Digital Commons Network^™

Iron Dysregulation In Covid-19 And Reciprocal Evolution Of Sars-Cov-2: Natura Nihil Frustra Facit, Yash Gupta, Dawid Maciorowski, Brian Medernach, Daniel P. Becker Ph.D., Ravi Durvasula, Claudia R. Libertin, Prakasha Kempaiah

Chemistry: Faculty Publications and Other Works

After more than a year of the COVID-19 pandemic, SARS-CoV-2 infection rates with newer variants continue to devastate much of the world. Global healthcare systems are overwhelmed with high positive patient numbers. Silent hypoxia accompanied by rapid deterioration and some cases with septic shock is responsible for COVID-19 mortality in many hospitalized patients. There is an urgent need to further understand the relationships and interplay with human host components during pathogenesis and immune evasion strategies. Currently, acquired immunity through vaccination or prior infection usually provides sufficient protection against the emerging variants of SARS-CoV-2 except Omicron variant requiring recent booster. New …

Rethinking Integration Of Environmental And Behavioral Stressors; Back To Energy Homeostasis And Function, Patricia E. Molina

School of Medicine Faculty Publications

No abstract provided.

Using A Stochastic Continuous-Time Markov Chain Model To Examine Alternative Timing And Duration Of The Covid-19 Lockdown In Kuwait: What Can Be Done Now?, Mustafa Al-Zoughool, Tamer Oraby, Harri Vainio, Janvier Gasana, Joseph C. Longenecker, Walid Al Ali, Mohammad Alseaidan, Susie Elsaadany, Michael G. Tyshenko

School of Mathematical & Statistical Sciences Faculty Publications

Background

Kuwait had its first COVID-19 in late February, and until October 6, 2020 it recorded 108,268 cases and 632 deaths. Despite implementing one of the strictest control measures-including a three-week complete lockdown, there was no sign of a declining epidemic curve. The objective of the current analyses is to determine, hypothetically, the optimal timing and duration of a full lockdown in Kuwait that would result in controlling new infections and lead to a substantial reduction in case hospitalizations.

Methods

The analysis was conducted using a stochastic Continuous-Time Markov Chain (CTMC), eight state model that depicts the disease transmission and …

Race, Public Health, And The Epidemic Of Incarceration, Thalia González, Emma Kaeser

Nebraska Law Bulletin (Selected Issues)

COVID-19 is one of the greatest health crises of our time. While increased attention on the adverse individual and population-level effects of the pandemic for incarcerated people has motivated reforms and stimulated scholarly attention on carceral policies as health policies, this is only a first step. In this moment of heightened public consciousness around racism and health across all our public systems, this essay highlights the need for broader, health-justice-centered approaches to mass incarceration along the entire continuum. As new legal reforms emerge in this moment, we challenge the public health law community to work alongside racial justice, economic justice, …

2022-01-07_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated three times a week on Mondays, Wednesdays and Fridays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Care) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, …

How Does Lc/Ms Compare To Uv In Coffee Authentication And Determination Of Antioxidant Effects? Brazilian And Middle Eastern Coffee As Case Studies, Enas A. El-Hawary, Ahmed Zayed, Annegret Laub, Luzia V. Modolo

Faculty Journal Articles

Coffee is a popular beverage owing to its unique flavor and diverse health benefits. The current study aimed at investigating the antioxidant activity, in relation to the phytochemical composition, of authenticated Brazilian green and roasted Coffea arabica and C. robusta, along with 15 commercial specimens collected from the Middle East. Ultra-high-performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-ESI–HRMS) and UV spectrometry were employed for profiling and fingerprinting, respectively. With the aid of global natural product social molecular networking (GNPS), a total of 88 peaks were annotated as belonging to different chemical classes, of which 11 metabolites are reported for …

Emergence Of Clinical Clostridioides Difficile Isolates With Decreased Susceptibility To Vancomycin, Charles Darkoh, Kadiatou Keita, Chioma Odo, Micah Oyaro, Eric L Brown, Cesar A Arias, Blake M Hanson, Herbert L Dupont

Faculty, Staff and Student Publications

BACKGROUND: Clostridioides difficile infection (CDI) is a leading cause of hospital-associated antibiotic-related diarrhea and deaths worldwide. Vancomycin is one of the few antibiotics recommended for both nonsevere and severe CDI cases. We sought to determine whether vancomycin nonsusceptible C. difficile strains are circulating in the patient population.

