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Torborg A, Meyer H, El Fiky M, Fawzy M, Elhadi M, Ademuyiwa AO, Osinaike BB, Hewitt-Smith A, Nabukenya MT, Bisegerwa R, Bouaoud S, Abdoun M, El Adib AR, Kifle Belachew F, Gebre M, Taye DB, Kechiche N, Fadalla T, Abdallah B, Chaibou MS, Nyarko MYA, Ki KB, Shalongo S, Mulwafu W, Thomson E, Traore MM, Ndonga A, Bittaye M, Samateh AL, Munlemvo DM, Kalongo JJ, Coulibaly Y, Coulibaly Y, Ravelojaona V, ANDRIAMANARIVO L, RAHERISON AR, RANDRIAMIZAO HMR, RAMKALAWAN K, Omar MA, Ndikontar R, Joseph D, Dahir S, Mohamed M, Ali Daoud H, Ndarukwa P, OTIOBANDA GF, Banguti P, Neil K, Derbew M, Fanny M, Smalle I, Taylor EH, Duvenage H, Hardy A, Kluyts H, Pearse R, Biccard B, AARON OI, Abd Elazeem Mohammed HAS, Abdalkarim B, Abdalla A, Abdallah MAA, Abdeewi S, Abdel Ghafar T, Abdelaleem A, Abdelaleem IA, Abdelgader K, Abdelgadir W, Abdelhafez M, Abdelhalim A, Abdelkabir M, Abdelkader Osman M, Abdelkarim M, Abdelkarim M, Abdelmohsen SM, Abdelnassir M, Abdelrahman ASM, Abdelwahed AE, Abdelzaher M, Abderrahim BA, Abdoulaye T, Abdulai S, Abdulghaffar YA, Abdullah F, Abdullahi LB, Abdullahi M, Abdulrazik S, Abdulsalam KI, Abdulwahed E, Abdus-Salam R, ABE TOLUSHE, Abera Mulugeta G, Aboelghait AA, Abol Oyoun N, Aboubekr B, Abraham M, Abu M, Abuagila AA, Abubakar M, Abugilah M, Abuzeid IA, Achouri D, Acquah SA, Adam NBA, ADAMU AUWAL, Adamu KM, ADAMU MUHAMMAD, ADAMU S, Adane SG, Adeaga M, Adebayo S, Adedire A, Adegoke PA, Ademuyiwa AO, Adeniyi AA, Adeoye I, Aderibigbe G, ADEROUNMU A, ADEYEMI WILLIAMS, ADEYEMO A, Adigun T, Adika ED, ADISA AO, Adjei E, Adjepong-Tandoh EK, Ads AM, ADUMAH DCC, ADUMAH LO, Adzamli I, Afari J, Afedo W, Affan A, AFOLAYAN AO, Agaba S, Agbeno E, Agbonrofo P, Aghadi I, AGU EDITH, Agyen T, Agyen-Mensah K, Ahensan D, Ahmad MH, AHMED A, Ahmed L, Ahmed NYAA, Ahmed R, Ahmed Jroush M, ahmed maghur H, AHOGNI GG, Ait Yahia S, Aji N, Aji SA, Akerele W, Akhideno I, Akinmokun I, AKINNIYI AT, Akinniyi A, AKINYEMI S, Akitoye OA, AKPAETTE IC, Akuma TJ, Akuokor D, Akwei CNA, Al Bashir RBH, Al Gharyani MF, al Islam ben Jouira R, Aladelusi T, Alakaloko F, Alameen H, Alameen Moheyaldeen M, Alaogaly M, Alarabi R, Alawami M, Alazabi BM, Alazabi M, Albakosh BA, ALBDULRRAZIQ HUSAYNMOHAMMEDE, Aldieb A, Aldressi W, Alegbeleye GE, Alfa Y, Alhadad Q, Alhaddad AR, Alhaddad HF, Alhadi A, Alhamali A, Alharam A, Alhlafi M, Alhouwasi B, Alhudhairy S, Ali AMA, Ali AJ, Ali A, Ali A, Ali E, Ali M, Ali S, Ali YY, Ali Ahmed A, Aliozor S, Aljamal S, Alkaseek A, Alkhalifa E, Alkoni S, Allie A, Almelyan K, Almugaddami A, Almujreesi A, Alqady E, Alragheai AA, Alshareea E, Alshareef A, Alsori M, Altomy SA, Al-Touny A, Al-Touny SA, Alum Aguma R, Alwaer NM, Al-zletni H, Alzwai M, Amaambo N, Amah CC, Amary M, Amengle LA, Amesho SLO, Ametepe M, Amkhatirah E, Amnaina MG, Amoah B, Amoah JK, Amo-Aidoo NAS, Amoako-Boateng M, Ampong J, Anane-Fenin B, Anarfi S, Andriamanarivo ML, Aniakwo L, Aniteye E, Ankrah LNA, Anno A, Anyanwu LJC, Anyigba E, Appeadu-Mensah W, Appiah-Thompson P, Apraku-Peprah EL, Aremu SK, Arinaitwe M, Armah R, Arthur A, Arthur D, Asah-Opoku K, Asante M, Asante-Asamani A, Asare A, Asasira L, Ashfersh M, ASHINDOITIANG JA, Ashong J, Ashraf Salah M, Asiedu C, Asiedu I, Asiyanbi K, Asla A, Asman W, Asoegwu EJ, Assalhi M, Assim C, Asudo FD, Atai AG, Ateeqa SB, Atim T, Atindama S, ATIQUI IJLAL, Atrih Z, Attah RA, Awad AK, Awedew AF, Awedew AF, Aween H, Awere-Kyere L, Awindaogo J, Awori Achani M, Ayad K, Azab A, Azas A, Aziza B, Azize DA, AZOUI A, Azouz J, Baba S, Babalola OF, Babiker M, Baddoo D, Badi A, BADMUS SA, Badr H, Bah A, Bah FY, Bah K, Bah MT, Bahroun S, Baidoo E, Baidoo K, Baidoo R, Bakare A, Bakeer HB, Baky Fahmy MA, Balogun J, Bamigboye B, Bankah P, Banson M, Barhouma YE, Barongo M, BASHIR RABIU MOHAMMED, Bassem A, Bedair MAA, Beeharry HR, Beeharry S, Bekele S, Belie O, Belkhair A, Ben Ahmed Y, Ben Ashur A, Ben Hamida B, Benade C, BENMANSEUR S, Bensebti AA, BERDAI MA, Beyuo V, Biala M, Bilson-Amoah E, Bin wali SS, Binnawara M, Birlie Chekol W, Birqeeq G, Biyase T, Blankson PK, Boakye B, Boakye B, Boakye-Acheampong K, Boakye-Yiadom K, Boateng J, Bobaker S, Bode C, Bogoslovskiy A, Bolarinwa ES, Boretti L, Botchway MT, Botha C, BOUDA BD, BOURENANE H, BOUZBID S, Boye J, Branny M, Brown GD, Brown W, Bua E, BWALA KEFASJOHN, Camara B, Camara ML, Carol T, Ceesay W, Chafee K, Chaklie Agegnehu B, Chamir C, Chaziya PYC, Chellan C, Cheniki N, Chennouf S, Chepkoech E, Chilango C, Chinda JY, Chokwe TM, Choutri H, Christian NA, Chukwu I, Chummun G, Cilliers C, Cloete E, Collison C, Cronje L, Daary D, DAD B, Daddy H, Dahilo EA, Dairam J, Dalaf MS, Damson P, Daneji SM, Daniel A, Daoud A, Daoud H, Darat TD, Darko KO, Darko K, Davidson K, Davies A, Dawang YD, Dayal K, Dayie M, de Goede A, de Goede A, Deelawar BW, Derwish K, Desalu I, Dessalegn Beza A, Dhege C, Dhilraj D, Diallo TS, Diaw M, Diaw Diop A, DIENE M, Dieng M, Dippenaar T, Djagbletey R, Djedid NK, Djouonang KT, Dominique S, Drammeh B, Drissi H, du Bruyn A, Dube T, Dufe R, Dung D, Earl E, Ebrahem OKA, Ebrahim Z, Edena ME, Effa Ngono R, Egbuchulem K, Egdeer A, Eguma SA, Ehimhantie M, EJIOFOR OC, Ejuma LO, Ekenze S, Ekhmaj RA, Ekor O, EKPA S, Ekpemo CS, Ekudo J, Ekwunife OH, El Koraichi A, El Magrahi H, El Mejrab M, El Sadek R, El YOUBI H, Eladani O, Elamesh SAH, Elamien M, Elamin Elnour MA, Elbadawy MA, Elbaseet H, Elderwy AA, Elebute O, Elgamal M, Elgenidy A, Elghareeb A, Elgherwi L, Elhadad R, Elhadi A, Elhassan M, Elkhouly AM, Ellebedy M, ELMAJRI MOHAMEDFUAD, Elmandouh O, Elmandouh R, Elmorsi R, ELOMBILA M, Elsadek M, Elsalhawy S, Elsayem K, Elshafiey M, El-Sharkawi M, Elshazly M, Eltaub D, Eltayeb AA, Eltayeb MEZ, Eltegani Abdalla A, ElWakeel M, Embu H, Emoru A, Enicker B, Enti D, Entsua-Mensah K, Eseile SI, Essuman VA, Et-taghy H, Etwire V, Eyaman KD, Ezbeida M, EZEKIEL ANTHONYSABO, Ezidiegwu SU, Ezomike UO, FABOYA O, Fadlalmola H, FAGBAYIMU OM, Faida H, FALL K, Farahat S, Faraj A, Faraj N, Farghaly A, Farhat KOA, Farinyaro AU, Fathi Bani G, Fattah A, Fawzy M, Fening N, Fentahun Emrie A, Fidieley M, Fikadu Keneni D, Fischer M, Flint M, Fodo N, Fofana N, Fokeerah N, Folami E, Folokwe S, Fonternel D, Fosi Kamga G, Fotso LK, Fourtounas M, Frankish L, Gabier I, Gacii VM, Gaffoor MS, Gagara M, GALADIMA HA, Gamubaka R, Ganey M, Ganiyu OO, Gasa N, Gatheru AP, Gawu VS, Gaya SSD, GAYE I, Gebremichael Ganta A, Gelaw KG, Geldenhuys L, Getachew Tegegn A, Ghemmied M, Ghmagh R, GILES AHEREZA, Ginsburg RG, Girma K, Gjam F, Glover-Addy H, Gobin V, Gomeh P, Gomez D, Gorelyk A, Gossaye A, Govender V, Grant J, Grayson BL, Grobbelaar M, Gueye KR, GUIRO H, Gumede S, Gurure D, Gusibat A, Gyeke-Boafo NK, HACHEMI S, Haddis K, Haidar A, Haif A, Hameed-Ikram S, Hamid H, Hamukwaya D, Hanson NA, Hanzi J, Hardcastle T, Harissou A, Hasan A, Hasan HB, Hasan NB, Hashi AS, Hashish AA, Hassaan I, Hassan S, Hassan SA, Hassan T, Hassan Z, Hassane ML, Hassanein M, Hawu Y, Haywood D, Heelan H, Hendricks N, Hillah A, Hlela Q, HMAMOUCHI B, Hoko Z, Honny D, Honore S, Houidi S, Human T, Hussain E, Hussain Kona MH, Hussein Y, Ibekwe TS, Ibiyemi A, IBIYEYE TAIBAT, Ibrahim IA, Ibrahim LI, Ibrahim S, Ibrahim Abubakar A, Ibrahim Alain T, Idipo F, Idoko G, Idowu O, Idris MEA, Igaga EN, Iindongo E, IITULA P, IKOTUN O, ILLE G, Imposo DH, Invernizzi J, Irungu E, Isbayqah AM, Isbayqah EM, Ismael G, Ismail AM, Itambi AM, Jabang JN, Jaga R, Jaganath U, Jaiteh L, Jallow CS, James O, Javed S, Jithoo S, Jlidi S, Joel L, Johnson M, JONES TAIWO, Jooma Z, Joomye S, Joosab M, JOUINI R, Jubail MJ, Juggoo C, Jumbi TM, Kaabar N, Kabirou M, Kabiru AM, Kabre BY, Kache S, Kacimi SEO, KADAS ABUBAKARSAIDU, KAHANSIM B, Kalipa M, Kalongo JJK, Kalu NE, Kamate B, Kamwangen GM, Kandjimi M, Kanjana-Zondo N, Kankpeyeng L, Kapalamula T, Karadji S, Kargbo MA, Karghul M, Kaskar R, Kasker R, Kasobya F, Kassem O, Kateregga G, Kayima P, Kedwany AM, Ken-Amoah S, Kenneth TK, KERISSE ANEH, KERKENI Y, Khairi R, Khaled M, Khalifa E, Khalifa MS, Khalil MK, Khattab MSI, Khodary AR, Khumalo BF, Khumalo P, Kigayi JP, Kimutai TK, KINDO B, KIRFI ABDULLAHIMUSA, Koggoh P, Koko AA, Kopieniak M, Kotagiri C, Kotey E, Kouicem AT, Kpangkpari R, Kudoh V, Kufonya N, Kuhn W, Kutor J, Kwakye A, Kynes JM, Lambrechts L, Lamiri R, LANRE OLOKONASIRUDEEN, Larvie P, Lateef AK, LATRECHE S, Lawal T, Leballo G, Lebereki S, Lee D, Leeb G, Leonard T, LEYONO-MAWANDZA PDG, Likongo TB, Limalia Z, LIMAN HARUNAUSMAN, Loae N, Lompoli BNE, Lusungu D, M.Mokhtar FALZ, Madany MEDM, Maddy RJ, Madombwe G, Mafabi S, Magashi MK, Maharaj S, Mahfouz SM, Mahlare KRV, Mahmoud F, Maikassoua M, Maison P, Maiwald D, Makhoba P, Makinita SG, Makou epse Tolefac M, Malau TK, Mamathuntsha TG, Mamo TN, Mamuda A, Mandundzo P, Mangray H, Mani S, Manneh EK, Mansour NM, Manyere DV, Mapurisa A, Mare P, Martin ME, Mashaal A, Mashaya S, Masilela PB, Mathebula R, Mathinya T, Matlala TK, Matlou M, Matos-Puig R, Matoug S, Maudarbocus MJ, Mavesere HP, Mavila J, Mayet S, Maygag M, Mbatha N, Mbatudde R, Mbiya Kapinga A, Mbuyamba J, Mbuyi AT, Mdlalose N, Prowling M, Mejeni N, Mekonnen Ejigu Y, Merghani S, Metogo JEN, Mhiri R, Mhone L, Michael A, Miko AM, Milad A, Mishra R, Mjadu L, Mkhontwana N, Mlambo N, Mncwango Z, Mngoma G, Mnguni M, Modekwe VI, Mogane P, Moghazy R, Mogotsi K, Mohalal MS, Mohamed AAA, Mohamed M, Mohamed MEE, Mohamed SA, Mohamedkheir MA, Mohammad AL, Mohammad AD, Mohammad AM, Mohammed A, Mohammed M, Mohammed RI, Mohammed R, Mohammed TSA, Mohammedosman D, Mohsen SM, Molla Getahun A, Moloisi M, Monib FA, Moodley K, Moopanar M, Morgan F, Moris B, Morna M, Moses V, Mostafa MM, Motiang M, Motseoile T, Motshabi P, MOUSSAOUI N, Mpoto DB, MPOY EMY MONKESSA CM, MRARA BUSISIWE, Mshelbwala PM, Msherghi A, Msibi T, Mubunda RK, Muhammad AB, Muhammad S, Muhanguzi J, Muhindo R, Mukenga MM, Mukuna PM, Mulewa D, Munanzvi KS, Mungur L, Munubi A, Munyalo FS, Muriithi JM, Musa AA, Musa K, Musa MAE, Musana F, Musewu TD, Musiitwa AK, Mwangi CM, Mwepu IM, Mwepu MI, Mwika PM, Mwiti TM, Myeni P, Mzoneli N, Naana R, Nabukenya G, Nabunya S, Naidoo A, Naidoo V, Naidu P, Nakyanzi C, Nambi E, Nampawu MJ, Nampiina G, Namutebi H, Nana B, Nanda JSY, Nanimambi J, Nantongo B, Napolitano L, Naser A, Nassar AS, Nassar MS, Nasser N, Nawezo JG, NDIAYE A, NDIAYE CAT, Ndiaye F, Ndibarekera SH, Ndjoko SM, Ndlovu M, Nduwayezu R, Negash S, Nehema S, Neil K, Neizer M, NEJMI S, Nezam-Parast M, Ng How Tseung K, Ngcelwane T, Ngene I, Nghidinwa H, Ngissah R, Ngock GFFN, Ngouane D, Ngumi Z, Nibret Y, NIENGO OUTSOUTA G, Njie M, NJOKANMA RA, Nkhata L, Nkhuna NT, Nkosi N, Nkosi S, Nkwembe