Journal Article > ResearchFull Text
PLOS Glob Public Health. 2023 March 29; Volume 3 (Issue 3); e0001644.; DOI:10.1371/journal.pgph.0001644
Thurtle N, Kirby KA, Greig J, Bil K, Dargan PI, et al.
PLOS Glob Public Health. 2023 March 29; Volume 3 (Issue 3); e0001644.; DOI:10.1371/journal.pgph.0001644
Mother-to-child-transmission of lead via the placenta is known to result in congenital lead toxicity. Between 2010 and 2021, Médecins Sans Frontières and other stakeholders responded to a severe lead poisoning outbreak related to artisanal gold mining in Northern Nigeria. Extensive environmental remediation occurred following outbreak identification; source control efforts are ongoing within the community. We aimed to describe the prevalence of congenital lead poisoning in this cohort and analyse the association between neonatal blood lead concentration (BLC) and medium-term lead-related outcomes during the study period. Children enrolled in the lead poisoning programme between July 2010 and 25 January 2018 who had a screening BLC at ≤4 weeks of age were included. For time-to-event analysis, medium-term outcomes were classified as lead-related (death from lead encephalopathy, and/or met chelation threshold) and non-lead-related (non-lead-related death, on programme no chelation, exit from programme without chelation). Cox regression analysis and ROC analysis were performed. 1468 children were included. All-cause mortality 2.3%; geometric mean neonatal BLC 13.7 μg/dL; ‘lead-related death or treatment’ 19.3%. For every doubling in neonatal BLC, there was an almost 8-fold increase in adjusted hazard ratio (HR) for the composite lead-related outcome (p<0.001). A neonatal BLC ≥ 15.0 μg/dL had 95% sensitivity for identifying children who went on to have the composite outcome (with specificity 67%; positive likelihood ratio 2.86). Congenital lead poisoning predicts ongoing exposure in this population, even after environmental remediation. This suggests a complex, early, multidisciplinary approach to source control and exposure management is required when elevated neonatal BLC is observed in lead poisoning clusters in low-and-middle-income contexts.
Journal Article > ResearchFull Text
Rev Panam Salud Publica. 2021 November 1; Volume 45; e147.; DOI:10.26633/RPSP.2021.147
Schuurmans J, Borgundvaag E, Finaldi P, Senat-Delva R, Desauguste F, et al.
Rev Panam Salud Publica. 2021 November 1; Volume 45; e147.; DOI:10.26633/RPSP.2021.147
OBJECTIVES
To determine the prevalence of maternal death, stillbirth and low birthweight in women with (pre-)eclampsia and complicated pregnancies or deliveries in Centre de Références des Urgences Obstétricales, an obstetric emergency hospital in Port-au-Prince, Haiti, and to identify the main risk factors for these adverse pregnancy outcomes.
METHODS
We conducted a retrospective cohort study of pregnant women admitted to Centre de Référence des Urgences Obstétricales between 2013 and 2018 using hospital records. Risk factors investigated were age group, type of pregnancy (singleton, multiple), type of delivery and use of antenatal care services.
RESULTS
A total of 31 509 women and 24 983 deliveries were included in the analysis. Among these, 204 (0.6%) maternal deaths (648 per 100 000 women giving birth), 1962 (7.9%) stillbirths and 11 008 (44.1%) low birthweight neonates were identified. Of all admissions, 10 991 (34.9%) were women with (pre-)eclampsia. Caesarean section significantly increased the risk of maternal death in the women with a complicated pregnancy and women with (pre-)eclampsia, but reduced the risk of stillbirth in such women. Not attending antenatal care was associated with a significantly higher risk of stillbirth (odds ratio (OR) 4.82; 95% confidence interval (CI) 3.55-6.55) and low birthweight (OR 1.40; 95% CI 1.05-1.86) for women with complicated pregnancies.
CONCLUSION
To prevent and treat pregnancy complications as early as possible, antenatal care attendance is crucial. Improving the quality of and access to antenatal care services and providing it free to all pregnant women in Haiti is recommended.
To determine the prevalence of maternal death, stillbirth and low birthweight in women with (pre-)eclampsia and complicated pregnancies or deliveries in Centre de Références des Urgences Obstétricales, an obstetric emergency hospital in Port-au-Prince, Haiti, and to identify the main risk factors for these adverse pregnancy outcomes.
METHODS
We conducted a retrospective cohort study of pregnant women admitted to Centre de Référence des Urgences Obstétricales between 2013 and 2018 using hospital records. Risk factors investigated were age group, type of pregnancy (singleton, multiple), type of delivery and use of antenatal care services.
RESULTS
A total of 31 509 women and 24 983 deliveries were included in the analysis. Among these, 204 (0.6%) maternal deaths (648 per 100 000 women giving birth), 1962 (7.9%) stillbirths and 11 008 (44.1%) low birthweight neonates were identified. Of all admissions, 10 991 (34.9%) were women with (pre-)eclampsia. Caesarean section significantly increased the risk of maternal death in the women with a complicated pregnancy and women with (pre-)eclampsia, but reduced the risk of stillbirth in such women. Not attending antenatal care was associated with a significantly higher risk of stillbirth (odds ratio (OR) 4.82; 95% confidence interval (CI) 3.55-6.55) and low birthweight (OR 1.40; 95% CI 1.05-1.86) for women with complicated pregnancies.
CONCLUSION
To prevent and treat pregnancy complications as early as possible, antenatal care attendance is crucial. Improving the quality of and access to antenatal care services and providing it free to all pregnant women in Haiti is recommended.
Journal Article > CommentaryFull Text
ATS Sch. 2022 November 15; Volume 3 (Issue 4); 625-630.; DOI:10.34197/ats-scholar.2022-0071CM
Haj-Hassan TA, Mtaweh H, Martinez D, Mema B
ATS Sch. 2022 November 15; Volume 3 (Issue 4); 625-630.; DOI:10.34197/ats-scholar.2022-0071CM
Journal Article > EditorialFull Text
BMJ. 2021 December 20; Volume 375; n3126.; DOI:10.1136/bmj.n3126
Caluwaerts S
BMJ. 2021 December 20; Volume 375; n3126.; DOI:10.1136/bmj.n3126
Conference Material > Slide Presentation
Lavilla KM, Teal J, Schausberger B, Sankoh M, Conteh AB, et al.
MSF Scientific Days International 2022. 2022 May 11; DOI:10.57740/pyhg-f359
Conference Material > Slide Presentation
Formation virtuelle comme catalyseur d’amelioration des soins neonataux au CSREF de Douentza / Mali
Rubona F, Ibongu E, Bah AJ, Dianouni F, Wepnyui H
MSF Paediatric Days 2024. 2024 May 4; DOI:10.57740/rleZ6pb8
Français
Conference Material > Poster
Kowalski M, Minka Obama B, Catho G, Dewez JE, Merglen A, et al.
MSF Paediatric Days 2024. 2024 May 3; DOI:10.57740/DCmLugFl15
Français
Conference Material > Poster
Gutierrez Popoca M, Tancred T
MSF Paediatric Days 2024. 2024 May 3; DOI:10.57740/C0eEY7Ha
Conference Material > Poster
Iscla M, Alamba PP, Pesqueria R, Nggilari J, Danjuma M
MSF Paediatric Days 2022. 2022 November 30; DOI:10.57740/bzw2-w143
Conference Material > Poster
Kenntner S, Samba Yadensi M, Fiddler J, Baieli E, Leone G, et al.
MSF Paediatric Days 2022. 2022 November 30; DOI:10.57740/j7vc-x981