Neonatal sepsis in low-income countries: epidemiology, diagnosis and prevention
- 25 February 2020
- journal article
- research article
- Published by Taylor & Francis in Expert Review of Anti-infective Therapy
- Vol. 18 (5) , 443-452
Abstract
Introduction: Sepsis accounts for up to one third of neonatal deaths in the world each year. The World Health Organization acknowledges neonatal sepsis as a major global health concern, and that the highest burden occurs in low- and middle-income countries (LMICs). Despite major research and clinical progress in this area, we still lack accurate diagnostic tools for neonatal sepsis, complicating the management of this condition. Areas covered: The purpose here is to review the latest data on the incidence, diagnosis, prevention and management of neonatal sepsis in LMIC. We discuss the limitations of current diagnostic tests – including their lack of availability – and how this may influence global estimates of cases. We review the benefits of antenatal, intrapartum and post-natal preventive measures. We briefly discuss the management, highlighting the emergence of antimicrobial resistance. Finally, we expose some high priorities areas. Expert opinion: Neonatal sepsis is a challenging condition requiring a multifaceted approach to address the major diagnostic issues, but also the underlying socio-economic causes that nourish epidemic cases in LMIC. Focusing on antibiotics as a main pillar of intervention is likely to engender antimicrobial resistance, eventually hindering the appreciable gains LMICs have achieved in neonatal health outcomes.Keywords
This publication has 96 references indexed in Scilit:
- Risk of Early-Onset Neonatal Infection with Maternal Infection or Colonization: A Global Systematic Review and Meta-AnalysisPLOS Medicine, 2013
- Interventions to reduce neonatal mortality from neonatal tetanus in low and middle income countries - a systematic reviewBMC Public Health, 2013
- Accuracy of WHO Verbal Autopsy Tool in Determining Major Causes of Neonatal Deaths in IndiaPLOS ONE, 2013
- Tuberculosis in pregnancy: The challenges for South Asian countriesJournal of Obstetrics and Gynaecology Research, 2012
- Association between Clean Delivery Kit Use, Clean Delivery Practices, and Neonatal Survival: Pooled Analysis of Data from Three Sites in South AsiaPLOS Medicine, 2012
- Neonatal morbidity and mortality in tribal and rural communities in Central IndiaIndian Journal of Community Medicine, 2011
- Pathophysiology and Treatment of Septic Shock in NeonatesClinics in Perinatology, 2010
- Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysisBMJ, 2010
- Neonatal Meningitis: What Is the Correlation Among Cerebrospinal Fluid Cultures, Blood Cultures, and Cerebrospinal Fluid Parameters?Pediatrics, 2006
- Volume of blood required to detect common neonatal pathogensThe Journal of Pediatrics, 1996