CM, Nnaji C, Nneji-Akazie T, Nongqo N, Nortey M, Noutakdie Tochie J, Nsaful J, Nsimire BB, Nte SK, Ntshingila C, Ntsie NP, Ntsoane D, Ntumy MY, Nuer-Allornuvor G, Nuhu S, Nutsuklo P, Nwachukwu CU, NWAFULUME NNAEMEKA, Nwangwu E, Nwankwo EP, Nyame CA, Nyamekye E, Nyankah E, Nyoka-Mokgalong C, Oase D, Obande JO, Obbeng A, Obeng-Adjei GI, Obianyo I, Obianyo NE, Obiechina S, OBRI AI, ODI TEMITOPE, Odingo J, Oelofsen S, Ofori E, Ofori-Adjei D, Ogaji IM, Ogundoyin OO, OGUNLEYE OLABISI, OGUNS A, Ogunsua O, Ohemeng-Mensah E, Ojediran O, Ojediran O, Ojewuyi A, Ojewuyi O, Ojo A, OJO OO, Ojo O, Okedare A, Okenwa SC, Oko AG, Okojie N, Okonkwo LN, Okoth P, Okunlola AI, Okunlola CK, Okurut M, Oladimeji M, Oladiran A, Olagunju GR, Olajide ARL, Olajide AT, Olang PR, Olayinka O, Olori S, Olulana D, Olulana DI, Olusanya B, Omar DE, Omar MA, Onakpoya U, ONeil M, Onen H, ONYEKA C, Oosthuizen A, Opandoh I, Opiyo S, Oppong J, Orewole TO, Orji M, Osagie O, Osagie OT, Osaheni O, Osama Sleem A, Osawa FO, Osei F, Osei-Nketiah S, Osei-Poku D, Osman A, Osman Ahmed M, Osman Suliman SO, Otchere K, Othman AAA, Othman E, Othman M, Otim P, Otim T, Otman RH, Otoki V, OUDJHIH M, OUEDRAOGO I, OUEDRAOGO PJ, Ousmane Hamady I, Ouyahia A, OWOJUYIGBE A, Owoo C, Owoo P, Owusu Boamah M, Oyedele A, Oyedepo O, Oyegbola C, Panday J, Parker EUE, Parker I, Parker RK, Pembe JN, Percivale B, Pereko J, Pérez M, Perumal N, Pillay L, Pretorius R, Prinsloo R, Pryce C, Puryag A, QUADRI OR, Quansah K, Quarcoopome C, Quarshie A, Quartson E, Quashie-Sam J, Rabiu A, Rabiu T, Rahma M, Rahman GA, Rais M, Rajah C, Rakotondrainibe A, Ramakrishnan R, Ramatou S, Ramdawon B, Ramdhani K, Ramkaun Y, RAPHAEL OSELE, Raslan HMA, Redelinghuys C, Riffi O, Rikhotso H, Roberts CAP, Robertson C, Roland N, Roos J, S. Abdalgadir E, Saad A, Saad MM, Saad El-Tanekhy A, Saadi C, Saadu T, Saber M, Sabir Yassin FM, Sabo VY, Sabra TA, Saeid DA, Safar A, Sagboze S, Sahnoun L, Salahu BM, Salami K, Salawu AI, Saleh H, Saleh IA, Saleh KM, Salele AM, Salem F, Salem O, Salih MAIA, Salisu I, Sall M, SAMB CF, Sangak IA, Sanoussi NM, Sanya D, Sanyang AB, Sarpong P, SARR JN, Schnaubelt R, Searyoh K, SECK NF, Secka AS, Seif M, Seilbea Y, Semret Hailu B, Sepenu P, Sewlall J, Seyi-Olajide J, Shai S, Shalaby AMO, SHAPHAT IBRAHIM, Shava G, Sheidu Owuda A, Sheshe AA, Shetiwy M, Shezi N, Shihab MH, Shitakumuna H, Shitaye N, Shitta AH, Sholadoye TT, Shouasha P, Shu'aibu NG, Shuiap NM, Sibeko B, Sikhakhane S, Sikwete G, Sime Gizaw H, Simelane N, Simon E, Singh U, SIRAJALDIN A, Siriboe E, Siyothula T, Siyotula T, Smart-Yeboah A, SMITH S, Solala S, Soliman EA, Solo CE, Sombéwendin Charles I, Sonaike M, Songden DZ, Sottie D, Soualili Z, Soula E, Souleymane S, SOWANDE OA, Spytko A, Srir DOM, Ssebuguzi L, Stegmann GF, Strauss L, Struwig E, Succi M, Suleiman AR, Suliman M, Swartz M, Taha TM, Takai IU, Takou BH, Takrouney MH, Takure A, TALABI AO, Tall M, Taute C, Tawfik M, Taylor J, Tembe DS, Temesgen F, Tesfaye E, Theko D, Thiart M, Thompson R, Thuer L, Tientcheu Fabrice T, Tilahun ZB, Tilahun Woldetsadik T, Timo M, Timotews N, Tjiyokola D, Tolani MA, TOUABTI S, Traoré D, Tsegha LJ, Tseli M, Tumuhimbise C, Tumukunde J, Tunkara SFS, Turshan L, Turton E, Uchendu CC, UDIE GU, UDOSEN JE, Ugalahi M, Ugwu EM, UGWU IE, Ugwu JO, Ugwunne CA, Ukpabio UE, Umar AM, UMEH CL, Ungen R, Usang U, Usenbo T, Usman MI, UWAYESU R, Van Aswegen B, van der Byl A, van der Linde P, van der Walt S, van Schalkwyk HP, van Tonder C, van Vuuren S, van Wyk J, van Zyl S, Wabule A, Wacays A, Waheed Mowafy G, Waisiko B, Walawah D, Walithandia E, Wamwaki J, Wataaka N, Wessels N, Wessels N, Williams E, WILLIAMS O, Woldegiorgis A, Wolfaardt G, Wondossen M, Woodun R, Workineh ST, Wubetu S, Yahia M, Yakubu H, Yakubu SY, Yalewu DZ, YAMEOGO TAC, Yeboah F, YENYI AHUKA LONGOMBE T, Younes E, Young C, Younis N, Younus TYI, YUSUF STEPHEN, Zaki F, Zbida I, Zenda T, ZERIZER Y, Zingoni K, Zitouni H, ZONGO PV, Zubi A, Zulu N, Zulu N, Yakubu H, Yakubu SY, Yalewu DZ, YAMEOGO TAC, Yeboah F, YENYI AHUKA LONGOMBE T, Younes E, Young C, Younis N, Younus TYI, YUSUF STEPHEN, Zaki F, Zbida I, Zenda T, ZERIZER Y, Zingoni K, Zitouni H, ZONGO PV, Zubi A, Zulu N, Zulu N. Outcomes after surgery for children in Africa (ASOS-Paeds): a 14-day prospective observational cohort study. Lancet 2024; 403:1482-1492. [PMID: 38527482 DOI: 10.1016/s0140-6736(24)00103-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Safe anaesthesia and surgery are a public health imperative. There are few data describing outcomes for children undergoing anaesthesia and surgery in Africa. We aimed to get robust epidemiological data to describe patient care and outcomes for children undergoing anaesthesia and surgery in hospitals in Africa. METHODS This study was a 14-day, international, prospective, observational cohort study of children (aged <18 years) undergoing surgery in Africa. We recruited as many hospitals as possible across all levels of care (first, second, and third) providing surgical treatment. Each hospital recruited all eligible children for a 14-day period commencing on the date chosen by each participating hospital within the study recruitment period from Jan 15 to Dec 23, 2022. Data were collected prospectively for consecutive patients on paper case record forms. The primary outcome was in-hospital postoperative complications within 30 days of surgery and the secondary outcome was in-hospital mortality within 30 days after surgery. We also collected hospital-level data describing equipment, facilities, and protocols available. This study is registered with ClinicalTrials.gov, NCT05061407. FINDINGS We recruited 8625 children from 249 hospitals in 31 African countries. The mean age was 6·1 (SD 4·9) years, with 5675 (66·0%) of 8600 children being male. Most children (6110 [71·2%] of 8579 patients) were from category 1 of the American Society of Anesthesiologists Physical Status score undergoing elective surgery (5325 [61·9%] of 8604 patients). Postoperative complications occurred in 1532 (18·0%) of 8515 children, predominated by infections (971 [11·4%] of 8538 children). Deaths occurred in 199 (2·3%) of 8596 patients, 169 (84·9%) of 199 patients following emergency surgeries. Deaths following postoperative complications occurred in 166 (10·8%) of 1530 complications. Operating rooms were reported as safe for anaesthesia and surgery for neonates (121 [54·3%] of 223 hospitals), infants (147 [65·9%] of 223 hospitals), and children younger than 6 years (188 [84·3%] of 223 hospitals). INTERPRETATION Outcomes following anaesthesia and surgery for children in Africa are poor, with complication rates up to four-fold higher (18% vs 4·4-14%) and mortality rates 11-fold higher than high-income countries in a crude, unadjusted comparison (23·15 deaths vs 2·18 deaths per 1000 children). To improve surgical outcomes for children in Africa, we need health system strengthening, provision of safe environments for anaesthesia and surgery, and strategies to address the high rate of failure to rescue. FUNDING Jan Pretorius Research Fund of the South African Society of Anaesthesiologists and Association of Anesthesiologists of Uganda.
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Opler M, Negash S, Tatsumi K, Liu C, Komaroff M, Capodilupo G, Hasebe M, Echevarria B, Blattner R, Citrome L. Use of a novel study insight analytics (SIA) methodology to improve PANSS data quality and signal detection in a global clinical trial in schizophrenia. Schizophr Res 2024; 267:239-246. [PMID: 38581826 DOI: 10.1016/j.schres.2024.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 02/29/2024] [Accepted: 03/31/2024] [Indexed: 04/08/2024]
Affiliation(s)
- M Opler
- WCG Inc., New York, NY, USA.
| | | | | | - C Liu
- WCG Inc., New York, NY, USA
| | - M Komaroff
- Noven Pharmaceuticals, Inc., Jersey City, NJ, USA
| | | | - M Hasebe
- Hisamitsu Pharmaceutical Co., Inc., Tosu, Japan
| | | | | | - L Citrome
- New York Medical College, New York, NY, USA
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Yap A, Olatunji BT, Negash S, Mweru D, Kisembo S, Masumbuko F, Ameh EA, Lebbie A, Bvulani B, Hansen E, Philipo GS, Carroll M, Hsu PJ, Bryce E, Cheung M, Fedatto M, Laverde R, Ozgediz D. Out-of-pocket costs and catastrophic healthcare expenditure for families of children requiring surgery in sub-Saharan Africa. Surgery 2023; 174:567-573. [PMID: 37385869 DOI: 10.1016/j.surg.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/04/2023] [Accepted: 05/24/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Out-of-pocket healthcare costs leading to catastrophic healthcare expenditure pose a financial threat for families of children undergoing surgery in Sub-Saharan African countries, where universal healthcare coverage is often insufficient. METHODS A prospective clinical and socioeconomic data collection tool was used in African hospitals with dedicated pediatric operating rooms installed philanthropically. Clinical data were collected via chart review and socioeconomic data from families. The primary indicator of economic burden was the proportion of families with catastrophic healthcare expenditures. Secondary indicators included the percentage who borrowed money, sold possessions, forfeited wages, and lost a job secondary to their child's surgery. Descriptive statistics and multivariate logistic regression were performed to identify predictors of catastrophic healthcare expenditure. RESULTS In all, 2,296 families of pediatric surgical patients from 6 countries were included. The median annual income was $1,000 (interquartile range 308-2,563), whereas the median out-of-pocket cost was $60 (interquartile range 26-174). Overall, 39.9% (n = 915) families incurred catastrophic healthcare expenditure, 23.3% (n = 533) borrowed money, 3.8% (n = 88%) sold possessions, 26.4% (n = 604) forfeited wages, and 2.3% (n = 52) lost a job because of the child's surgery. Catastrophic healthcare expenditure was associated with older age, emergency cases, need for transfusion, reoperation, antibiotics, and longer length of stay, whereas the subgroup analysis found insurance to be protective (odds ratio 0.22, P = .002). CONCLUSION A full 40% of families of children in sub-Saharan Africa who undergo surgery incur catastrophic healthcare expenditure, shouldering economic consequences such as forfeited wages and debt. Intensive resource utilization and reduced insurance coverage in older children may contribute to a higher likelihood of catastrophic healthcare expenditure and can be insurance targets for policymakers.