METHODS: Stool samples from patients with CDI were collected from 438 and 98 patients at a large university hospital in Houston, Texas, and Nairobi, Kenya, respectively. The stools were examined for the presence of vancomycin and metronidazole nonsusceptible C. difficile using broth dilution culture, Etest (BioMérieux, France), polymerase chain reaction (PCR), whole-genome sequencing, …

Understanding Perceptions And Practices For Designing An Appropriate Community-Based Kangaroo Mother Care Implementation Package: Qualitative Exploratory Study, Shabina Ariff, Ikram Maznani, Maria Asif Bhura, Zahid Memon, Tayyaba Arshad, Tariq Ahmed Samejo, Shujaat Zaidi, Muhammad Umer, Imran Ahmed, Muhammad Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Low birth weight (LBW) is a common outcome of preterm birth, which increases the risk of an infant's morbidity and mortality. Approximately 20 million infants are born with LBW globally per year. Since a significant number of births in Pakistan take place at home, it is important to focus on the use of kangaroo mother care (KMC), the practice of skin-to-skin contact, in communities to prevent neonatal mortality and morbidity.
Objective: We employed a formative research approach to understand the context of communities and facilities with regard to neonatal care and KMC practice. The broader aims were to inform …

Plga/Peg Nanoparticles Loaded With Cyclodextrin-Peganum Harmala Alkaloid Complex And Ascorbic Acid With Promising Antimicrobial Activities, Sherif Ashraf Fahmy, Noha Khalil Mahdy, Hadeer Al Mulla, Hassan Mohamed El Said Azzazy

Faculty Journal Articles

Antimicrobial drugs face numerous challenges, including drug resistance, systemic toxic effects, and poor bioavailability. To date, treatment choices are limited, which warrants the search for novel potent antivirals, including those extracted from natural products. The seeds of Peganum harmala L. (Zygophyllaceae family) have been reported to have antimicrobial, antifungal, and anticancer activities. In the present study, a 2-hydroxy propyl-β-cyclodextrin (HPβCD)/harmala alkaloid-rich fraction (HARF) host–guest complex was prepared using a thin-film hydration method to improve the water solubility and bioavailability of HARF. The designed complex was then co-encapsulated with ascorbic acid into PLGA nanoparticles coated with polyethylene glycol (HARF–HPßCD/AA@PLGA-PEG NPs) using …

Otitis Media Practice During The Covid-19 Pandemic., Tal Marom, Jacob Pitaro, Udayan Shah, Sara Torretta, Paola Marchisio, Ayan Kumar, Patrick Barth, Sharon Ovnat Tamir

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The global coronavirus disease-2019 (COVID-19) pandemic has changed the prevalence and management of many pediatric infectious diseases, including acute otitis media (AOM). Coronaviruses are a group of RNA viruses that cause respiratory tract infections in humans. Before the COVID-19 pandemic, coronavirus serotypes OC43, 229E, HKU1, and NL63 were infrequently detected in middle ear fluid (MEF) specimens and nasopharyngeal aspirates in children with AOM during the 1990s and 2000s and were associated with a mild course of the disease. At times when CoV was detected in OM cases, the overall viral load was relatively low. The new severe acute respiratory syndrome …

