance against first-line antimicrobials (ampicillin and gentamicin) was common among Gram-negative bacteria (39%; range, 25%-100%). Factors significantly associated with bacteremia included the following: gender, hydration status, musculoskeletal examination findings, admission to the Medical Research Council The Gambia at London School of Hygiene & Tropical Medicine hospital, and meeting sepsis criteria. Those associated with increased mortality were presence of a comorbidity, clinical pallor, tachypnea, and altered consciousness. Tachycardia was associated with reduced mortality. Conclusions:The bacteremia rate in children with suspected childhood life-threatening infectious diseases in The Gambia is high. The pattern of pathogen prevalence and antimicrobial resistance has changed over time compared with previous studies illustrating the importance of robust bacterial surveillance programs in resource-limited settings.
| S-EPMC6798247 | biostudies-literature
Project description:Groin pain is a frequently occurring complaint in presentations to the Emergency Department. Muscular sprain is often a differential diagnosis, however serious conditions such as pyomyositis should not be ignored. This case report presents a child with atraumatic right groin pain, which was initially diagnosed as a muscular sprain. The patient later re-presented out of hours to the Emergency Department with what was found to be extensive pelvic abscesses. He was subsequently found to have bilateral pneumonia and later developed a pericardial effusion and osteomyelitis of the right iliac bone, sacroiliac joint and sacrum. With multiple surgical interventions and appropriate antibiotics, he made a full recovery and was discharged home after a total admission time of 41 days. The causative organism was found to be Panton-Valentine leucocidin-positive methicillin-susceptible Staphylococcus aureus.
| S-EPMC5990082 | biostudies-literature
Project description:The opioid epidemic has increased hospital admissions for serious infections related to opioid abuse. Our findings demonstrate that addiction medicine consultation is associated with increased treatment for opioid use disorder (OUD), greater likelihood of completing antimicrobial therapy, and reduced readmission rates among patients with OUD and serious infections requiring hospitalization.
| S-EPMC6522678 | biostudies-literature