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Affiliation(s)
- Ava Yap
- Center of Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, CA.
| | | | - Samuel Negash
- Department of Paediatric Surgery, Menelik II Hospital, Addis Ababa, Ethiopia
| | - Dilon Mweru
- Department of Surgery, Centre Hospitalier Bethesda, Goma, Democratic Republic of Congo
| | - Steve Kisembo
- Department of Surgery, Centre Hospitalier Bethesda, Goma, Democratic Republic of Congo
| | - Franck Masumbuko
- Department of Surgery, Hôpital Provincial Général de Reférence de Bukavu, Bukavu, Democratic Republic of Congo
| | - Emmanuel A Ameh
- Department of Paediatric Surgery, National Hospital Abuja, Abuja, Nigeria
| | - Aiah Lebbie
- Department of Surgery, Connaught Hospital, Freetown, Sierra Leone
| | - Bruce Bvulani
- Department of Surgery, University Teaching Hospital, Lusaka, Zambia
| | - Eric Hansen
- Department of Surgery, Kijabe Hospital, Kijabe, Kenya
| | | | - Madeleine Carroll
- Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Phillip J Hsu
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Emma Bryce
- Kids Operating Room, Edinburgh, Scotland, United Kingdom; Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Maija Cheung
- Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Maira Fedatto
- Kids Operating Room, Edinburgh, Scotland, United Kingdom
| | - Ruth Laverde
- Center of Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, CA
| | - Doruk Ozgediz
- Center of Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, CA
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Hussien M, Capo-Chichi N, Starr N, Johansen E, Negash S, Utam T, Negussie T, Fernandez K, Weiser TG. Correction: Exploring the Use of a Fit-for-Purpose Surgical Headlight in Sub-Saharan Africa: Mixed Methods Study. World J Surg 2023; 47:1647. [DOI: 10.1007/s00268-023-07001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Hussien M, Capo-Chichi N, Starr N, Johansen E, Negash S, Utam T, Negussie T, Fernandez K, Weiser TG. Exploring the Use of a Fit-for-Purpose Surgical Headlight in Sub-Saharan Africa: Mixed Methods Study. World J Surg 2023; 47:1633-1646. [PMID: 36864223 DOI: 10.1007/s00268-023-06952-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND High-quality surgical lighting is often lacking in low-resource settings. Commercial surgical headlights are unavailable due to high cost and supply and maintenance challenges. We aimed to understand user needs of a surgical headlight for low-resource settings by evaluating a preselected robust but relatively inexpensive headlight and lighting conditions. METHODS We observed headlight use by ten surgeons in Ethiopia and six in Liberia. All surgeons completed surveys about their lighting environment and experience using headlight, and were subsequently interviewed. Twelve surgeons completed logbooks on headlight use. We distributed headlights to 48 additional surgeons, and all surgeons were surveyed for feedback. RESULTS In Ethiopia, five surgeons ranked operating room light quality as poor or very poor; seven delayed or cancelled operations within the last year and five described intraoperative complications due to poor lighting. In Liberia, lighting was rated as "good", however fieldnotes, and interviews noted generator fuel-rationing, and poor lighting conditions. In both countries, the headlight was considered extremely useful. Surgeons recommended nine improvements, including comfort, durability, affordability and availability of multiple rechargeable batteries. Thematic analysis identified factors influencing headlight use, specifications and feedback, and infrastructure challenges. CONCLUSION Lighting in surveyed operating rooms was poor. Although conditions and need for the headlights differed between Ethiopia and Liberia, headlights were considered highly useful. However, discomfort was a major limiting factor for ongoing use, and the hardest to objectively characterise for specification and engineering purposes. Specific needs for surgical headlights include comfort and durability. Refinement of a fit-for-purpose surgical headlight is ongoing.
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Affiliation(s)
- Muaad Hussien
- Department of Surgery and Urology, Mälarsjukhuset Hospital, Eskilstuna, Sweden.
| | - Nina Capo-Chichi
- Smile Train, New York, USA
- Lifebox Foundation Inc., New York, USA
| | - Nichole Starr
- Lifebox Foundation Inc., New York, USA
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | | | - Samuel Negash
- Lifebox Foundation Inc., New York, USA
- Department of Surgery, Menelik II Hospital, Addis Ababa, Ethiopia
| | - Terseer Utam
- Lifebox Foundation Inc., New York, USA
- Department of Surgery, Redemption Hospital, New Kru Town, Monrovia, Liberia
| | - Tihitena Negussie
- Lifebox Foundation Inc., New York, USA
- Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Thomas G Weiser
- Lifebox Foundation Inc., New York, USA
- Department of Surgery, Stanford University, Stanford, CA, USA
- Department of Clinical Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK
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Negash S, Jembere T, Abera G, Kedir E, Eshetu B. Gastric outlet obstruction due to peptic ulcer disease in a 5 years-old female child. Case report. June 23, 2022. Int J Surg Case Rep 2023; 105:108086. [PMID: 37018952 PMCID: PMC10112143 DOI: 10.1016/j.ijscr.2023.108086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Gastric outlet obstruction (GOO) is a spectrum of congenital and acquired conditions that prevent the passage of gastric contents beyond the proximal duodenum. Peptic ulcer disease (PUD), which causes GOO, is extremely rare in children, with an incidence of 1 per 100,000 live births. Because of the rarity of the disease in children, we report a case of GOO due to PUD in a 5-year-old child. CASE PRESENTATION We report a case of an acquired GOO due to PUD in a 5-year-old female child who presented with vomiting, weight loss, and epigastric pain of 3 months' duration. Her diagnosis of GOO secondary to PUD was made by upper gastrointestinal (UGI) endoscopy despite a negative stool H. pylori antigen. She was managed with proton pump inhibitor (PPI), which results in improvement of signs and symptoms. She has been on follow-up for the last 6 months and has remained asymptomatic. CLINICAL DISCUSSION H. pylori-positive GOO is successfully treated with PPI and antibiotic therapy. The role of H. pylori therapy in PUD-related GOO is less clear, although eradication is warranted as a primary intervention. CONCLUSION GOO secondary to PUD may occur in the absence of Helicobacter pylori infection (HPI). Our patient demonstrated response to medical management in the acute phase of ulceration.
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Affiliation(s)
- Samuel Negash
- Department of Pediatrics, Jimma University, Ethiopia.
| | | | | | | | - Beza Eshetu
- Department of Pediatrics, Jimma University, Ethiopia
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Mekonnen B, Solomon N, Wondimu W, Tesfaye M, Negash S. Work-related disease symptoms and occupational injuries among coffee processing industry workers in Bench-Sheko and Kaffa Zones Southwest, Ethiopia: A mixed-method study. Front Public Health 2022; 10:1034957. [PMID: 36620283 PMCID: PMC9813667 DOI: 10.3389/fpubh.2022.1034957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Occupational injuries have become one of the most critical rooting causes paying to infirmities and life-threatening conditions in developed and developing countries. Workers in the coffee industry face some occupational health and safety issues. However, there is limited evidence on this important public health issue. Hence, this research was conducted to assess work-related disease symptoms and occupational injuries among coffee processing workers in Southwest, Ethiopia. Methods A cross-sectional study supplemented with a qualitative method was done. A total of 721 workers were involved in the study for quantitative information. In addition, we performed a total of 22 in-depth and five key informant interviews for generating qualitative evidence. Quantitative data was collected by an interview-based questionnaire which is adapted from similar studies. We conducted descriptive, binary logistic, and multivariable regression analysis as necessary, to ascertain the factors affecting occupational injuries. We collected qualitative data guided by an interview guide, transcribed verbatim, and analyzed using ATLAS ti version-8 by applying a content analysis approach. Finally, quotes from participants that had exemplary ideas were triangulated along with quantitative findings. Result The overall prevalence rate of work-related symptoms and occupational injuries among coffee processing workers were 21.7 and 13.4% respectively. Age group 30-39 and 40-49 (Adjusted odds ratio (AOR) 1.95, 95% CI 1.37, 2.79, (AOR 3.28, 95% CI 1.89, 5.69, respectively, income level (AOR 0.24, 95% CI 0.16, 0.36, p = 0.000), experience (AOR 1.64, 95% CI 1.04, 2.60, p = 0.034), and smoking cigarette (AOR 5.59, 95% CI 2.78, 11.26, p = 0.000) were significantly associated with the work-related symptom. In addition, training related to the job (AOR 11.88, 95% CI1.34, 105.57, p = 0.026) was significantly associated with occupational injuries among coffee processing industry workers. Conclusion The prevalence of work-related symptoms and occupational injuries was high among coffee processing industry workers in southwest Ethiopia. Therefore, there is a need for regulations for both government and industry owners to advance the occupational conditions and ergonomic structure of coffee processing industries.
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Affiliation(s)
- Besufekad Mekonnen
- Department of Environmental Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia,*Correspondence: Besufekad Mekonnen ✉
| | - Nahom Solomon
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Wondimagegn Wondimu
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Melkamsew Tesfaye
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Samuel Negash
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Trümmler J, Heumann E, Helmer SM, Stock C, Busse H, Heinrichs K, Negash S, Horn J, Niephaus Y, Pischke CR. Attitudes towards vaccination are associated with vaccination behaviour among university students. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Vaccination behaviour is influenced by various determinants. Evidence indicates a higher COVID-19 vaccine hesitancy among university students due to their age and a lower risk of complications compared to the general population in Germany. However, little is known about other COVID-19-related determinants for the population of German university students. This study aimed to investigate determinants of vaccination behaviour among German university students.
Methods
The cross-sectional COVID-19 German Student Well-being Study was conducted at five German universities at the end of 2021 via an online survey (n = 7.267). Multiple logistic regressions were calculated to examine associations of vaccination behaviour (not vaccinated vs. fully vaccinated) and attitudes towards vaccination (5Cs: confidence in the safety of the vaccine, complacency - not perceiving diseases as high risk, constraints - structural and psychological barriers, calculation - engagement in information seeking, collective responsibility - willingness to protect others), health literacy in a pandemic (CHL-P), and additional determinants.
Results
All 5Cs were associated with the vaccination status ‘fully vaccinated’, except for complacency. Regarding CHL-P, we found that students who felt that the current scientific knowledge about COVID-19 in terms of the policy decisions on pandemic measures was very complex had a higher odds for being vaccinated (OR = 3.02; 95% CI: 2.26-4.04). Regarding additional determinants, the analysis revealed that students who had been previously infected had in all regressions a lower odds for being vaccinated compared to students with no previous infection.
Conclusions
Due to the strong association of the attitudes towards vaccination and vaccination behaviour among university students, we recommend that the different components of the 5Cs should be considered in future COVID-19 vaccination campaigns in the university context.
Key messages
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Affiliation(s)
- J Trümmler
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - E Heumann
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
| | - SM Helmer
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
| | - C Stock
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
- Unit of Health Promotion Research, University of Southern Denmark , Esbjerg, Denmark
| | - H Busse
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - K Heinrichs
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
| | - S Negash
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - J Horn
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - Y Niephaus
- Department of Social Sciences, University of Siegen , Siegen, Germany
| | - CR Pischke
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
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Negash S, Horn J, Heumann E, Helmer SM, Busse H, Heinrichs K, Pischke CR, Trümmler J, Niephaus J, Mikolajczyk R. Change in the financial situation of students during COVID-19 and its impact on depressive symptoms. Eur J Public Health 2022. [PMCID: PMC9619890 DOI: 10.1093/eurpub/ckac130.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Students faced unique challenges during the COVID-19 pandemic that may have affected their financial situation as well as their mental health. This study sought to examine whether changes in financial situation before and during the COVID-19 pandemic were associated with depressive symptoms among German university students. Methods The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS; N = 7,267) was implemented at five German universities between 27.10. and 14.11.2021. Students were asked if they had had sufficient financial resources to cover monthly expenses before the pandemic, as well as during the first and third waves of the pandemic. Depressive symptoms were assessed using the CES-D 8 (score ranges 0-24) and the PHQ-2 (0-6); higher scores indicating more severe depressive symptoms. Linear regression models were used to examine associations between variables. Results A worsened financial situation between the first and the third wave of the pandemic was associated with a one point (0.95) increase on the CES-D 8 scale (95% CI: 0.61, 1.29) and an improved financial situation with a decrease by 0.81 points (95% CI: -1.20, -0.42). A worsened financial situation was associated with a 0.26-point increase in PHQ-2 (95% CI: 0.14, 0.37) and an improved financial situation with a -0.12-point decrease (95% CI: -0.25, 0.01). Similarly, worsened financial situation in the third wave compared to prior to the pandemic, was also associated with an increase in CES-D 8 score and PHQ-2 and an improved financial situation with a decrease in CES-D 8 and PHQ-2. Conclusions Our findings suggest associations between students’ financial situation during the COVID-19 pandemic and their mental health. Due to their instable financial situation, students are a vulnerable group in need of mental and financial support during pandemic crises. Key messages
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Affiliation(s)
- S Negash
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - J Horn
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - E Heumann
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
| | - SM Helmer
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - H Busse
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - K Heinrichs
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
| | - CR Pischke
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - J Trümmler
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - J Niephaus
- Department of Social Sciences, University of Siegen , Siegen, Germany
| | - R Mikolajczyk
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
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Heumann E, Helmer SM, Busse H, Negash S, Pischke CR, Trümmler J, Niephaus Y, Stock C. Anxiety among students during the pandemic - Results from the C-19 German Student Well-being Study. Eur J Public Health 2022. [PMCID: PMC9594184 DOI: 10.1093/eurpub/ckac131.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Anxiety is widespread among university students. The COVID-19 pandemic af-fected students’ mental health negatively. Given the long duration of the pandemic monitoring mental health remains important. This study aims to determine to which extent anxiety is preva-lent among students (1), what factors are associated with it (2) and which student groups are mostly affected (3). Methods The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) sur-veyed mental health and well-being of students at five universities in Germany from 27.10.-14.11.21. Anxiety was assessed using the GAD-2. Associations between anxiety and sociodem-ographic, socioeconomic/social support factors as well as health- and COVID-19-related factors were determined using multiple binary logistic regression models. Results The mean age of students was 24.1 years (SD = 4.9), 67% were women and 31% men. The prevalence of anxiety was 32% and diverse gender (OR = 3.98, 95% CI: 1.71-9.23), a com-plicated relationship status (OR = 1.66, 95% CI: 1.06-2.60), the lack of a confidant (OR = 2.50, 95% CI: 1.80-3.46), and financial difficulties (e.g., being able to cover monthly expenses; OR = 1.76, 95% CI: 1.36-2.29) were associated with anxiety. Participants who were worried about (re)infection with COVID-19 had a 1.28-times higher chance (OR, 95% CI: 1.03-1.59) for anxie-ty. Students who were (rather) not worried that a relative would become severely ill with COVID-19 had a lower chance to experience anxiety (OR = 0.72, 95% CI: 0.53-0.98) as well as those who were confident receiving medical care in case of an infection with COVID-19 (OR = 0.80, 95% CI: 0.65-0.98). Conclusions Concepts for prevention and counselling in terms of mental health problems in students should be developed considering specific stressors due to the pandemic. Key messages • This study shows that anxiety is widespread among university students and associated with a variety of stressors. • The findings can help to develop specific concepts for prevention and counselling.