Neonatal Sepsis: A Systematic Review Of Core Outcomes From Randomised Clinical Trials, Cían J. Henry, Gergana Semova, Ellen Barnes, Isabel Cotter, Tara Devers, Aisyah Rafaee, Andreea Slavescu, Niamh O. Cathain, Danielle Mccollum, Edna Roche, David Mockler, John Allen, Judith Meehan, Claus Klingenberg, Jos M. Latour, Den Hoogen A Van, Tobias Strunk, Eric Giannoni, Luregn J. Schlapbach, Marina Degtyareva, Frans B. Plötz, Boode Wp De, Lars Naver, James L. Wynn, Helmut Küster, Jan Janota, Fleur M. Keij, Irwin K.M. Reiss, Joseph M. Bliss, Joseph M. Bliss, Joyce M. Koenig, Mark A. Turner, Christopher Gale, Eleanor J. Molloy

School of Nursing and Midwifery

Abstract Background The lack of a consensus definition of neonatal sepsis and a core outcome set (COS) proves a substantial impediment to research that influences policy and practice relevant to key stakeholders, patients and parents. Methods A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In the included studies, the described outcomes were extracted in accordance with the provisions of the Core Outcome Measures in Effectiveness Trials (COMET) handbook and registered. Results Among 884 abstracts identified, 90 randomised controlled trials (RCTs) were included in this review. Only 30 …

Surgical Management During The Covid-19 Era At A Private Tertiary Care Hospital Of Karachi, Pakistan: A Cross-Sectional Study, Nida Zahid, Erum Baig, Gulzar S. Lakhani, Hasnain Zafar, Asad Latif, Syed Ather Enam

Department of Surgery Docs

Background: The coronavirus disease 2019 (COVID-19), declared a pandemic in March 2020, has affected the entire healthcare system, including the surgical practice. Guidelines for the management of surgical patients during this COVID-19 era need to be established to provide timely yet safe surgical care. In this study, we aimed to evaluate the outcomes of the COVID-19 testing algorithm established for surgery patients presenting to a tertiary care hospital in Karachi, Pakistan, and to compare the outcomes among patients who underwent elective versus emergency surgery.
Methodology: This is a cross-sectional study conducted at a tertiary care hospital in Pakistan to apply …

Mental Fatigue And Its Relationship With Cognitive Flexibility Among Students Of Faculty Of Educational Sciences At Al Al-Bayt University, Omar Al-Adamat

An-Najah University Journal for Research - B (Humanities)

The aim of this study is to investigate the relationship between mental fatigue and cognitive flexibility among students of the Faculty of Educational Sciences at Al al-Bayt University. The sample of the study consisted of (174) male and female undergraduate students who were chosen randomly. To achieve the study objectives, the mental fatigue scale and the cognitive flexibility scale were used. The results showed that the level of mental fatigue and cognitive flexibility was moderate. The results also showed that there are statistically significant differences in the level of mental fatigue attributed to sex variable for the benefit of male …

Distribution Of Serotypes And Antibiotic Resistance Of Invasive Pseudomonas Aeruginosa In A Multi-Country Collection, Shamima Nasrin, Nicolas Hegerle, Shaichi Sen, Joseph Nkeze, Sunil Sen, Jasnehta Permala-Booth, Myeongjin Choi, James Sinclair, Milagritos D. Tapia, Sadia Shakoor

Department of Pathology and Laboratory Medicine

Background: Pseudomonas aeruginosa is an opportunistic pathogen that causes a wide range of acute and chronic infections and is frequently associated with healthcare-associated infections. Because of its ability to rapidly acquire resistance to antibiotics, P. aeruginosa infections are difficult to treat. Alternative strategies, such as a vaccine, are needed to prevent infections. We collected a total of 413 P. aeruginosa isolates from the blood and cerebrospinal fluid of patients from 10 countries located on 4 continents during 2005-2017 and characterized these isolates to inform vaccine development efforts. We determined the diversity and distribution of O antigen and flagellin types and …

Implementation Of The Comprehensive Unit-Based Safety Program To Improve Infection Prevention And Control Practices In Four Neonatal Intensive Care Units In Pune, India, Julia Johnson, Asad Latif, Bharat Randive, Abhay Kadam, Uday Rajput, Aarti Kinikar, Nandini Malshe, Sanjay Lalwani, Tushar B. Parikh, Umesh Vaidya

Department of Anaesthesia

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.
Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate …

