Maternal and Child Health Commons^™

Development Of The Infant Gut Microbiome Predicts Temperament Across The First Year Of Life, Molly Fox, S. Melanie Lee, Kyle S. Wiley, Venu Lagishetty, Curt A. Sandman, Jonathan P. Jacobs, Laura M. Glynn

Psychology Faculty Articles and Research

Perturbations to the gut microbiome are implicated in altered neurodevelopmental trajectories that may shape life span risk for emotion dysregulation and affective disorders. However, the sensitive periods during which the microbiome may influence neurodevelopment remain understudied. We investigated relationships between gut microbiome composition across infancy and temperament at 12 months of age. In 67 infants, we examined if gut microbiome composition assessed at 1–3 weeks, 2, 6, and 12 months of age was associated with temperament at age 12 months. Stool samples were sequenced using the 16S Illumina MiSeq platform. Temperament was assessed using the Infant Behavior Questionnaire-Revised (IBQ-R). Beta …

Evaluating Motor Performance With The Bruininks-Oseretsky Test Of Motor Proficiency In Impoverished Pakistani Children, Zehra Habib Hasan, Fariha Shaheen, Arjumand Rizvi, Jelena Obradovic, Aisha Khan Yousafzai

Department of Paediatrics and Child Health

Objective: To evaluate the sensitivity of the modified Brief Form of Bruininks Oseretsky Test in identifying motor differences secondary to malnutrition and poverty.
Methods: This longitudinal cohort study was conducted at Nowshero Feroze, Sindh from 2013 to 2014 and comprised data drawn from children who participated in a randomised controlled trial, that assessed responsive stimulation and nutrition interventions in the first two years of life. Outcome measures included motor development assessed using Brief Form of Bruininks Oseretsky Test, child anthropometry and household economic and demographic information. Data was analysed using SPSS 15 and STATA 12.
Results: Of the 1058 children, …

Impact Of Local Terminology On The Design Of A Community-Based Diagnostic And Management Algorithm For Postpartum Sepsis: Findings Of Formative Research, Shabina Ariff, Fatima Mir, Wafa Aftab, Farrukh Raza, Shujaat Zaidi, Sheraz Memon, Amnesty Lefevre, Linda A. Bartlett, Peter Winch, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Postpartum sepsis is one of the leading causes of maternal mortality and morbidity in developing countries. This formative research elicits local terms used for postpartum illnesses and symptoms of postpartum sepsis with the aim of improving postpartum diagnosis and management in Pakistan.
Methods: We conducted 34 in-depth interviews with recently delivered women (RDW), traditional birth attendants (TBAs), healthcare providers and family members of RDW from rural Sindh to explore local Sindhi terms used to describe postpartum sepsis and related symptoms. During interviews, all participants were asked to orally free list common symptoms of postpartum illnesses; those who were aware …

Tiny Tusks Internship: Marketing Towards Breastfeeding: How Marketing Can Either Help Or Hinder How Breastfeeding Is Perceived, Hailey Tremmel

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Tiny Tusks Breastfeeding and Infant Support is a program run by faculty and students in the Eleanor Mann School of Nursing program that allows for breastfeeding mothers in attendance at the University of Arkansas sporting events to have a place to pump or provide care to their infant. How marketing towards breastfeeding is portrayed has a huge impact on helping breastfeeding mothers to feel properly educated and supported about the decision to breastfeed. The purpose of this literature review is to demonstrate how marketing tactics can affect the view of breastfeeding, whether that be positive or negative. The results found …

How Covid-19 Has Fundamentally Changed Clinical Research In Global Health, Jay J H. Park, Robin Mogg, Gerald E. Smith, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Craig R. Rayner, Jeanine Condo, Eric H. Decloedt, Jean B. Nachega, Gilmar Reis, Edward J. Mills

Department of Paediatrics and Child Health

COVID-19 has had negative repercussions on the entire global population. Despite there being a common goal that should have unified resources and efforts, there have been an overwhelmingly large number of clinical trials that have been registered that are of questionable methodological quality. As the final paper of this Series, we discuss how the medical research community has responded to COVID-19. We recognise the incredible pressure that this pandemic has put on researchers, regulators, and policy makers, all of whom were doing their best to move quickly but safely in a time of tremendous uncertainty. However, the research community's response …