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Affiliation(s)
- E Heumann
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
| | - SM Helmer
- Human and Health Sciences, University of Bremen , Bremen, Germany
| | - H Busse
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - S Negash
- Institute for Medical Epidemiology, Martin Luther University Halle-Wittenberg , Halle (Saale), Germany
| | - CR Pischke
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - J Trümmler
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - Y Niephaus
- Department of Social Sciences, University of Siegen , Siegen, Germany
| | - C Stock
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
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Heumann E, Helmer SM, Busse H, Negash S, Pischke CR, Trümmler J, Niephaus Y, Stock C. Depressive Symptome Studierender während der dritten Welle
der COVID-19-Pandemie – Ergebnisse der COVID-19 German Student
Well-being Study (C19 GSWS). Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- E Heumann
- Charité – Universitätsmedizin Berlin, Institut
für Gesundheits- und Pflegewissenschaft, Berlin,
Deutschland
| | - SM Helmer
- Universität Bremen, Fachbereich Human- und
Gesundheitswissenschaften, Bremen, Deutschland
| | - H Busse
- Leibniz-Institut für Präventionsforschung und
Epidemiologie – BIPS, Abteilung Prävention und Evaluation,
Bremen, Deutschland
| | - S Negash
- Martin-Luther-Universität Halle-Wittenberg, Institut
für Medizinische Informatik, Biometrie und Epidemiologie, Halle (Saale),
Deutschland
| | - CR Pischke
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - J Trümmler
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - Y Niephaus
- Universität Siegen, Seminar für Sozialwissenschaften,
Siegen, Deutschland
| | - C Stock
- Charité – Universitätsmedizin Berlin, Institut
für Gesundheits- und Pflegewissenschaft, Berlin,
Deutschland
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Negash S, Getachew H, Tamirat D, Mammo TN. Hirschsprung disease managed with one-stage transanal endorectal pullthrough in a low-resource setting without frozen section. BMC Surg 2022; 22:89. [PMID: 35260130 PMCID: PMC8905736 DOI: 10.1186/s12893-022-01536-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the past few decades, surgery for Hirschsprung's disease (HD) has evolved into a minimally invasive, single-stage procedure with excellent outcomes. Intraoperative frozen section biopsy is critical for this procedure to avoid the potential risk of leaving a retained aganglionic segment. However, this facility is not available in most low-income countries. Therefore, a two-stage procedure with an initial colostomy is still practiced in the developing world. We aimed to evaluate the outcome of single-stage transanal pullthrough performed in a facility without frozen section biopsy. METHODS A retrospective review of all patients who underwent transanal pullthrough in two teaching hospitals over a 6-year period (2015-2020). RESULTS Forty-seven children underwent transanal endorectal pullthrough (TERPT). Age at surgery ranged from 2 months to 6 years and mean weight was 8.7 kg. Barium enema did not show transition zone in 6 patients (12.8%) while others demonstrated short segment HD. Intraoperatively, the transition zone was visualized in 40 patients (85%). TERPT alone was performed in 35 (74.5%), TERPT with laparotomy to visualize transition zone in 9 (26.7%) and TERPT with transabdominal mobilization was required in 3 (6.4%). Definitive histopathologic examination revealed aganglionic segment pullthrough in 4 (8.5%) and transitional zone pullthrough in another 4 (8.5%). However, with long term follow up all eight children remained asymptomatic and no intervention was required. CONCLUSIONS Transanal pullthrough offers reduced number of surgeries and faster recovery. We have also observed a good functional outcome despite a discrepancy with pathology results. Overall, our data suggests it is a safe and viable option for the treatment of short segment HD in facilities where frozen section is not available.
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Affiliation(s)
- Samuel Negash
- Unit of Pediatric Surgery, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Hanna Getachew
- Unit of Pediatric Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dagnachew Tamirat
- Department of Pathology, Addis Ababa University, Addis Ababa, Ethiopia
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Negash S, Anberber E, Ayele B, Ashebir Z, Abate A, Bitew S, Derbew M, Weiser TG, Starr N, Mammo TN. Operating room efficiency in a low resource setting: a pilot study from a large tertiary referral center in Ethiopia. Patient Saf Surg 2022; 16:3. [PMID: 34996487 PMCID: PMC8742370 DOI: 10.1186/s13037-021-00314-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The operating room (OR) is one of the most expensive areas of a hospital, requiring large capital and recurring investments, and necessitating efficient throughput to reduce costs per patient encounter. On top of increasing costs, inefficient utilization of operating rooms results in prolonged waiting lists, high rate of cancellation, frustration of OR personnel as well as increased anxiety that negatively impacts the health of patients. This problem is magnified in developing countries, where there is a high unmet surgical need. However, no system currently exists to assess operating room utilization in Ethiopia. METHODOLOGY A prospective study was conducted over a period of 3 months (May 1 to July 31, 2019) in a tertiary hospital. Surgical case start time, end time, room turnover time, cancellations and reason for cancellation were observed to evaluate the efficiency of eight operating rooms. RESULTS A total of 933 elective procedures were observed during the study period. Of these, 246 were cancelled, yielding a cancellation rate of 35.8%. The most common reasons for cancellation were related to lack of OR time and patient preparation (8.7% and 7.7% respectively). Shortage of facilities (instrument, blood, ICU bed) were causes of cancelation in 7.7%. Start time was delayed in 93.4% (mean 8:56 am ± 52 min) of cases. Last case completion time was early in 47.9% and delayed in 20.6% (mean 2:54 pm ± 156 min). Turnover time was prolonged in 34.5% (mean 25 min ± 49 min). Total operating room utilization ranged from 10.5% to 174%. Operating rooms were underutilized in 42.7% while overutilization was found in 14.6%. CONCLUSION We found a high cancellation rate, most attributable to late start times leading to delays for the remainder of cases, and lack of preoperative patient preparation. In a setting with a high unmet burden of surgical disease, OR efficiency must be maximized with improved patient evaluation workflows, adequate OR staffing and commitment to punctual start times. We recommend future quality improvement projects focusing on these areas to increase OR efficiency.
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Affiliation(s)
- Samuel Negash
- Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Endale Anberber
- Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Blen Ayele
- Department of Anesthesia, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zeweter Ashebir
- Department of Anesthesia, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ananya Abate
- Department of Anesthesia, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Miliard Derbew
- Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
- Lifebox Foundation, London, UK
| | - Thomas G Weiser
- Lifebox Foundation, London, UK
- Department of Surgery, University of Edinburgh, Edinburgh, UK
- Department of Surgery, Stanford University, Stanford, USA
| | - Nichole Starr
- Lifebox Foundation, London, UK
- Department of Surgery, University of California San Francisco, San Francisco, USA
| | - Tihitena Negussie Mammo
- Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
- Lifebox Foundation, London, UK
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14
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Negash S, Temesgen F. Primary closure of gastroschisis aided by ileostomy: A new management approach for low resource settings. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2021.102135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Bekele BB, Bogale B, Negash S, Tesfaye M, Getachew D, Weldekidan F, Yosef T. Public health interventions on prescription redemptions and secondary medication adherence among type 2 diabetes patients: systematic review and meta-analysis of randomized controlled trials. J Diabetes Metab Disord 2021; 20:1933-1956. [PMID: 34900834 DOI: 10.1007/s40200-021-00878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022]
Abstract
Background Despite the inadequate filling of prescriptions among chronic care patients has been a problem, little is known about the intervention effect on it. Objective The aim of this systematic review and meta-analysis (SRMA) was to investigate the effectiveness of various public health interventions on primary and secondary medication adherence among T2DM patients. Methods Searching was done from the major databases; Cochrane Library, Medline/PubMed, EBSCOhost, and SCOPUS. A hand search was made to find grey works of literature. Articles focused on interventions to enhance primary and secondary medication among type 2 diabetes mellitus patients were included. After screening and checking eligibility, the methodological quality was assessed. Secondary medication adherence was synthesized descriptively due to measurement and definition variations across studies. Finally, a meta-analysis was made using the fixed effects model for primary medication adherence. Results 3992 studies were screened for both primary and secondary medication adherences. Among these, 24 studies were included in the analysis for primary (5) and secondary (19) medication adherence. Pooled relative medication redemption difference was RD = 8% (95% CI: 6-11%) among the intervention groups. Age, intervention, provider setting, and IDF region were determinant factors of primary medication adherence. About two-thirds of the studies revealed that interventions were effective in improving secondary medication adherence. Conclusion Both primary and secondary medications were enhanced by a variety of public health interventions for patients worldwide. However, there is a scarcity of studies on primary medication adherence globally, and in resource-limited settings for the type of adherences. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00878-0.
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Affiliation(s)
- Bayu Begashaw Bekele
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.,Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia.,Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Biruk Bogale
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Samuel Negash
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Melkamsew Tesfaye
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Dawit Getachew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Fekede Weldekidan
- Department of Public Health, College of Health Science, Ethiopian Defence University, Addis Ababa, Ethiopia
| | - Tewodros Yosef
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
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16
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Negash S, Tigabe W, Kiflu W, Derbew M. Pediatric Surgical Volume at the TASH: Experience after the Expansion of Pediatric Surgery Program. Ethiop J Health Sci 2021; 31:1193-1198. [PMID: 35392327 PMCID: PMC8968358 DOI: 10.4314/ejhs.v31i6.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Ethiopia has a high unmet need for pediatric surgical conditions. Over the past 5 years, new changes have been introduced to the pediatric surgery division at Addis Ababa University to overcome this issue. The changes include initiation of pediatric surgery residency, allocating operating room for pediatric surgery, weekend surgical campaign and starting ultrasound guided hydrostatic reduction. We conducted this study to evaluate the pattern and outcome of pediatric surgical cases after these changes. METHODS The study was a retrospective review conducted at Tikur Anbessa Hospital from Jan - Dec 2019. Data was collected from duty report forms that included emergency procedures, admissions and mortalities. Data on elective procedures was collected from operation theater log books. RESULTS Overall, a total of 1590 pediatric surgical procedures were performed during 2019 of which 942 cases were elective and 648 were emergency. This was an increment in number of surgeries performed by 75%. The leading emergency procedure was aerodigestive foreign body removal which increased by 46%. Surgery for intussusception has decreased by 30% with increasing use of hydrostatic reduction. Overall, average morbidity and mortality was 3.5% and 6.9% respectively. Morbidity and mortality rates were similar throughout the year. CONCLUSION The study shows increased productivity over the past year with the changes made in the department. There is also no increment in morbidity and mortality during the start of the academic year. This implies adequate consultant supervision of residents during transition.