The First 2 Years Of Covid-19: Lessons To Improve Preparedness For The Next Pandemic, Jennifer B. Nuzzo, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

On December 31, 2019, the World Health Organization (WHO) Country Office in China reported novel “viral pneumonias of unknown cause” in Wuhan, but China did not confirm case clusters until January 3, 2020. Two years later, more than 285 million cases and 5.4 million deaths have been reported. As of December 2021, more than 800 000 COVID-19 deaths have occurred in the US, surpassing the 675 446 total deaths that occurred during the great influenza pandemic of 1918. The COVID-19 pandemic reduced global economic growth by an estimated 3.2% in 2020, with trade declining by 5.3%; an estimated 75 million …

Comparison Of Percutaneous Vs Oral Infection Of Hamsters With The Hookworm Ancylostoma Ceylanicum: Parasite Development, Pathology And Primary Immune Response, Richard D. Bungiro, Lisa M. Harrison, Blaise Dondji, Michael Cappello

Biology Faculty Scholarship

Background

Hundreds of millions of people in poor countries continue to suffer from disease caused by bloodfeeding hookworms. While mice and rats are not reliably permissive hosts for any human hookworm species, adult Golden Syrian hamsters are fully permissive for the human and animal pathogen Ancylostoma ceylanicum. Similar to humans, hamsters may be infected with A. ceylanicum third-stage larvae orally or percutaneously. Oral infection typically leads to consistent worm yields in hamsters but may not accurately reflect the clinical and immunological manifestations of human infection resulting from skin penetration.

Methodology/Principal findings

In this study we compared host responses …

2022-January-05-Researchers Investigate Sars-Cov-2 Immune Response, University Marketing And Communication, East Tennessee State University

ETSU News

Making Strides in COVID-19 Research

JOHNSON CITY (Jan. 5, 2022) — Members of the Center of Excellence in Inflammation, Infectious Disease, and Immunity (CIIDI) at East Tennessee State University have been making strides in understanding SARS-CoV-2, recently publishing their second article describing a study examining the immune reaction to SARS-CoV-2 (the virus responsible for COVID-19). 

The article, “SARS-CoV-2 specific memory T cell epitopes identified in COVID-19-recovered subjects,” was published in Virus Research.  

Given that …

Thrombospondin-1 Expression And Modulation Of Wnt And Hippo Signaling Pathways During The Early Phase Of Trypanosoma Cruzi Infection Of Heart Endothelial Cells, Ashutosh Arun, Kayla J. Rayford, Ayorinde Cooley, Tanu Rana, Girish Rachakonda, Fernando Villalta, Siddharth Pratap, Maria F. Lima, Nader Sheibani, Pius N. Nde

Publications and Research

The protozoan parasite, Trypanosoma cruzi, causes severe morbidity and mortality in afflicted individuals. Approximately 30% of T. cruzi infected individuals present with cardiac pathology. The invasive forms of the parasite are carried in the vascular system to infect other cells of the body. During transportation, the molecular mechanisms by which the parasite signals and interact with host endothelial cells (EC) especially heart endothelium is currently unknown. The parasite increases host thrombospondin-1 (TSP1) expression and activates the Wnt/β-catenin and hippo signaling pathways during the early phase of infection. The links between TSP1 and activation of the signaling pathways and …

Industry 4.0 Technologies For The Manufacturing And Distribution Of Covid-19 Vaccines, Azza Sarfraz, Zouina Sarfraz, Muzna Sarfraz, Aminah Abdul Razzack, Shehar Bano, Sarabjot Singh Makkar, Sindhu Thevuthasan, Trissa Paul, Muhammad Khawar Sana, Nishwa Azeem

Department of Paediatrics and Child Health

Background: The evolutionary stages of manufacturing have led us to conceptualize the use of Industry 4.0 for COVID-19 (coronavirus disease 2019), powered by Industry 4.0 technologies. Using applications of integrated process optimizations reliant on digitized data, we propose novel intelligent networks along the vaccine value chain. Vaccine 4.0 may enable maintenance processes, streamline logistics, and enable optimal production of COVID-19 vaccines.
Vaccine 4.0 framework: The challenge in applying Vaccine 4.0 includes the requirement of large-scale technologies for digitally transforming manufacturing, producing, rolling-out, and distributing vaccines. With our framework, Vaccine 4.0 analytics will target process performance, process development, process stability, compliance, …