Urgently Seeking Efficiency And Sustainability Of Clinical Trials In Global Health, Jay J H. Park, Rebecca F. Grais, Monica Taljaard, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Jean B. Nachega, Nathan Ford, Denis Xavier, Andre P. Kengne, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current …

Determinants Of Short Birth Intervals Among Married Women: A Cross-Sectional Study In Karachi, Pakistan, Sidrah Nausheen, Maria Asif Bhura, Kristy Hackett, Imtiaz Hussain, Zainab Shaikh, Arjumand Rizvi, Uzair Ansari, David Canning, Iqbal Shah, Sajid Bashir Soofi

Department of Obstetrics & Gynaecology

Introduction: Birth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan.
Methods: We used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were …

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial, Melissa S. Bauserman, Carla M. Bann, K Michael Hambidge, Ana L. Garces, Lester Figueroa, Jamie L. Westcott, Jackie K. Patterson, Elizabeth M. Mcclure, Sumera Ali Aziz, Sarah Saleem

Community Health Sciences

Background: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.
Objective: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.
Methods: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Hyperglycemia During The First Three Days Of Life Increases The Risk Of Retinopathy Of Prematurity In Extremely Low Birth Weight Infants, Jihan M. Esmail, Ramasubbareddy Dhanireddy Md

Longitudinal Scholar's Project

Background: The association between hyperglycemia and ROP has been inconsistent in previous studies. Extremely low birth weight (ELBW) infants are at high risk for ROP. They also experience hypoglycemia initially and hyperglycemia while receiving IV glucose infusion. The effect of initial hypoglycemia on hyperglycemia associated ROP risk is unknown.

Objective: To study the effect of initial hypoglycemia and subsequent hyperglycemia during the first three days of life on the incidence of ROP and severe ROP in ELBW (birth weight ≤1000g) infants.

Methods: Clinical and demographic data were collected from 227 ELBW infants born during the years 2017-2019 at the Regional …

Examining Factors Associated With Bcg And Poliomyelitis Vaccination Coverage In Tanzanian And Kenyan Children Aged 12 To 23 Months Using Dhs Surveys, Ognyan Simeonov

Independent Study Project (ISP) Collection

The rapid spread of infectious diseases in eastern Africa has made vaccination a major health factor in the region. This study aims to evaluate the factors affecting vaccination coverage with the BCG and Poliomyelitis vaccines in Tanzanian and Kenyan children aged 12 to 23 months. In May 2021, we collected data from the Demographic and Health Surveys (DHS) from 2014-2016 for Kenya and Tanzania and evaluated how different variables such as the sex of the child, maternal age, maternal educational level, availability of health facilities, access to electricity in the household, and birth order affect the vaccination coverage. We used …

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …

Feasibility, Usability And Acceptability Of Paediatric Lung Ultrasound Among Healthcare Providers And Caregivers For The Diagnosis Of Childhood Pneumonia In Resource-Constrained Settings: A Qualitative Study, Atif Riaz, Olga Cambaco, Laura Elizabeth Ellington, Jennifer L. Lenahan, Khatia Munguambe, Usma Mehmood, Sana Qaisar, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan

Department of Paediatrics and Child Health

Objectives: Paediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.
Design: Prospective qualitative study using semistructured interviews SETTING: Two referral hospitals in Mozambique and Pakistan PARTICIPANTS: A total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.
Results: HCPs …

Development And Feasibility Testing Of A Play-Based Psychosocial Intervention For Reduced Patient Stress In A Pediatric Care Setting: Experiences From Pakistan, Muneera A. Rasheed, Vardah Bharuchi, Waliyah Mughis, Ayesha Hussain

Department of Paediatrics and Child Health

Background: Hospitalization can be a source of great stress for children and their families. In high-income countries, there are specialized staff to help children cope using different techniques including play. However, it is a major challenge in low and middle-income countries (LMIC) due to financial constraints and untrained human resource. The objective of study was to develop and test the feasibility and acceptance of a psychology trainee-delivered model postulated on employing play as a means of enhancing child-parent interactions leading to reduced stress during hospitalization.
Methods: This study was conducted in the paediatric ward of a tertiary care private hospital …