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Affiliation(s)
- Samuel Negash
- Division of Pediatric Surgery, Department of Surgery, Addis Ababa University, Ethiopia
| | - Workiye Tigabe
- Division of Pediatric Surgery, Department of Surgery, Addis Ababa University, Ethiopia
| | - Woubedel Kiflu
- Division of Pediatric Surgery, Department of Surgery, Addis Ababa University, Ethiopia
| | - Miliard Derbew
- Division of Pediatric Surgery, Department of Surgery, Addis Ababa University, Ethiopia
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Wright NJ, Leather AJ, Ade-Ajayi N, Sevdalis N, Davies J, Poenaru D, Ameh E, Ademuyiwa A, Lakhoo K, Smith ER, Douiri A, Elstad M, Sim M, Riboni C, Martinez-Leo B, Akhbari M, Tabiri S, Mitul A, Aziz DAA, Fachin C, Niyukuri A, Arshad M, Ibrahim F, Moitt N, Doheim MF, Thompson H, Ubhi H, Williams I, Hashim S, Philipo GS, Herrera L, Yunus A, Vervoort D, Parker S, Benaskeur YI, Alser OH, Adofo-Ansong N, Alhamid A, Salem HK, Saleh M, Elrais SA, Abukhalaf S, Shinondo P, Nour I, Aydin E, Vaitkiene A, Naranjo K, Dube AM, Ngwenya S, Yacoub MA, Kwasau H, Hyman G, Elghazaly SM, Al-Slaibi I, Hisham I, Franco H, Arbab H, Samad L, Soomro A, Chaudhry MA, Karim S, Khattak MAK, Nah SA, Dimatatac DM, Choo CSC, Maistry N, Mitul AR, Hasan S, Karim S, Yousuf H, Qureshi T, Nour IR, Al-Taher RN, Sarhan OAK, Garcia-Aparicio L, Prat J, Blazquez-Gomez E, Tarrado X, Iriondo M, Bragagnini P, Rite S, Hagander L, Svensson E, Owusu S, Abdul-Mumin A, Bagbio D, Ismavel VA, Miriam A, T S, Anaya Dominguez M, Ivanov M, Serban AM, Derbew M, Elfiky M, Olivos Perez M, Abrunhosa Matias M, Arnaud AP, Negida A, King S, Fazli MR, Hamidi N, Touabti S, Chipalavela RF, Lobos P, Jones B, Ljuhar D, Singer G, Hasan S, Cordonnier A, Jáuregui L, Zvizdic Z, Wong J, St-Louis E, Shu Q, Lui Y, Correa C, Pos L, Alcántara E, Féliz E, Zea-Salazar LE, Ali L, Peycelon M, Anatole NK, Jallow CS, Lindert J, Ghosh D, Adhiwidjaja CF, Tabari AK, Lotfollahzadeh S, Mussein HM, Vatta F, Pasqua N, Kihiko D, Gohil H, Nour IR, Elhadi M, Almada SA, Verkauskas G, Risteski T, Peñarrieta Daher A, Outani O, Hamill J, Lawal T, Mulu J, Yapo B, Saldaña L, Espineda B, Toczewski K, Tuyishime E, Ndayishimiye I, Raboe E, Hammond P, Walker G, Djordjevic I, Chitnis M, Son J, Lee S, Hussien M, Malik S, Ismail EM, Boonthai A, Dahman NBH, Hall N, Castedo Camacho FR, Sobrero H, Butler M, Makhmud A, Novotny N, Hammouri AG, Al-Rayyes M, Bvulani B, Muraveji Q, Murzaie MY, Sherzad A, Haidari SA, Monawar AB, Samadi DAZ, Thiessen J, Venant N, Hospital SI, Jérémie N, Mbonicura JC, Vianney BJM, Tadesse A, Negash S, Roberts CA, Jabang JN, Bah A, Camamra K, Correa A, Sowe B, Gai A, Jaiteh M, Raymond KJ, Mvukiyehe JP, Itangishaka I, Kayibanda E, Manirambona E, Lule J, Costas-Chavarri A, Shyaka Gashugi I, Ndata A, Gasana G, Nezerwa YC, Simeon T, Muragijimana JDD, Rashid S, Msuya D, Elisante J, Solanki M, Manjira E, Lodhia J, Jusabani M, Tarmohamed M, Koipapi S, Souhem T, Sara N, Sihem B, Dania B, Toufik IA, Mounira BNEI, Habiba A, Aragão L, Gonçalves V, Lino Urquizo MM, Varela MF, Mercado P, Horacio B, Damiani A, Mac C, Putruele D, Liljesthrom K, Bernaus M, Jauri C, Cripovich A, Bianchin E, Puig MG, Andreussi L, Iracelay S, Marcos D, Herrera C, Palacios N, Avile R, Serezo B, Montoya D, Cepeda R, Vaquila J, Veronica S, Pardo L, Valeria P, Julio L, Martin AD, Lucio P, Gabriel C, Marianella D, Calderón Arancibia JA, Huespe E, Losa GN, Arancibia Gutiérrez E, Scherl H, Gonzalez DE, Baistrocchi V, Silva Y, Galdeano M, Medard P, Sueiras I, Romero Manteola E, Defago VH, Mieres C, Alberto C, Cornelli F, Molina M, Ravetta P, Patiño Gonzalez CC, Dallegre MB, Szklarz MT, Leyba MF, Rivarola NI, Charras MD, Morales A, Caseb P, Toselli L, Millán C, Junes MDC, Di Siervi O, Gilardi J, Simon S, Contreras CS, Rojas N, Arnoletto LB, Blain OE, Bravo MN, Sanchez N, Herrera Pesara LM, Moreno ME, Sferco CA, Huq U, Ferdousi T, Al-Mamun A, Sultana S, Mahmud R, Mahmud K, Sayeed F, Svirsky A, Sempertegui D, Negrete A, Teran A, Sadagurschi M, Popovic N, Karavdic K, Milisic E, Jonuzi A, Mesic A, Terzic S, Dendusic N, Biber E, Sehic A, Zvizdic N, Letic E, Saracevic A, Hamidovic A, Selak N, Horozic D, Hukic L, Muhic A, Vanis N, Sokolovic E, Sabic A, Becker K, Novochadlo Klüppel E, dos Santos Dias AIB, Agulham MA, Bischoff C, Sabbatini S, Fernandes de Souza R, Souza Machado AB, Werneck Raposo J, da Silva Augusto ML, Martins BM, de Souza Santos Ferreira M, Fernandes de Oliveira D, Silva dos Santos C, Ribeiro de Fernández y Alcázar F, Alves Dutra da Silva É, Furtado M, Tamada H, Silva Ferreira dos Santos M, Lopes de Almeida T, Oliveira de Andrade S, Gurgel do Amaral AC, Sartori Giovanoni L, de Deus Passos Leles K, Corrêa Costa E, Feldens L, Ferraz Schopf L, Soares de Fraga JC, Colombo de Holanda F, Brolin Santis Isolan PM, Loyola Ferreira J, Bruxel CL, Lopes Teixeira Ferdinando D, Zottis Barcelos F, Baseggio N, Knorr Brenner N, Trindade Deyl R, Dure C, Nunes Kist I, Bueno Mazzuca R, Bueno Motter S, Ramos Y, Suzana Trein C, Rezende Rosa B, de Assis Silva M, Menin FA, Semensato Carloni IC, Norberto da Silva JA, Gomes AL, Girão Tauffer M, Bassan Gonçalves PC, Nogueira Marques GM, Moriya E, Labonia C, Carrasco AL, Furtado Meyer K, Farion-Aguiar L, Amado F, Antunes A, Silva E, Telles L, Almeida G, Belmino Gadelha AA, de Azevedo Belesa F, Gonçalves da Cunha, Jr A, Souza Barros B, Zanellato JB, Guimarães P, Silva KID, Ribas B, Reuter C, Casado FT, Correa Leite MT, Testoni D, Guinsburg R, de Campos Vieira Abib S, Khodor Cury E, Dornellas do Nascimento S, Almeida Aguiar A, Melo Gallindo R, Gonçalves Borges C, Liu Y, Duote C, Wang J, Gao Z, Liang L, Luo W, Zhao X, Chen R, Wang P, Han Y, Huang T, Donglai H, Xiaodong G, Junjie C, Zhu L, Wu G, Bao X, Li H, Lv J, Li Z, Yong F, Gao ZC, Bai Q, Tang W, Xie H, Motee J, Zhu J, Wen G, Ruan W, Li S, Chen L, Huang S, Lv Z, Lu J, Huang L, Yu M, Dajia W, Bai YZ, Rincon LC, Mancera J, Alzate Gallego E, Torres-Canchala L, Silva Beltrán N, Osorio Fory G, Castaño Avila D, Forero Ladino AM, Gomez J, Jaramillo M, Morales O, Sanchez B, Tinoco Guzmán NJ, Castañeda Espinosa S, Prieto Vargas O, Pardo LM, Toral E, Cáceres Aucatoma F, Hinostroza D, Valencia S, Salinas V, Landivar Cino E, Ponce Fajardo GY, Astudillo M, Garcia V, Muñoz G, Verduga L, Verduga I, Murillo E, Bucaram E, Guayelema M, Marmol M, Sanchez J, Vergara C, Mena A, Velaña J, Salazar K, Lara S, Chiriboga E, Silva J, Gad D, Samy D, Elsadek MA, Mohammed HM, Abouheba M, Ali KO, Rashwan H, Fawzy OM, Kamel TM, Nemer R, Hassan MA, Falah EH, Abdelhady DS, Zain M, Ibrahim EAA, Elsiraffy OO, Aboelela A, Farag EM, Oshiba AM, Emam OS, Attia AM, Laymouna MA, Ghorab IA, Mohammed MM, Soliman NA, Ghaly KAE, Sadek K, Elsherbiny M, Saleh A, Sheir H, Wafa T, Elmenam MA, Abdelmaksoud S, Reda A, Mansour I, Elzohiri M, Waseem B, Elewaily M, El-Ghazaly M, Elhattab A, Shalaby A, Elsaied A, Adawy A, Sadek M, Ahmed MA, Herdan MO, Elassall GMH, Mohammed AA, Takrouney MH, Essa TM, Mahmoud AM, Saad AM, Fouly MAN, Ibrahim MA, Nageh M, Saad MM, Badr H, Fouda MF, Nofal AH, Almohamady H, Arafa MA, Amad M, Mansour MA, O'Connor J, O'Connor Z, Anatole N, Nkunzimana E, Machemedze S, Dieudonné L, Appeadu-Mensah W, Anyomih TTK, Alhassan P, Abantanga FA, Michael V, Mary Koshy R, Raj A, Kumar V, PT S, Prabhu PS, Vosoughi A, Al-Mayoof AF, Fadhle MJ, Joda AE, Algabri HNO, Al-Taher RN, Abdelhamid SS, Al-Momani HM, Amarin M, Zaghlol LY, Alsaadi NN, Qwaider YZ, Qutishat H, Aliwisat AH, Arabiat E, Bsisu I, Murshidi RM, Jabaiti MS, Bataineh ZA, Abuhayyeh HA, Quran TMA, Za'nouneh FJA, Alebbini MM, Qudah HA, Hussein OG, Murad AM, Amarin JZ, Suradi HH, Alzraikat SH, Omari RY, Matour BM, Al-Halbouni L, Zurikat RO, Yanis AH, Hussein SA, Shoubaki A, Ghanem WH, David K, Chitiavi SW, Mose M, Mugo R, Ndungu J, Mwai T, Shahbal S, Malik J, Chauhan N, Syovata F, Ochieng K, Omendo Liyenzero P, Hussain SR, Mugambi S, Ochieng R, Elkhazmi EOA, Khaled A, Albozidi A, Enbaya MB, Elgammudi M, Soula E, Khalel WIA, Elhajjaji YA, Alwaggaa NA, Ghayth S, Zreeg DA.S, Tantush SA, Bibas F, Layas T, Sharif RAM, Aljadidi WOFS, Tarek A, Ahmed H, Essamilghi KAM, Alfoghi M, Abuhlega MA, Arrmali S, Abduljawad FM, Alosta HM, Abuajaila A, Abdelmutalib F, Bashir F, Almengar I, Annajjar MH, Deyab A, Elzowawi F, Krayem Y, Drah W, Meftah A, Mohammed A, Arrmalli LA, Aljaboo H, Elayeb A, Altomi M, Altaweel A, Tumi M, Bazozi HM, Shaklawoon A, Alglaib MM, Elkaloush AA, Trainba S, Swessi H, Alnaeri A, Shnishah AE, Mustufa H, Gargum SA, Tarniba SA, Shalluf HA, Shokri HA, Sarkaz TL, Tababa O, Elhadi A, Naunova VC, Jovcheski L, Kamilovski M, Gavrilovska-Brzanov A, Latiff ZA, Pauzi SFM, Osman M, Lim F, Bakar AHA, Zaman ASK, Ishak S, Teo R, Qi DTTH, Othman MYB, Zahari DDZB, Hassan ZBM, Shan CH, Lechmiannandan A, Tamaddun HFB, Adanan MFSBM, Abdullah MYB, Junyi W, Nor MTM, Noor WR, Hassan MRB, Dalek NFRA, Hashim HHB, Zarwawi AZB, Vellusamy VMM, Yuen QS, Kannessan HA, Ramli NB, Bujarimin ASB, Anntinea J, Dass A, Khalid HM, Hanifah NABM, Jyun KWY, Razak RBA, Naim NABM, Hamzah SNABH, Vidal CRZ, Bracho Blanchet E, Dávila Perez R, Fernandez Portilla E, Villegas Silva R, Ibarra D, Calderon Moore A, Carrasco-Ortega C, Noguez Castillo M, Herappe Mellado D, Yanowsky Reyes G, Gonzalez Cortez LF, Santana Ortiz R, Orozco Perez J, Corona C.Rivera JR, Cardenas Ruiz Velasco JJ, Quiles Corona M, Peña Padilla C, Bobadilla Morales L, Corona Rivera A, Rios Flores IM, Aranda Sánchez CI, Ambriz-González G, Martínez Hernández Magro N, León Frutos FJ, Cárdenas Barón JDJ, González Ojeda A, Yarza Fernández J, Porras JD, Aguirre-Lopez P, Sánchez Paredes V, Montalvo Marin A, Diaz Gomez JM, Caamal LJ, Bulnes Mendizabal D, Sanchez Valladares P, Garcia Martinez H, Adesanya O, Olanrewaju M, Adegboyega R, Abdulraheem N, Aremo A, Dedeke F, Chukwuemeka ALJ, Mohammad MA, Lawalbarau A, Collins N, Ibukunolu O, Shonubi A, Ladipo-Ajayi O, Elebute OA, Seyi-Olajide J, Alakaloko F, Ihediwa G, Olayade K, Bode C, Ogundoyin O, Olulana DI, Egbuchulem IK, Kumolalo FO, Ulasi I, Ezomike UO, Ekenze SO, Nwankwo EP, Nwangwu EI, Chukwu I, Amah CC, Obianyo NE, Williams O, Osuoji RI, Faboya OM, Ajai OT, Abdulsalam MA, Agboola TH, Temilade BB, Osazuwa M, Salawu MM, Ejinkeonye EC, Yola MM, Mairami AB, Otuneye AT, Igoche M, Tanimola AG, Ajao EA, Agelebe E, Olori S, Mshelbwala PM, Osagie O, Oyinloye A, Abubakar AM, Oyebanji L, Shehu I, Cletus C, Bamanga A, Suleiman F, Adamu S, C.Nwosu D, S.Alkali Y, Jalo I, Rasaki A, T.Sambo Y, A.Mohammed K, M.Ballah A, Modekwe V, Ekwunife OH, Ezidiegwu US, Osuigwe AN, Ugwu JO, Ugwunne CA, Akhter N, Gondal MF, Raza R, Chaudary AR, Ali H, Nisar MU, Jamal MU, Pandit GS, Mumtaz U, Amjad MB, Talat N, Rehman WU, Saleem M, Mirza MB, Hashim I, Haider N, Hameed S, Saleem A, Dogar S, Sharif M, Bashir MK, Naumeri F, Rani Z, Baniowda MA, Ba'baa' B, Hassan MYM, Darwish A, Sehwiel AS, Shehada M, Balousha AG, Ajrami Y, Alzamari AAM, Yaghi B, Al-saleem HSHA, Farha MSA, Abdelhafez MOM, Anaya F, Qadomi AB, Odi AANB, Assi MAF, Sharabati F, Abueideh A, Beshtawi DMS, Arafat H, Khatatba LZA, Abatli SJ, Al-Tammam H, Jaber D, Kayed YIO, Abumunshar AA, Misk RA, Alzeer AMS, Sharabati M, Ghazzawi I, Darras OM, M.Qabaja M, Hajajreh MS, Samarah YA, Yaghi DH, Qunaibi MAF, Mayaleh AA, Joubeh S, Ebeido A, Adawi S, Adawi I, Alqor MOI, Arar AS, Awad H, Abu-Nejmah F, Shabana OS, Alqarajeh F, Alzughayyar TZ, Madieh J, Sbaih MF, Alkareem RMA, Lahlooh RA, Halabi YA, Baker W, Almusleh TFH, Tahyneh AAA, Atatri YYM, Jamie NA, Massry NAA, Lubbad W, A.Nemer A, Alser M, Salha AAS, Alnahhal K, Elmzyyen AM, Ghabayen ATS, Alamrain AAA, Al-Shwaikh SH, Elshaer OA, Shaheen N, Fares J, Dalloul H, Qawwash A, Jayyab MA, Ashour DA, Shaheen AA, Naim SRR, Shiha EA, Dammagh NMA, Almadhoun W, Al-Salhi AA, Hammato AY, Salim JM, Hasanain DK, Alwadia SMS, Nassar I, Al-Attar HM, Alshaikhkhalil HAA, Jamie YMKA, Ashour YS, Alijla SS, Tallaa MAE, Abuattaya AA, Wishah BD, ALDIRAWI MOHAMMEDA, Darwish AS, Alzerei ST, Wishah N, Alijla S, Garcia I, Diaz Echegaray M, Cañapataña Sahuanay VR, Trigoso Mori F, Alvarado Zelada J, Salinas Barreto JJ, Rivera Altamirano P, Torres Miranda C, Anicama Elias R, Rivera Alvarez J, Vasquez Matos JP, Ayque Rosas