Trends In Premature Mortality From Acute Myocardial Infarction In The United States, 1999 To 2019, Sourbha S. Dani, Ahmad N. Lone, Zulqarnain Javed, Muhammad S. Khan, Muhammad Zia Khan, Edo Kaluski, Salim S. Virani, Michael D. Shapiro, Miguel Cainzos‐Achirica, Khurram Nasir

Office of the Provost

Pagination are not provided by the author/publisher. This work was published before the author joined Aga Khan University.

2022-01-04_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated three times a week on Mondays, Wednesdays and Fridays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Care) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, …

Challenges, Inquiry, And Recommendations: Effective Covid-19 Vaccine Management In The Face Of Public Mistrust And Concern, Rosemary M. Caron, M. Girard Dorsey

Faculty Publications

By examining concerns about safety, compliance, and distribution through an interdisciplinary approach of public health and history, we argue that historical and contemporary mistrust of immunizations serves to challenge the successful management of a COVID-19 vaccine program in the U.S. Unique circumstances surrounding the development of a COVID-19 vaccine, including pressure for rapid production, unclear communication from public health officials, and existing resistance to behavioral protective public health policy measures (e.g., mask-wearing) complicate widespread vaccine adoption. Currently, the demand for first and second COVID-19 vaccine doses, as well as the COVID-19 booster, continues to fluctuate in the U.S. population as …

Changes In Covid-19 Vaccine Hesitancy Among Black And White Individuals In The Us, Kilhoe Na, Tasleem J. Padamsee, Robert M. Bond, Graham N. Dixon, Shelly R. Hovick, Erik C. Nisbet, Duane T. Wegener, R. Kelly Garrett

Communication and Media Faculty Publications

Importance: COVID-19 has disproportionately affected Black individuals in the US; however, vaccination rates among Black individuals trail those among other racial groups. This disparity is often attributed to a high level of vaccine hesitancy among Black individuals, but few studies have examined changes in vaccine hesitancy over time. Objectives: To compare changes in vaccine hesitancy between Black and White individuals in the US and to examine mechanisms that might help explain the observed differences. Design, Setting, and Participants: This survey study used 7 waves of data collected using a panel design. A total of 1200 English-speaking adults in the US …

Assessment Of Regional Variability In Covid-19 Outcomes Among Patients With Cancer In The United States., Jessica E Hawley, Tianyi Sun, David D Chism, Narjust Duma, Julie C Fu, Na Tosha N Gatson, Sanjay Mishra, Ryan H Nguyen, Sonya A Reid, Oscar K Serrano, Sunny R K Singh, Neeta K Venepalli, Ziad Bakouny, Babar Bashir, Mehmet A Bilen, Paolo F Caimi, Toni K Choueiri, Scott J Dawsey, Leslie A Fecher, Daniel B Flora, Christopher R Friese, Michael J Glover, Cyndi J Gonzalez, Sharad Goyal, Thorvardur R Halfdanarson, Dawn L Hershman, Hina Khan, Chris Labaki, Mark A Lewis, Rana R Mckay, Ian Messing, Nathan A Pennell, Matthew Puc, Deepak Ravindranathan, Terence D Rhodes, Andrea V Rivera, John Roller, Gary K Schwartz, Sumit A Shah, Justin A Shaya, Mitrianna Streckfuss, Michael A Thompson, Elizabeth M Wulff-Burchfield, Zhuoer Xie, Peter Paul Yu, Jeremy L Warner, Dimpy P Shah, Benjamin French, Clara Hwang

Kimmel Cancer Center Faculty Papers

Importance: The COVID-19 pandemic has had a distinct spatiotemporal pattern in the United States. Patients with cancer are at higher risk of severe complications from COVID-19, but it is not well known whether COVID-19 outcomes in this patient population were associated with geography.

