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Öztürk B, Yaradilmiş RM, Azapağasi E, Öztürk Z, Fettah A, Tuygun N. Attention to diseases that re-emerge due to refusal of vitamin K: an infant case. Blood Coagul Fibrinolysis 2023; 34:118-121. [PMID: 36719808 DOI: 10.1097/mbc.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Intramuscular vitamin K injection is recommended for all newborns to prevent bleeding. However, the number of parents who reject vitamin K is at an increase. We present a 1-month girl who presented with haemorrhagic shock due to extraordinary intra-thoracic bleeding. The patient was treated with thoracentesis and blood transfusion. Parents were informed the about the benefits of Vitamin K and they were convinced to continue a routine immunization programme.
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Affiliation(s)
- Betül Öztürk
- Department of Pediatric Emergency, University of Health Sciences, Dr Sami Ulus Maternity and Children's Education and Research Hospital
| | - Raziye Merve Yaradilmiş
- Department of Pediatric Emergency, University of Health Sciences, Dr Sami Ulus Maternity and Children's Education and Research Hospital
| | - Ebru Azapağasi
- Department of Pediatric Intensive Care, Gazi University Faculty of Medicine
| | | | - Ali Fettah
- Department of Pediatric Hematology-Oncology, University of Health Sciences, Dr Sami Ulus Maternity and Children's Education and Research Hospital, Ankara, Turkey
| | - Nilden Tuygun
- Department of Pediatric Emergency, University of Health Sciences, Dr Sami Ulus Maternity and Children's Education and Research Hospital
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Gaps in the coverage of vitamin K 1 prophylaxis among newborns in India: insights from secondary analysis of data from the Health Management Information System. Public Health Nutr 2021; 24:5589-5597. [PMID: 34431473 DOI: 10.1017/s1368980021003670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Despite operational guidelines, anecdotal evidence suggests that newborn vitamin K1 prophylaxis is not practiced routinely in India. This study determined the coverage of vitamin K1 prophylaxis among newborns in the country. DESIGN Nationwide cross-sectional data on live births and newborns receiving vitamin K1 during the 2019-2020 reporting period were abstracted from the Health Management Information System (HMIS). The coverage estimates of newborn vitamin K1 prophylaxis were derived nationally and also for individual states and union territories (UT). Additionally, coverage heterogeneities were investigated using classifiers, viz. geography, socio-demographic index (SDI), special developmental categories and institutional birth rate (IBR). SETTING India. PARTICIPANTS 20 208 804 newborns documented with HMIS. RESULTS Vitamin K1 was administered to overall 62·36 % newborns (95 % CI: 62·34 to 62·38 %). The Central zone (49·0 %), low SDI states (54·39 %), Empowered Action Group states (53·32 %) and states with low IBR (44·69 %) had the lowest coverage amongst their respective groupings. Across the individual states and UT, the coverage ranged widely from 22·18 % (in Tripura) to 99·38 % (in Puducherry), exhibiting considerable variability (coefficient of variation: 33·74 %) and inequality (Gini coefficient: 0·17). While the coverage in eight states/UT (i.e. Arunachal Pradesh, Manipur, Nagaland, Tripura, Uttar Pradesh, Uttarakhand, Telangana and Andaman & Nicobar Islands) was below 50 %; only five states/UT (i.e. Chandigarh, Gujarat, Goa, Puducherry and Tamil Nadu) achieved above 90 % coverage. CONCLUSION Vitamin K1 prophylaxis was not practiced in more than one-third newborns in India. It calls for identifying the barriers, addressing the gaps and implementing newborn vitamin K1 prophylaxis more effectively throughout the country.
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Islam MS, Al-Masud A, Maixenchs M, Cossa S, Guilaze R, Diarra K, Fofana I, Hussain F, Blevins J, Kone A, Arifeen SE, Mandomando I, Bassat Q, Sage EO, Gurley ES, Munguambe K. Rumor surveillance in support of minimally invasive tissue sampling for diagnosing the cause of child death in low-income countries: A qualitative study. PLoS One 2021; 16:e0244552. [PMID: 33507902 PMCID: PMC7842994 DOI: 10.1371/journal.pone.0244552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022] Open
Abstract
In low-and middle-income countries, determining the cause of death of any given individual is impaired by poor access to healthcare systems, resource-poor diagnostic facilities, and limited acceptance of complete diagnostic autopsies. Minimally invasive tissue sampling (MITS), an innovative post-mortem procedure based on obtaining tissue specimens using fine needle biopsies suitable for laboratory analysis, is an acceptable proxy of the complete diagnostic autopsy, and thus could reduce the uncertainty of cause of death. This study describes rumor surveillance activities developed and implemented in Bangladesh, Mali, and Mozambique to identify, track and understand rumors about the MITS procedure. Our surveillance activities included observations and interviews with stakeholders to understand how rumors are developed and spread and to anticipate rumors in the program areas. We also engaged young volunteers, local stakeholders, community leaders, and study staff to report rumors being spread in the community after MITS launch. Through community meetings, we also managed and responded to rumors. When a rumor was reported, the field team purposively conducted interviews and group discussions to track, verify and understand the rumor. From July 2016 through April 2018, the surveillance identified several rumors including suspicions of organs being harvested or transplanted; MITS having been performed on a living child, and concerns related to disrespecting the body and mistrust related to the study purpose. These rumors, concerns, and cues of mistrust were passed by word of mouth. We managed the rumors by modifying the consent protocol and giving additional information and support to the bereaved family and to the community members. Rumor surveillance was critical for anticipating and readily identifying rumors and managing them. Setting up rumor surveillance by engaging community residents, stakeholders, and volunteers could be an essential part of any public health program where there is a need to identify and react in real-time to public concern.
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Affiliation(s)
- Md Saiful Islam
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
- School of Public Health and Community Medicine, UNSW, Sydney, Australia
- * E-mail:
| | - Abdullah Al-Masud
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Maria Maixenchs
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Saquina Cossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Rui Guilaze
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | - Issa Fofana
- Center for Vaccine Development, Bamako, Mali
| | - Faruqe Hussain
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - John Blevins
- Emory Global Health Institute, Atlanta, GA, United States of America
| | - Ahoua Kone
- Emory Global Health Institute, Atlanta, GA, United States of America
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Quique Bassat
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Barcelona, Spain
- Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Emily S. Gurley
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Faculty of Medicine, Eduardo Mondlane Universities, Maputo, Mozambique
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The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study. CHILDREN-BASEL 2020; 7:children7030022. [PMID: 32244943 PMCID: PMC7140801 DOI: 10.3390/children7030022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 11/17/2022]
Abstract
Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child’s case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted.
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