F, Ledesma Peraza J, Gutarra Palomino A, Vega Centen S, Casquero V, Ortiz Argomedo MR, Lapouble F, Llap Unchón G, Delgado Malaga FP, Ortega Sotelo L, Gamboa Kcomt S, Villalba Villalba A, Mendoza Leon NR, Cardenas Alva LR, Loo Neyra MS, Alanguia Chipana CL, Torres Picón CMDJ, Huaytalla Quiroz N, Dominguez D, Segura Calle C, Arauco J, Ormeño Calderón L, Ghilardi Silva X, Fernandez Wilson MD, Gutierrez Maldonado JE, Diaz Leon C, Berrocal Anaya W, Chavez Galvez P, Aguilar Gargurevich PP, Diaz Castañeda FDM, Guisse C, Ramos Paredes E, Apaza Leon JL, Aguilar Aguilar F, Ramirez De La Cruz R, Flores Carbajal L, Mendoza Chiroque C, Sulca Cruzado GJ, Tovar Gutierrez N, Sotelo Sanchez J, Paz Soldan C, Hernández Córdova K, Delgado Quinteros EF, Brito Quevedo LM, Mendoza Oviedo JJ, Samanez Obeso A, Paredes Espinoza P, de Guzman J, Yu R, Cosoreanu V, Ionescu S, Mironescu A, Vida L, Papa A, Verdeata R, Gavrila B, Muntean L, Lukac M, Stojanovic M, Toplicic D, Slavkovic M, Slavkovi A, Zivanovic D, Kostic A, Raicevic M, Nkuliza D, Sidler D, Vos CD, Merwe EV, Tasker D, Khamag O, Rengura C, Siyotula T, Jooma U, Delft DV, Arnold M, Mangray H, Harilal S, Madziba S, Wijekoon N, Gamage T, Bright BP, Abdulrahman A, Mohammed OAA, Salah M, Ajwa AEA, Morjan M, Batal MM, Faks V, Mouti MB, Assi A, Al-Mouakeh A, Tarabishi AS, Aljarad Z, Alhamid A, Khorana J, Poocharoen W, Liukitithara S, Sriniworn A, Nuntasunti W, Ngerncham M, Phannua R, Thaiwatcharamas K, Tanming P, Sahnoun L, Kchiche N, Abdelmoumen R, Eroğlu E, Ozen MA, Cömert HSY, İmamoğlu M, Sarıhan H, Kader Ş, Mutlu M, Aslan Y, Beşir A, Geze Ş, Çekiç B, Yalcinkaya A, Sönmez K, Karabulut R, Türkyılmaz Z, Şeref K, Altın M, Aykut M, Akan M, Erdem M, Ergenekon E, Türkyılmaz C, Keleş E, Canözer A, Yeniay AÖ, Eren E, Cesur İB, Özçelik Z, Kurt G, Mert MK, Kaya H, Çelik M, Karakus SC, Erturk N, Suzen A, Hakan N, Akova F, Pasaoglu M, Eshkabilov S, Yuldashev RZ, Abdunomonovich DA, Muslimovich AM, Patel A, Kapihya C, Ensar N, Nataraja RM, Sivasubramaniam M, Jones M, Teague W, Tanny ST, Thomas G, Roberts K, Venkatraman SS, Till H, Pigeolet M, Dassonville M, Shikha A, Win WSP, Ahmad ZAH, Meloche-Dumas L, Caouette-Laberge L, St-Vil D, Aspirot A, Piché N, Joharifard S, Safa N, Laberge JM, Emil S, Puligandla P, Shaw K, Wissanji H, Duggan E, Guadagno E, Puentes MC, Leal PO, Mendez Benavente C, Rygl M, Trojanová B, Berková K, Racková T, Planka L, Škvařil J, Štichhauer R, Sabti S, Macdonald A, Bouhadiba N, Kufeji D, Pardy C, Mccluney S, Keshtgar A, Roberts R, Rhodes H, Burns K, Garrett-Cox R, Ford K, Cornwall H, Ravi K, Arthur F, Losty P, Lander T, Jester I, Arul S, Gee O, Soccorso G, Singh M, Pachl M, Martin B, Alzubair A, Kelay A, Sutcliffe J, Middleton T, Thomas AH, Kurian M, Cameron F, Sivaraj J, Thomas MC, Rex D, Jones C, Bradshaw K, Bonnard A, Delforge X, Duchesne C, Gall CL, Defert C, Laraqui Hossini S, Guerin F, Hery G, Fouquet-Languillat V, Kohaut J, Broch A, Blanc T, Harper L, Delefortrie T, Ballouhey Q, Fourcade L, Grosos C, Parmentier B, Levard G, Grella MG, Renaux Petel M, Grynberg L, Abbo O, Mouttalib S, Juricic M, Scalabre A, Haraux E, Rissmann A, Krause H, Goebel P, Patzer L, Rolle U, Schmedding A, Antunez-Mora A, Tillig B, Bismarck SV, Barbosa PR, Knorr C, Stark D, Brunero M, Avolio L, Manni F, Molinelli M, Guazzotti M, Raffaele A, Romano PG, Cavaiuolo S, Parigi GB, Juhasz L, Rieth A, Strumila A, Dagilytė R, Liubsys A, Gurskas P, Malcius D, Mikneviciute A, Vinskaite A, Barauskas V, Vierboom L, Hall T, Beasley S, Goddard L, Stringer M, Weeratunga N, Adams S, Cama J, Wong M, Jayaratnam S, Kukkady A, Samarakkody U, Gerus S, Patkowski D, Wolny A, Koszutski T, Tobor S, Osowicka M, Czauderna P, Wyrzykowski D, Garnier H, Anzelewicz S, Marta O, Knurowska A, Weiszewsk A, Grabowski A, Korlacki W, Pasierbek M, Wolak P, Piotrowska A, Roszkiewicz A, Kalicińsk P, Trypens A, Kowalewsk G, Sigalet D, Alsaied A, Ali M, Alsaggaf A, Ghallab A, Owiwi Y, Zeinelabdeen A, Fayez M, Atta A, Zidan M, Radwan AS, Shalaby H, Abdelbaqi R, Alattas K, Kano Y, Sindi O, Alshehri A, Altokhais T, Alturki F, Almosaibli M, Krisanova D, Abbas W, Yang HB, Kim HY, Youn JK, Chung JH, Cho SH, Hwang IJ, Lee JY, Song ES, Arboleda J, Ruiz de Temiño Bravo M, Siles Hinojosa A, García M, Casal Beloy I, Oliu San Miguel D, Molina Vazquez ME, Alonso V, Sanchez A, Gomez O, Carrillo I, Wester T, Mesas Burgos C, Hagander L, Salö M, Omling E, Rudolfson N, Granéli C, Arnadóttir H, Grottling E, Abrahamsson K, Gatzinsky V, Dellenmark Blom M, Borbonet D, Puglia P, Jimenez Morejon V, Acuna G, Moraes M, Chan J, Brahmamdam P, Tom A, Sherer K, Gonzales B, Cunningham A, Krishnaswami S, Baertschiger R, Leech M, Williams R, Camp L, Gosain A, Mora M, Lyttle BD, Chang J, McColl Makepeace L, Fowler KL, Mansfield S, Hodgman E, Amaechi C, Beres A, Pernik MN, Dosselman LJ, Almasri M, Jain S, Modi V, Fernandez Ferrer M, Coon J, Gonzalez J, Honhar M, Ruzgar N, Coghill G, Ullrich S, Cheung M, Løfberg K, Greenberg J, Davenport K, Gadepalli S, Fox S, Johnson S, Pilkington M, Hamilton A, Lin N, Sola J, Yao Y, Davis JK, Langer M, Vacek J, Abdullah F, Khlevner J, Middlesworth W, Levitt M, Ahmad H, Siddiqui SM, Bowder A, Derks T, Amoabin AA, Pinar B, Owusu-Sekyere F, Saousen B, Naidoo R, Karamustafic A, Oliveira DPD, Motter SB, Andrade J, Šafus A, Langley J, Wilke A, Deya C, Murtadi HM, Berzanskis M, Calistus N, Ajiboye OS, Felix M, Olabisi OO, Erçin S, Muradi T, Burks SS, Lerma S, Jacobson J, Calancea C, Valerio-Vazquez R, Sikwete G, Sekyere O, Mbonisweni A, Syed S, Hyeon CS, Pajouhandeh F, Kunfah SMP. Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study. Lancet 2021; 398:325-339. [PMID: 34270932 PMCID: PMC8314066 DOI: 10.1016/s0140-6736(21)00767-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/10/2021] [Accepted: 03/25/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. METHODS We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. FINDINGS We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36-39) and median bodyweight at presentation was 2·8 kg (2·3-3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88-4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59-2·79], p<0·0001), sepsis at presentation (1·20 [1·04-1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4-5 vs ASA 1-2, 1·82 [1·40-2·35], p<0·0001; ASA 3 vs ASA 1-2, 1·58, [1·30-1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02-1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41-2·71], p=0·0001; parenteral nutrition 1·35, [1·05-1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47-0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50-0·86], p=0·0024) or percutaneous central line (0·69 [0·48-1·00], p=0·049) were associated with lower mortality. INTERPRETATION Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030. FUNDING Wellcome Trust.
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Zewdie K, Negash S, Bizuneh Y, Woldemichael F, Temesgen F. Rachipagus parasitic twins: A case series and review of literature. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2020.101049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bekele BB, Negash S, Bogale B, Tesfaye M, Getachew D, Weldekidan F, Balcha B. Effect of diabetes self-management education (DSME) on glycated hemoglobin (HbA1c) level among patients with T2DM: Systematic review and meta-analysis of randomized controlled trials. Diabetes Metab Syndr 2021; 15:177-185. [PMID: 33360516 DOI: 10.1016/j.dsx.2020.12.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS Type 2 Diabetes mellitus (T2DM) has been a global public health issue causing in physical, financial and psychosocial crises. The aim of this systematic review and meta-analysis (SRMA) was to evaluate the Diabetes Self-Management Education or Support (DSME/S) on glycosylated hemoglobin (HbA1c) among T2DM patients. METHODS This SRMA was made according to preferred reporting Items for systematic review and Meta-analysis (PRISMA) guidelines. The relevant articles were searched from four databases: Cochrane Library, MEDLINE (EBSCOhost), MEDLINE/PubMed and SCOPUS. Quality assessment was carried out. Pooled standard mean difference in HbA1c were calculated to obtain the effect size with random effect assumption. Subgroup analysis was conducted for assessing heterogeneity among the studies. RESULTS A total of 1312 studies were identified from databases. Among these 25 studies met inclusion criteria. From these 20 were included in the meta-analysis. In meta-analysis a pooled standard mean difference in HbA1c was -0.604 (95% confidence interval = -0.854 -0.353, I2 = 90.3, p < 0.001). In subgroup analysis a significant reduction was seen among studies with less than four months, upper middle followed by lower middle income countries (LMICs), Western Pacific (WP) followed by Middle Eastern and Northern African (MENA) regions with moderate to substantial heterogeneity. CONCLUSION However, there is paucity of studies in underdeveloped countries. Therefore, further studies validated to these contexts are needed to evaluate the DSME effectiveness. TRIAL REGISTRATION PROSPERO database CRD42020124236.
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Affiliation(s)
- Bayu Begashaw Bekele
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia; Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, 4028, Hungary.
| | - Samuel Negash
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Biruk Bogale
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Melkamsew Tesfaye
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Dawit Getachew
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Fekede Weldekidan
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Behailu Balcha
- School of Public Health, College of Medicine and Health Sciences, Woliata Sodo University, Sodo, Ethiopia
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Bekele BB, Negash S, Bogale B, Tesfaye M, Getachew D, Weldekidan F, Balcha B. The effectiveness of diabetes self-management education (DSME) on glycemic control among T2DM patients randomized control trial: systematic review and meta-analysis protocol. J Diabetes Metab Disord 2020; 19:1631-1637. [PMID: 33520857 PMCID: PMC7843690 DOI: 10.1007/s40200-020-00584-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 07/01/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Type 2 Diabetes mellitus (T2DM) has been a global pandemic resulting in physical, financial and psychosocial crises. Thus, it is important to investigate pooled effectiveness of Diabetes Self-Management Education (DSME) on glycemic control among T2DM patients. OBJECTIVE The aim of this systematic review and meta-analysis is to investigate the association between DSME or Support (DSME/S) and glycemic control among T2DM patients. METHODS The systematic review and meta-analysis will include studies conducted throughout the world from 2010 to 2019. T2DM patients and their clinical, anthropometric, biomarkers from baseline to end line will be recorded. We will search all relevant articles from five databases namely; Cochrane Library, BioMed Central, MEDLINE (EBSCOhost), MEDLINE/PubMed and SCOPUS. Key terms will be used for questing relevant articles. Further efforts will be made to check quality of studies base on quality assessment instruments. Finally, the report will be made according Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Pooled standard mean difference in HbA1c will be used to calculate the effect size between the variables with random effects analysis assumption. Further subgroup analysis will be carried out for assessing the risk difference among groups. CONCLUSION Based on the existing and eligible researches this systematic review and meta-analysis will bring the best evidence on the effectiveness of DSME/S on glycemic control among the T2DM patients. Moreover, the subgroup analysis will inform the effectiveness heterogeneity based on continent, International Diabetes Federation (IDF) region, intervention period, World bank economic classification and glycemic markers used to follow the patients. The proposed review has been registered in the International PROSPERO website with registration number CRD42020124236.