Objective: To quantify spatiotemporal variation in COVID-19 outcomes among patients with cancer.

Design, Setting, and Participants: This registry-based retrospective cohort study included patients with a historical diagnosis of invasive malignant neoplasm and laboratory-confirmed SARS-CoV-2 infection between March and November 2020. Data were collected from cancer care delivery centers in the United States.

Exposures: Patient residence was categorized …

Covid-19 Newsletter (Vol. 102), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Role Of Three Bird Species In The Life Cycle Of Two Sarcocystis Spp. (Apicomplexa, Sarcocystidae) In The Czech Republic, Ondřej Máca, David González-Solís

Harold W. Manter Laboratory of Parasitology: Library Materials

Birds are one of the groups involved in the development of Sarcocystis Lankester (1882), serving either as intermediate or definitive hosts. The white-tailed sea eagle Haliaeetus albicilla (Linnaeus, 1758), red kite Milvus milvus (Linnaeus, 1758) (both Accipitriformes) and common starlings Sturnus vulgaris Linnaeus, 1758 (Passeriformes) were examined to elucidate their participation in the development of Sarcocystis, as well as to determine the specific identity of the parasites based on morphological and especially molecular analyses. In 2020–2021, one white-tailed eagle, one red kite and five common starlings were parasitologically examined for the presence of Sarcocystis using flotation centrifugation coprological method …

The Yersinia High-Pathogenicity Island Encodes A Siderophore-Dependent Copper Response System In Uropathogenic Escherichia Coli, George L Katumba, Hung Tran, Jeffrey P Henderson

Open Access Publications

Siderophores are iron chelators used by microbes to bind and acquire iron, which, once in the cell, inhibits siderophore production through feedback repression mediated by the ferric uptake repressor (Fur). Yersiniabactin (Ybt), a siderophore associated with enhanced pathogenic potential among

Sars-Cov-2 Spreads Through Cell-To-Cell Transmission, Cong Zeng, John P Evans, Tiffany King, Yi-Min Zheng, Eugene M Oltz, Sean P J Whelan, Linda J Saif, Mark E Peeples, Shan-Lu Liu

Open Access Publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible coronavirus responsible for the global COVID-19 pandemic. Herein, we provide evidence that SARS-CoV-2 spreads through cell-cell contact in cultures, mediated by the spike glycoprotein. SARS-CoV-2 spike is more efficient in facilitating cell-to-cell transmission than is SARS-CoV spike, which reflects, in part, their differential cell-cell fusion activity. Interestingly, treatment of cocultured cells with endosomal entry inhibitors impairs cell-to-cell transmission, implicating endosomal membrane fusion as an underlying mechanism. Compared with cell-free infection, cell-to-cell transmission of SARS-CoV-2 is refractory to inhibition by neutralizing antibody or convalescent sera of COVID-19 patients. While angiotensin-converting …

Cost-Effectiveness Analysis Of Implementing An Integrated Neonatal Care Kit To Reduce Neonatal Infection In Rural Pakistan, Fiona Muttalib, Karen Chung, Lisa Grace Pell, Shabina Ariff, Sajid Soofi, Shaun K. Morris, Beate Sander

Department of Paediatrics and Child Health

Objective:
To evaluate the cost-effectiveness of distribution of the integrated neonatal care kit (iNCK) by community health workers from the healthcare payer perspective in Rahimyar Khan, Pakistan.
Setting:
Rahimyar Khan, Pakistan.
Participants:
N/A.
Intervention:
Cost-utility analysis using a Markov model based on cluster randomised controlled trial (cRCT: NCT02130856) data and a literature review. We compared distribution of the iNCK to pregnant mothers to local standard of care and followed infants over a lifetime horizon.
Primary and secondary outcome measures:
The primary outcome was incremental net monetary benefit (INMB, at a cost-effectiveness threshold of US$15.50), discounted at 3%. Secondary outcomes …