Association Between Preterm-Birth Phenotypes And Differential Morbidity, Growth, And Neurodevelopment At Age 2 Years: Results From The Interbio-21st Newborn Study, Jose Villar, María C. Restrepo-Méndez, Rose Mcgready, Fernando C. Barros, Cesar G. Victora, Shama Munim, Aris T. Papageorghiou, Roseline Ochieng, Rachel Craik, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Importance: The etiologic complexities of preterm birth remain inadequately understood, which may impede the development of better preventative and treatment measures.
Objective: To examine the association between specific preterm-birth phenotypes and clinical, growth, and neurodevelopmental differences among preterm newborns compared with term newborns up to age 2 years.
Design, setting, and participants: The INTERBIO-21st study included a cohort of preterm and term newborn singletons enrolled between March 2012 and June 2018 from maternity hospitals in 6 countries worldwide who were followed up from birth to age 2 years. All pregnancies were dated by ultrasonography. Data were analyzed from November 2019 …

Enteric Fever, Buddha Basnyat, Farah Naz Qamar, Priscilla Rupali, Tahmeed Ahmed, Christopher M. Parry

Department of Paediatrics and Child Health

No abstract provided.

Conducting Household Surveys On Reproductive Health In Urban Settings: Lessons From Karachi, Pakistan, Mirbaz Khan, Sidrah Nausheen, Imtiaz Hussain, Kristy Hackett, Kaneez Zehra, Khalid Feroz, David Cannin, Iqbal Shah, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Data collection is the most critical stage in any population health study and correctly implementing fieldwork enhances the quality of collected information. However, even the most carefully planned large-scale household surveys can encounter many context-specific issues. This paper reflected on our research team's recent experience conducting surveys for a quasi-experimental evaluation of a reproductive health program in urban areas of Karachi, Pakistan. We aim to describe the issues encountered and lessons learned from this process, and present some potential solutions for conducting future household surveys in similar urban environments.
Methods: The study followed a three-stage random sampling design. Initially, …

Abstract To Publication Conversion In Pediatric Critical Care Medicine In Pakistan, Anwarul Haque, Mohammad Shahzad, Humaira Jurair, Naveed Ur Rehman Siddiqui, Sidra Ishaque, Qalab Abbas

Department of Paediatrics and Child Health

Background: To determine the rate of conversion of abstracts presented at conferences into full-text articles published in peer-reviewed journals in the field of pediatric critical care medicine (PCCM) in a developing country.
Methods: We retrospectively reviewed PCCM abstracts from Pakistan presented at national and international pediatric and critical care conferences over 10 years (January 2010 to March 2020). Data included abstract characteristics, such as presentation (poster/oral), presenter (fellow/resident), time of meeting (month and year), type of meeting, study design and topic; and publication characteristics, such as journal name, time (month and year) and first author. The primary outcome was publication …

Impact Of 10-Valent Pneumococcal Conjugate Vaccine (Pcv10) On Nasopharyngeal Carriage In Children 2 Years Of Age: Data From A Four-Year Time Series Cross-Sectional Study From Pakistan, Muhammad Imran Nisar, Shahira Shahid, Sajid Muhammad, Farah Khalid, Amjad Hussain, Sheraz Ahmed, Sadia Shakoor, Furqan Kabir, Aneeta Hotwani, Syed Asad Ali, Anita K. M. Zaidi, Fyezah Jehan, Najeeha Talat Iqbal

Department of Paediatrics and Child Health

The dataset described in this paper was collected for a time-series cross-sectional study exploring the impact of 10-valent Pneumococcal Conjugate Vaccine (PCV10) on nasopharyngeal (NP) carriage in children under 2 years of age from a rural population in Sindh, Pakistan. The study was carried out in two union councils of Matiari - Khyber and Shah Alam Shah Jee Wasi (Latitude 25.680298 / Longitude 68.502711). Data was collected on socio-demographics, clinical characteristics and vaccination status using android phone-based application. NP samples were collected using standard World Health Organisation (WHO) techniques, culture and serotyping was done using sequential Multiplex PCR described by …