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Affiliation(s)
- Bayu Begashaw Bekele
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, 4028 Hungary
| | - Samuel Negash
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Biruk Bogale
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Melkamsew Tesfaye
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Dawit Getachew
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Fekede Weldekidan
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Behailu Balcha
- School of Public Health, College of Medicine and Health Sciences, Woliata Sodo University, Sodo, Ethiopia
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Negash S, Girma H, Woldeselassie HG. Esophageal atresia type C with overlapping long upper pouch: A rare variant. Int J Surg Case Rep 2020; 72:251-254. [PMID: 32553938 PMCID: PMC7300232 DOI: 10.1016/j.ijscr.2020.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Esophageal atresia is one of the most common pediatric surgical conditions with a high mortality in developing countries. The esophagus and trachea have a complex embryologic development leading to a wide spectrum of esophageal atresia anomalies. Long upper esophageal pouch with distal tracheoesophageal fistula is one of these rare varieties. Only a handful of case reports exist on the subject thus far. Most reports are from low income countries. CASE PRESENTATION A neonate referred to our hospital after 2 weeks of life for excessive secretions, persistent respiratory distress and vomiting. Diagnosis of esophageal atresia was overlooked because nasogastric tube was advanced a considerable length. After repeat x-ray and esophagogram, we confirmed the diagnosis of type C esophageal atresia with a long upper esophageal pouch. Due to the dilemma in diagnosis, surgery was delayed after the 3rd week of life. Luckily the child survived even with extremely delayed intervention. CONCLUSION Esophageal atresia can have an uncommon presentation which causes confusion in the diagnosis. Physicians need to be aware of its existence to avoid unnecessary delays in the management. Fortunately, this variant generally seems to have a good prognosis.
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Affiliation(s)
- Samuel Negash
- Division of Pediatric Surgery, Department of Surgery, Addis Ababa University, Ethiopia.
| | - Hiwote Girma
- Division of Pediatric Surgery, Department of Surgery, Addis Ababa University, Ethiopia
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Abstract
BACKGROUND Penetrating thoracic injuries are uncommon in childhood. Massive penetrating injury due to impalement is even more rare and has scarcely been reported. It has a dramatic clinical presentation and is often fatal, depending on the organs injured. CASE PRESENTATION Two boys presented with an unusual mechanism of injury. They fell from a height to be impaled by a large stick. Appropriate emergency medical service was not available and surgery was delayed by more than 24 h after the accident. Both children were labelled "lucky" as they survived the injury without any significant sequelae. CONCLUSION We discuss two new cases of pediatric thoracic impalement and perform the first literature review on the subject. Emphasis should be given to the initial care which comprises avoiding premature removal, rapid transport, resuscitation, anti-tetanus and antibiotics. All reported cases had a favorable outcome, even those managed within the constraints of low-income countries.
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Affiliation(s)
- Samuel Negash
- Division of pediatric surgery, Department of surgery, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Tihitena Negussie Mammo
- Division of pediatric surgery, Department of surgery, Addis Ababa University, Addis Ababa, Ethiopia
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Negash S, Mesfin F, Egata G. Infants and young children feeding practice and associated factors among HIV positive mothers of children 0-23 months in health centers of Gulele sub-city, Addis Ababa, Ethiopia. BMC Res Notes 2019; 12:666. [PMID: 31639058 PMCID: PMC6805466 DOI: 10.1186/s13104-019-4729-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 10/12/2019] [Indexed: 11/10/2022] Open
Abstract
Objective A health facility based cross sectional study design was conducted among 358 randomly selected HIV positive mothers attending at four health centers from February 1 to 28, 2018. Magnitude of HIV positive mothers’ child feeding practice and associated factors was assessed according to WHO recommendation. Data were collected using structured pretested questionnaire and entered into EPI data version 3.1 and exported to SPSS version 20 computer software for analysis. Result The magnitude of recommended way of infant feeding practice among HIV positive mothers attending public health centers in Gulele sub-city is 37.4%, 95% CI (32.26–42.67). Statistically significant correlates of HIV exposed infant feeding practice of mothers in this study were knowledge of mother on HIV exposed infant feeding practice (AOR = 1.80 (95% CI 1.04–3.01)), head of family being father (AOR = 0.17 (95% CI 0.03–0.87)), having family (relatives) support (AOR = 2.05 (95% CI 1.00–4.18)) and information on HIV exposed infant feeding, practice (AOR = 1.77 (95% CI 1.07–2.93)).
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Affiliation(s)
- Samuel Negash
- Department of Public Health, College of Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia.
| | - Firehiwot Mesfin
- College of Health and Medical Science, School of Public Health, Haramaya University, Dire Dawa, Ethiopia
| | - Gudina Egata
- College of Health and Medical Science, School of Public Health, Haramaya University, Dire Dawa, Ethiopia
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Gashu Z, Jerene D, Datiko DG, Hiruy N, Negash S, Melkieneh K, Bekele D, Nigussie G, Suarez PG, Hadgu A. Seasonal patterns of tuberculosis case notification in the tropics of Africa: A six-year trend analysis in Ethiopia. PLoS One 2018; 13:e0207552. [PMID: 30475836 PMCID: PMC6261032 DOI: 10.1371/journal.pone.0207552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/01/2018] [Indexed: 11/19/2022] Open
Abstract
Objective Seasonal variations affect the health system’s functioning, including tuberculosis (TB) services, but there is little evidence about seasonal variations in TB case notification in tropical countries, including Ethiopia. This study sought to fill this gap in knowledge using TB data reported from 10 zones, 5 each from Amhara and Oromia regions. Methods Notified TB cases for 2010–2016 were analyzed using SPSS version 20. We calculated the quarterly and annual average TB case notification rates and the proportion of seasonal amplitudes. We applied Winters’ multiplicative method of exponential smoothing to break down the original time series into seasonal, trend, and irregular components and to build a suitable model for forecasting. Results A total of 205,575 TB cases were identified (47.8% from Amhara, 52.2% from Oromia), with a male-to-female ratio of 1.2:1. The means of 8,200 (24%), 7,992 (23%), 8,849 (26%), and 9,222 (27%) TB cases were reported during July-September, October-December, January-March, and April-June, respectively. The seasonal component of our model indicated a peak in April-June and a trough in October-December. The seasonal amplitude in Amhara region is 10% greater than that of Oromia (p < 0.05). Conclusions TB is shown to be a seasonal disease in Ethiopia, with a peak in quarter four and a low in quarter two of the fiscal year. The peak TB case notification rate corresponds with the end of the dry season in the two agrarian regions of Ethiopia. TB prevention and control interventions, such as efforts to increase community TB awareness about TB transmission and contact tracing, should consider seasonal variation. Regional variations in TB seasonality may require consideration of geographic-specific TB case-finding strategies. The mechanisms underlying the seasonal variation of TB are complex, and further study is needed.
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Affiliation(s)
- Z. Gashu
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
- * E-mail:
| | - D. Jerene
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - D. G. Datiko
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - N. Hiruy
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - S. Negash
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - K. Melkieneh
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - D. Bekele
- Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - G. Nigussie
- Amhara Regional Health Bureau, Addis Ababa, Ethiopia
| | - P. G. Suarez
- Management Sciences for Health, Arlington, Virginia, United States of America
| | - A. Hadgu
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
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Negash S, A. Bennett D, S. Wilson R, A. Schneider J, E. Arnold S. Cognition and Neuropathology in Aging: Multidimensional Perspectives from the Rush Religious Orders Study and Rush Memory and Aging Project. Curr Alzheimer Res 2011; 8:336-40. [DOI: 10.2174/156720511795745302] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 12/22/2010] [Indexed: 11/22/2022]
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Negash S, Narasimhan SR, Zhou W, Liu J, Wei FL, Tian J, Raj JU. Role of cGMP-dependent protein kinase in regulation of pulmonary vascular smooth muscle cell adhesion and migration: effect of hypoxia. Am J Physiol Heart Circ Physiol 2009; 297:H304-12. [PMID: 19411288 DOI: 10.1152/ajpheart.00077.2008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Exposure to prolonged hypoxia can result in pulmonary vascular remodeling and pulmonary hypertension. Hypoxia induces pulmonary vascular smooth muscle cell (PVSMC) proliferation and vascular remodeling by affecting cell adhesion and migration and secretion of extracellular matrix proteins. We previously showed that acute hypoxia decreases cGMP-dependent protein kinase (PKG) activity in PVSMC and that PKG plays a role in maintaining the differentiated contractile phenotype in normoxia. In this study, we investigated the effect of hypoxia on PVSMC adhesion and migration and the role of PKG in these functions. Ovine fetal pulmonary artery SMC were incubated in normoxia (Po(2) approximately 100 Torr) or hypoxia (Po(2) approximately 30-40 Torr) or treated with the PKG inhibitor DT-3 for 24 h in normoxia. To further study the role of PKG in the modulation of adhesion and migration, PVSMC were transiently transfected with a full-length PKG1alpha [PKG-green fluorescent protein (GFP)] or a dominant-negative construct (G1alphaR-GFP). Cell adhesion to extracellular matrix proteins was determined, and integrin-mediated adhesion was assessed by alpha/beta-integrin-mediated cell adhesion array. Exposure to hypoxia (24 h) and pharmacological inhibition of PKG1 by DT-3 significantly promoted adhesion mediated by alpha(4)-, beta(1)-, and alpha(5)beta(1)-integrins to fibronectin, laminin, and tenacin and also resulted in increased cell migration. Likewise, inhibition of PKG by expression of a dominant-negative PKG1alpha construct increased cell adhesion and migration, comparable to that induced by hypoxia. Dynamic actin reorganization associated with integrin-mediated cell adhesion is partly regulated by the actin-binding protein cofilin, the (Ser3) phosphorylation of which inhibits its actin-severing activity. We found that increased PKG expression and activity is associated with decreased cofilin (Ser3) phosphorylation, implying a role for PKG in the modulation of cofilin activity and actin dynamics. Together, these findings identify cGMP/PKG1 signaling as central to the functional differences between PVSMC exposed to normoxia versus hypoxia.
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Affiliation(s)
- S Negash
- Division of Neonatology, Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute, Torrance, CA 90502, USA.
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Kantarci K, Weigand SD, Przybelski SA, Shiung MM, Whitwell JL, Negash S, Knopman DS, Boeve BF, O'Brien PC, Petersen RC, Jack CR. Risk of dementia in MCI: combined effect of cerebrovascular disease, volumetric MRI, and 1H MRS. Neurology 2009; 72:1519-25. [PMID: 19398707 PMCID: PMC2843530 DOI: 10.1212/wnl.0b013e3181a2e864] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the combined ability of hippocampal volumes, 1H magnetic resonance spectroscopy (MRS) metabolites, and cerebrovascular disease to predict the risk of progression to dementia in mild cognitive impairment (MCI). METHODS We identified 151 consecutively recruited subjects with MCI from the Mayo Clinic Alzheimer's Disease Research Center and Patient Registry who underwent MRI and 1H MRS studies at baseline and were followed up with approximately annual clinical examinations. A multivariable proportional hazards model that considered all imaging predictors simultaneously was used to determine whether hippocampal volumes, posterior cingulate gyrus 1H MRS metabolites, white matter hyperintensity load, and presence of cortical and subcortical infarctions are complementary in predicting the risk of progression from MCI to dementia. RESULTS Seventy-five subjects with MCI progressed to dementia by last follow-up. The model that best predicted progression to dementia included age, sex, hippocampal volumes, N-acetylaspartate (NAA)/creatine (Cr) on 1H MRS, and cortical infarctions. Based on age- and sex-adjusted Kaplan-Meier plots, we estimated that by 3 years, 26% of the MCI patients with normal hippocampal volumes, NAA/Cr ratios >1 SD, and no cortical infarctions will progress to dementia, compared with 78% of the MCI patients with hippocampal atrophy, low NAA/Cr (< or =1 SD), and cortical infarction. CONCLUSIONS Multiple magnetic resonance (MR) markers of underlying dementia pathologies improve the ability to identify patients with prodromal dementia over a single MR marker, supporting the concept that individuals with multiple brain pathologies have increased odds of dementia compared with individuals with a single pathology.
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Affiliation(s)
- K Kantarci
- Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
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Smith GE, Pankratz VS, Negash S, Machulda MM, Petersen RC, Boeve BF, Knopman DS, Lucas JA, Ferman TJ, Graff-Radford N, Ivnik RJ. A plateau in pre-Alzheimer memory decline: Evidence for compensatory mechanisms? Neurology 2007; 69:133-9. [PMID: 17620545 DOI: 10.1212/01.wnl.0000265594.23511.16] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare logistic and bilogistic models to describe the pattern of cognitive decline in the preclinical phase of Alzheimer disease (AD). METHODS We conducted mixed effects modeling of Mayo Cognitive Factors Scores to determine the longitudinal pattern of cognitive decline in the period 10 years prior to and 5 years following a clinical diagnosis of AD. Our analysis included 199 people that eventually received a diagnosis of clinically probable AD. Participants had at least two neuropsychological evaluations including one before the evaluation at which they received the AD diagnosis. RESULTS A bilogistic model, including terms for a plateau in the course of cognitive decline, better fit longitudinal memory scores than a simple logistic model. On average the plateau began about 4 years prior to the clinical diagnosis of AD and ended with a decline that probably contributed to the clinical diagnosis of AD. A similar plateau was not evident in four other cognitive domains. CONCLUSIONS The current findings may support proposed compensatory hypotheses involving redundant memory systems, up-regulation of neurotransmitters, or recruitment of other neural networks.
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Affiliation(s)
- G E Smith
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA.
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Narasimhan SR, Negash S, Raj JU. 167 REGULATION OF PULMONARY VASCULAR SMOOTH MUSCLE CELL PROLIFERATION IN THE OVINE FETUS: ROLE OF CYCLIC GUANOSINE MONOPHOSPHATE-DEPENDENT PROTEIN KINASE. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0004.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Narasimhan S, Negash S, Raj JU. Regulation of Pulmonary Vascular Smooth Muscle Cell Proliferation in the Ovine Fetus: Role of Cyclic Guanosine Monophosphate–Dependent Protein Kinase. J Investig Med 2006. [DOI: 10.1177/108155890605401s51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- S.R. Narasimhan
- Division of Neonatology, Harbor-UCLA Medical Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles Biomedical Research Institute, Torrance, CA
| | - S. Negash
- Division of Neonatology, Harbor-UCLA Medical Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles Biomedical Research Institute, Torrance, CA
| | - J. U. Raj
- Division of Neonatology, Harbor-UCLA Medical Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles Biomedical Research Institute, Torrance, CA
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Gao C, Negash S, Wang HS, Ledee D, Guo H, Russell P, Zelenka P. Cdk5 mediates changes in morphology and promotes apoptosis of astrocytoma cells in response to heat shock. J Cell Sci 2001; 114:1145-53. [PMID: 11228158 DOI: 10.1242/jcs.114.6.1145] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The cyclin-dependent kinase member, Cdk5, is expressed in a variety of cell types, but neuron-specific expression of its activator, p35, is thought to limit its activity to neurons. Here we demonstrate that both Cdk5 and p35 are expressed in the human astrocytoma cell line, U373. Cdk5 and p35 are present in the detergent-insoluble cytoskeletal fraction of this cell line and Cdk5 localizes to filopodia and vinculin-rich regions of cell-matrix contact in lamellopodia. When exposed to a 46(o)C heat shock, U373 cells change shape, lose cell-matrix contacts and show increased levels of apoptosis. To test whether Cdk5 activation might play a role in these events, U373 cells were stably transfected with histidine-tagged or green fluorescent protein-tagged constructs of Cdk5 or a dominant negative mutation, Cdk5T33. Under normal growth conditions, growth characteristics of the stably transfected lines were indistinguishable from untransfected U373 cells and Cdk5 localization was not changed. However, when subjected to heat shock, cells stably transfected with Cdk5-T33 remained flattened, showed little loss of cell-matrix adhesion, and exhibited significantly lower levels of apoptosis. In contrast, cells that overexpressed wild-type Cdk5 showed morphological changes similar to those seen in untransfected U373 cells in response to heat shock and had significantly higher levels of apoptosis. Heat-shocked cells showed changes in p35 mobility and stability of the Cdk5/p35 complex consistent with endogenous Cdk5 activity. Together these findings suggest that endogenous Cdk5 activity may play a key role in regulating morphology, attachment, and apoptosis in U373 cells, and raise the possibility that Cdk5 may be a general regulator of cytoskeletal organization and cell adhesion in both neuronal and non-neuronal cells.
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Affiliation(s)
- C Gao
- National Eye Institute, NIH, Bethesda, MD 20892, USA
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Negash S, Yao Q, Sun H, Li J, Bigelow DJ, Squier TC. Phospholamban remains associated with the Ca2+- and Mg2+-dependent ATPase following phosphorylation by cAMP-dependent protein kinase. Biochem J 2000; 351:195-205. [PMID: 10998362 PMCID: PMC1221350 DOI: 10.1042/0264-6021:3510195] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We have used fluorescence and spin-label EPR spectroscopy to investigate how the phosphorylation of phospholamban (PLB) by cAMP-dependent protein kinase (PKA) modifies structural interactions between PLB and the Ca(2+)- and Mg(2+)-dependent ATPase (Ca-ATPase) that result in enzyme activation. Following covalent modification of N-terminal residues of PLB with dansyl chloride or the spin label 4-isothiocyanato-2,2,6,6-tetramethylpiperidine-N-oxyl ('ITC-TEMPO'), we have co-reconstituted PLB with affinity-purified Ca-ATPase isolated from skeletal sarcoplasmic reticulum (SR) with full retention of catalytic function. The Ca(2+)-dependence of the ATPase activity of this reconstituted preparation is virtually identical with that observed using native cardiac SR before and after PLB phosphorylation, indicating that co-reconstituted sarcoplasmic/endoplasmic-reticulum Ca(2+)-ATPase 1 (SERCA1) and PLB provide an equivalent experimental model for SERCA2a-PLB interactions. Phosphorylation of PLB in the absence of the Ca-ATPase results in a greater amplitude of rotational mobility, suggesting that the structural linkage between the transmembrane region and the N-terminus is destabilized. However, whereas co-reconstitution with the Ca-ATPase restricts the amplitude of rotational motion of PLB, subsequent phosphorylation of PLB does not significantly alter its rotational dynamics. Thus structural interactions between PLB and the Ca-ATPase that restrict the rotational mobility of the N-terminus of PLB are retained following the phosphorylation of PLB by PKA. On the other hand, the fluorescence intensity decay of bound dansyl is sensitive to the phosphorylation state of PLB, indicating that there are changes in the tertiary structure of PLB coincident with enzyme activation. These results suggest that PLB phosphorylation alters its structural interactions with the Ca-ATPase by inducing structural rearrangements between PLB and the Ca-ATPase within a defined complex that modulates Ca(2+)-transport function.
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Affiliation(s)
- S Negash
- Biochemistry and Biophysics Section, Department of Molecular Biosciences, University of Kansas, Lawrence, KS 66045-2106, USA
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Negash S, Huang S, Squier TC. Rearrangement of domain elements of the Ca-ATPase in cardiac sarcoplasmic reticulum membranes upon phospholamban phosphorylation. Biochemistry 1999; 38:8150-8. [PMID: 10387060 DOI: 10.1021/bi990599j] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Phospholamban (PLB) is a major target of the beta-adrenergic cascade in the heart, and functions to modulate rate-limiting conformational transitions involving the transport activity of the Ca-ATPase. To investigate structural changes within the Ca-ATPase that result from the phosphorylation of PLB by cAMP-dependent protein kinase (PKA), we have covalently bound the long-lived phosphorescent probe erythrosin isothiocyanate (Er-ITC) to cytoplasmic sequences within the Ca-ATPase. Under these labeling conditions, the Ca-ATPase remains catalytically active, indicating that observed changes in rotational dynamics reflect normal conformational transitions. Two major Er-ITC labeling sites were identified using electrospray ionization mass spectrometry (ESI-MS), corresponding to Lys464 and Lys650, which are respectively located within the phosphorylation and nucleotide binding domains of the Ca-ATPase. Frequency-domain phosphorescence measurements of the rotational dynamics of Er-ITC bound to these cytoplasmic sequences within the Ca-ATPase permit the resolution of the dynamic structure of individual domain elements relative to the overall rotational motion of the entire Ca-ATPase polypeptide chain. We observe a significant decrease in the rotational dynamics of Er-ITC bound to the Ca-ATPase upon phosphorylation of PLB by PKA, as evidenced by an increase in the residual anisotropy. These results suggest that phosphorylation of PLB results in a structural reorientation of the phosphorylation or nucleotide binding domains with respect to the membrane normal. In contrast, calcium activation of the Ca-ATPase in the presence of dephosphorylated PLB results in no detectable change in the rotational dynamics of Er-ITC, suggesting that calcium binding and PLB phosphorylation have distinct effects on the conformation of the Ca-ATPase. We suggest that PLB functions to alter the efficiency of phosphoenyzme formation following calcium activation of the Ca-ATPase by modulating the spatial arrangement between ATP bound in the nucleotide binding domain and Asp351 in the phosphorylation domain.
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Affiliation(s)
- S Negash
- Biochemistry and Biophysics Section, Department of Molecular Biosciences, University of Kansas, Lawrence 66045-2106, USA
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Abstract
Phospholipids containing phosphoethanolamine (PE) headgroups within biological membranes have been suggested to be important with respect to the functional regulation of membrane proteins, including the Ca-ATPase in sarcoplasmic reticulum (SR). To investigate the role of PE headgroups in modulating the catalytic activity of the Ca-ATPase, we have reconstituted the Ca-ATPase into unilamellar liposomes containing defined amounts of dioleoylphosphatidylethanolamine (DOPE) and dioleoylphosphatidylcholine (DOPC). The enzymatic activity of the Ca-ATPase progressively increases upon incorporation of increasing amounts of PE into reconstituted vesicles, and approaches that characteristic of native SR membranes. To identify structural changes that correlate with enzyme activation, we have used frequency-domain phosphorescence spectroscopy to measure the rotational dynamics of erythrosin isothiocyanate covalently bound to Lys464 in the phosphorylation domain of the Ca-ATPase. Progressive increases in the rotational dynamics of the phosphorylation domain result from the incorporation of increasing amounts of DOPE, and correlate with enhanced enzymatic function. These results suggest that PE headgroups induce dynamic structural rearrangements involving the phosphorylation domain that modify the rates of nucleotide utilization. In contrast, no changes in the rotational dynamics of the lipid acyl chains are observed irrespective of the PE content. Therefore, the enhanced ATP hydrolytic activity associated with the incorporation of DOPE into these proteoliposomes is the result of specific noncovalent interactions involving PE phospholipid headgroups and the Ca-ATPase.
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Affiliation(s)
- G W Hunter
- Biochemistry and Biophysics Section, Department of Molecular Biosciences, University of Kansas, Lawrence, Kansas 66045-2106, USA
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Negash S, Sun H, Yao Q, Goh SY, Bigelow DJ, Squier TC. Cytosolic domain of phospholamban remains associated with the Ca-ATPase following phosphorylation by cAMP-dependent protein kinase. Ann N Y Acad Sci 1998; 853:288-91. [PMID: 10603961 DOI: 10.1111/j.1749-6632.1998.tb08281.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Negash
- Department of Biochemistry, Cell, and Molecular Biology, University of Kansas, Lawrence 66045-2106, USA
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Huang S, Negash S, Squier TC. Erythrosin isothiocyanate selectively labels lysine464 within an ATP-protectable binding site on the Ca-ATPase in skeletal sarcoplasmic reticulum membranes. Biochemistry 1998; 37:6949-57. [PMID: 9578581 DOI: 10.1021/bi980275f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Conditions that permit the selective modification of an ATP-protectable site on the Ca-ATPase in skeletal sarcoplasmic reticulum (SR) membranes using erythrosin isothiocyanate (Er-ITC) have been identified. The major labeling site for Er-ITC has been identified using reversed-phase HPLC and positive FAB mass spectrometry after exhaustive tryptic digestion of the Er-ITC-modified Ca-ATPase. An ATP-protectable peptide corresponding to M452NVFNTEVRNLSK464VER467 is modified by Er-ITC, the average mass of which is 2830.1 +/- 0.3 Da. The exclusive modification of lysine residues indicates Lys464 as the site of Er-ITC modification. Derivatization with Er-ITC diminishes the secondary activation of steady-state ATPase activity and the rate of dephosphorylation by millimolar concentrations of ATP. In contrast, in the presence of micromolar ATP concentrations Er-ITC modification of the Ca-ATPase does not affect (i) the apparent affinity of ATP, (ii) the maximal extent of phosphoenzyme formation by ATP, (iii) the rate of steady-state ATP hydrolysis, or (iv) the rate of dephosphorylation of the Ca-ATPase. Furthermore, ATP utilization by the Ca-ATPase is unaffected by detergent solubilization, irrespective of Er-ITC modification, indicating that the secondary activation of ATP hydrolysis involves a single Ca-ATPase polypeptide chain. Therefore, Er-ITC does not interfere with the normal structural transitions associated with phosphoenzyme decay. Rather, these results indicate that Er-ITC bound to Lys464 interferes with either ATP binding to a low-affinity site or the associated structural transitions that modulate the rate of enzyme dephosphorylation.
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Affiliation(s)
- S Huang
- Department of Biochemistry, Cell and Molecular Biology, University of Kansas, Lawrence 66045-2106, USA
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Negash S, Chen LT, Bigelow DJ, Squier TC. Phosphorylation of phospholamban by cAMP-dependent protein kinase enhances interactions between Ca-ATPase polypeptide chains in cardiac sarcoplasmic reticulum membranes. Biochemistry 1996; 35:11247-59. [PMID: 8784178 DOI: 10.1021/bi960864q] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We have used spin-label EPR spectroscopy to examine possible alterations in protein-protein interactions that accompany the activation of the cardiac sarcoplasmic reticulum (SR) Ca-ATPase following the phosphorylation of phospholamban (PLB). Using a radioactive derivative of a maleimide spin label (MSL), we have developed conditions for the selective spin-labeling of the Ca-ATPase in both native cardiac and skeletal sarcoplasmic reticulum membranes. The rotational dynamics of the cardiac and skeletal Ca-ATPase isoforms in native SR membranes were measured using saturation transfer EPR. We report that the phosphorylation of PLB in cardiac SR results in a (1.8 +/- 0.2)-fold reduction in the overall rotational mobility of the Ca-ATPase. The alteration in the rotational dynamics of the Ca-ATPase is the direct result of the phosphorylation of PLB, and is not related to the phosphorylation of the Ca-ATPase or any other SR proteins since no alteration in the ST-EPR spectrum is observed as a result of conditions that phosphorylate the cardiac Ca-ATPase with ATP. Neither do the use of conditions that activate the Ca-ATPase in cardiac SR result in the alteration of the rotational dynamics or catalytic properties of the Ca-ATPase in skeletal SR where PLB is not expressed. Measurements of the rotational dynamics of stearic acid spin labels (SASL) incorporated into cardiac SR membranes with a nitroxide at the 5- and 12-positions using conventional EPR indicate that there is virtually no difference in the lipid acyl chain dynamics in cardiac SR membranes upon the phosphorylation of PLB. These results indicate that the decrease in the rotational dynamics of the Ca-ATPase in cardiac SR membranes associated with the phosphorylation of PLB is related to enhanced interactions between individual Ca-ATPase polypeptide chains due to (i) an alteration in the spatial arrangement of cardiac Ca-ATPase polypeptide chains within a defined oligomeric state or (ii) increased protein-protein associations. We suggest that altered interactions between Ca-ATPase polypeptide chains and PLB serves to modulate the activation barrier associated with calcium activation of the Ca-ATPase in cardiac SR membranes.
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Affiliation(s)
- S Negash
- Department of Biochemistry, University of Kansas, Lawrence 66045-2106, USA
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