Meropenem-Induced Pancytopenia In A Preterm Neonate: A Case Report, Kashif Hussain, Muhammad Sohail Salat, Naureen Mohammad, Ambreen Mughal, Sidra Idrees, Javaid Iqbal, Gul Ambreen

Department of Biological & Biomedical Sciences

Background: A post-marketing surveillance study has reported an association between meropenem use and the incidence of hematologic abnormalities, including leukopenia, thrombocytopenia, hemolysis, and neutropenia, but the precise incidence in neonates is unknown. Here, we report meropenem-induced pancytopenia in a preterm neonate.
Case presentation: A preterm newborn Pakistani received intravenous meropenem 40 mg/kg every 8 hours to treat Klebsiella pneumoniae in blood cultures and suspected meningitis. The baby developed severe thrombocytopenia, with a platelet count of 22 × 10³ cells/mm³, low hemoglobin level of 9.7 g/dl, and low absolute neutrophil count (ANC) of 816 cells/mm³ on days …

Mucosal Genomics Implicate Lymphocyte Activation And Lipid Metabolism In Refractory Environmental Enteric Dysfunction, Najeeha Talat Iqbal, Najeeb Rahman, Kamran Sadiq, Zubair Ahmad, Romana Idress, Junaid Iqbal, Sheraz Ahmed, Aneeta Hotwani, Fayyaz Umrani, Sana Syed, Syed Asad Ali

Department of Paediatrics and Child Health

Background & aims: Environmental enteric dysfunction (EED) limits the Sustainable Development Goals of improved childhood growth and survival. We applied mucosal genomics to advance our understanding of EED.
Methods: The Study of Environmental Enteropathy and Malnutrition (SEEM) followed 416 children from birth to 24 months in a rural district in Pakistan. Biomarkers were measured at 9 months and tested for association with growth at 24 months. The duodenal methylome and transcriptome was determined in 52 undernourished SEEM participants and 42 North American controls and celiac disease patients.
Results: After accounting for growth at study entry, circulating IGF-1 and ferritin predicted …

Characteristics Of Salmonella Recovered From Stools Of Children Enrolled In The Global Enteric Multicenter Study, Irene N. Kasumba, Caisey V. Pulford, Blanca M. Perez-Sepulveda, Sunil Sen, Nurulla Sayed, Jasnehta Permala-Booth, Sofie Livio Sofie Livio, Darren Heavens Darren Heavens, Ross Low Ross Low, Shahida Qureshi, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Background: The Global Enteric Multicenter Study (GEMS) determined the etiologic agents of moderate-to-severe diarrhea (MSD) in children under 5 years old in Africa and Asia. Here, we describe the prevalence and antimicrobial susceptibility of non-typhoidal Salmonella (NTS) serovars in GEMS and examine the phylogenetics of Salmonella Typhimurium ST313 isolates.
Methods: Salmonella isolated from children with MSD or diarrhea-free controls were identified by classical clinical microbiology and serotyped using antisera and/or whole genome sequence data. We evaluated antimicrobial susceptibility using the Kirby-Bauer disk diffusion method. Salmonella Typhimurium sequence types were determined using multi-locus sequence typing and whole genome sequencing was performed …

A Pathogenic Ufsp2 Variant In An Autosomal Recessive Form Of Pediatric Neurodevelopmental Anomalies And Epilepsy, Min Ni, Bushra Afroze, Chao Xing, Chunxiao Pan, Yanqiu Shao, Ling Cai, Brandi L. Cantarel, Jimin Pei, Nick V. Grishin, Stacy Hewson

Department of Paediatrics and Child Health

Purpose: Neurodevelopmental disabilities are common and genetically heterogeneous. We identified a homozygous variant in the gene encoding UFM1-specific peptidase 2 (UFSP2), which participates in the UFMylation pathway of protein modification. UFSP2 variants are implicated in autosomal dominant skeletal dysplasias, but not neurodevelopmental disorders. Homozygosity for the variant occurred in eight children from four South Asian families with neurodevelopmental delay and epilepsy. We describe the clinical consequences of this variant and its effect on UFMylation.
Methods: Exome sequencing was used to detect potentially pathogenic variants and identify shared regions of homozygosity. Immunoblotting assessed protein expression and post-translational modifications in patient-derived fibroblasts. …

Direct And Indirect Effect Of 10 Valent Pneumococcal Vaccine On Nasopharyngeal Carriage In Children Under 2 Years Of Age In Matiari, Pakistan, Muhammad Imran Nisar, Sheraz Ahmed, Fyezah Jehan, Shahira Shahid, Sadia Shakoor, Furqan Kabir, Aneeta Hotwani, Sahrish Munir, Sajid Muhammad, Farah Khalid, Syed Asad Ali, Anita K. M. Zaidi, Najeeha Talat Iqbal

Department of Paediatrics and Child Health

Background: Pakistan introduced Ten-valent pneumococcal-conjugate-vaccine PCV10 in 2012 as a 3 + 0 schedule without catch-up.
Methods: Children <2 years old in Matiari, Sindh provided nasopharyngeal swabs between 2014 and 2018, which were cultured for pneumococcus and serotyped through multiplex PCR at the Aga Khan University Hospital. Carriage rates over time for Vaccine-Type (VT) and Non-VT (NVT) serotypes were used to estimate direct, indirect, total and overall effects of vaccination. Regression analysis was used to determine factors associated with VT carriage.
Results: Pneumococcus was detected in 2370/3140 (75%). VT carriage decreased overall, 16.1-9.6% (p-trend <0.001); vaccinated (all 3 doses of PCV10 received) 11.3-8.1% (p-trend 0.031) and unvaccinated (no PCV10 dose received) 17.4-10.3% (p-trend 0.003) with a decline in serotypes 6B, 9V/9A and 19F. Immunization increased from 41.0% to 68.4% (p-trend 0.001). Direct effect of vaccine was 32.8% (95% CI 14.7-47.0%) and indirect effect 44.6%(95% CI 40.6-48.6%). Factors associated with decreased VT colonization were education 1-5 years (aOR 0.7, 95%CI 0.6-1.0), history of difficulty breathing (aOR 0.7, 95%CI 0.5-1.0), exposure to smoke (aOR 0.8, 95% CI 0.6-1.0), child fully immunized (aOR 0.7, 95%CI 0.5-1.0) and enrolled in 3rd (aOR 0.6, 95%CI 0.4-0.8) and 4th (aOR 0.6, 95%CI 0.5-0.9) year of the study whereas history of runny nose (aOR 1.5, 95% CI 1.2-1.9) was positively associated.
Conclusions: Decrease in VT pneumococcal carriage in vaccinated and unvaccinated children indicates herd immunity. Sustained increase in vaccine coverage and close long-term surveillance is warranted.

The Effects Of Combined Transcranial Brain Stimulation And A 4-Week Visuomotor Stepping Training On Voluntary Step Initiation In Persons With Chronic Stroke-A Pilot Study, Ira H Gewolb, Babatunde T Sobowale, Frank L Vice, Abhijit Patwardhan, Nino Solomonia, Eric W Reynolds

Faculty, Staff and Student Publications

Background: Suck-swallow rhythmicity and the integration of breathing into infant feeding are developmentally regulated. Neurological injury and breathing abnormalities can both impact feeding in preterm infants.

Objective: To determine the effects of neurologic injury independent of effects of disordered breathing on feeding biorhythms in premature infants.

Methods: Low-risk preterm infants (LRP), infants with Grade 3–4 Intraventricular Hemorrhage (IVH), those with bronchopulmonary dysplasia (BPD), and those with both BPD and IVH (BPD+IVH) were identified. Forty-seven infants, 32–42 weeks Postmenstrual Age (PMA) were evaluated on one or more occasions (131 studies). Of these, 39 infants (81 studies) were performed at >35 weeks …

Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand

Department of Paediatrics and Child Health

With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of pediatric …

High Flow Nasal Cannula Therapy In Children With Acute Respiratory Insufficiency In The Pediatric Intensive Care Unit Of A Resource-Limited Country: A Preliminary Experience, Bushra Saeed, Asim Azim, Anwar Ul Haque, Qalab Abbas

Department of Paediatrics and Child Health

A retrospective study was performed in children (aged one month - 16 years) receiving HFNC to determine the frequency, efficacy and adverse effects of high flow nasal cannula (HFNC) therapy in the pediatric intensive care unit (PICU), from January to December 2017. Treatment failure was defined as clinical deterioration on HFNC therapy such that mechanical ventilation (MV) was required. Clinical parameters before and after HFNC were assessed using repeated measures analysis of variance. A total of 120 patients received HFNC therapy (21% of total admissions). Primary diagnosis were respiratory disease (50%), central nervous system diseases (14.2%), sepsis (10.8%), and postoperative …

Development Of The Global Network For Women's And Children's Health Research's Socioeconomic Status Index For Use In The Network's Sites In Low And Lower Middle-Income Countries, Archana B. Patel, Carla M. Bann, Ana L. Garces, Nancy F. Krebs, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar

Community Health Sciences

Background: Socioeconomic status (SES) is an important determinant of health globally and an important explanatory variable to assess causality in epidemiological research. The 10th Sustainable Development Goal is to reduce disparities in SES that impact health outcomes globally. It is easier to study SES in high-income countries because household income is representative of the SES. However, it is well recognized that income is poorly reported in low- and middle- income countries (LMIC) and is an unreliable indicator of SES. Therefore, there is a need for a robust index that will help to discriminate the SES of rural households in a …

Determinants Of Infant And Young Complementary Feeding Practices Among Children 6-23 Months Of Age In Urban Pakistan: A Multicenter Longitudinal Study, Shabina Ariff, Kamran Sadiq, Javairia Khalid, Laila Sikanderali, Batha Tariq, Fariha Shaheen, Gul Nawaz Khan, Atif Habib, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Suboptimal feeding practices have a negative impact on children's health and growth in the first 2 years of life and increase their risk of undernutrition, morbidity, and mortality. The aim of the study was to assess the factors that influence infant and young child feeding practices among urban mothers in a hospital setting at Karachi, Pakistan.
Methods: A longitudinal multi-center cohort study was conducted in four countries, MULTICENTER BODY COMPOSITION REFERENCE STUDY (MBCRS) to produce normal body composition reference data in healthy infants from 3 months to 24 months of age. Repeated anthropometric (weight, length and head circumference) and …

Perinatal Substance Use Screenings In Marin County: A Brief Overview Of Screening Protocols And Identifying Gaps In Care, Breanna Wiliams

Master's Projects and Capstones

Introduction

Perinatal substance use continues to be a major public health issue in women’s health. The purpose of this study was to determine the frequency of substance use screenings in care and assess how well the existing services in Marin County are serving the needs of pregnant and parenting women and identifying the gaps and/or weaknesses in current practice.

Methods

Data for this study was collected via semi-structured interviews with five professionals that worked at the local community clinic, hospital and a non-profit agency. Some questions were slightly modified to be configured toward the participant’s specific profession.

Results

Results from …

Trends And Determinants Of Newborn Mortality In Kyrgyzstan: A Countdown Country Case Study, Mahdis Kamali, James E. Wright, Nadia Akseer, Hana Tasic, Kaitlin Conway, Saman Brar, Cholpon Imanalieva, Gerrit Maritz, Arjumand Rizvi, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Kyrgyzstan has made considerable progress in reducing child mortality compared with other countries in the region, despite a comparatively low economic standing. However, maternal mortality is still high. Given the availability of an established birth registration system, we aimed to comprehensively assess the trends and determinants of reproductive, maternal, newborn, and child health in Kyrgyzstan.
Methods: For this Countdown to 2030 country case study, we used publicly available data repositories and the national birth registry of Kyrgyzstan to examine trends and inequalities of reproductive, maternal, and newborn health and mortality between 1990 and 2018, at a national and subnational …