ORCID Profile
0000-0002-1634-0531
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Publisher: Oxford University Press (OUP)
Date: 09-2021
DOI: 10.1093/CID/CIAB528
Abstract: Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with & % of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths & months occurring in the community with in-hospital. We studied 829 RSV-related deaths & year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred & months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months IQR: 0.8−3.3) was lower than in-hospital (2.4 months IQR: 1.5−4.0 P & .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P & 0.0001). We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 07-2020
Publisher: BMJ
Date: 2023
DOI: 10.1136/BMJGH-2022-009495
Abstract: Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies. We screened ongoing studies in our sequential, prospective meta-analysis. We pooled in idual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale. We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women. Pregnant women with SARS-CoV-2 infection—as compared with uninfected pregnant women—were at significantly increased risk of maternal mortality (10 studies n=1490 RR 7.68, 95% CI 1.70 to 34.61) admission to intensive care unit (8 studies n=6660 RR 3.81, 95% CI 2.03 to 7.17) receiving mechanical ventilation (7 studies n=4887 RR 15.23, 95% CI 4.32 to 53.71) receiving any critical care (7 studies n=4735 RR 5.48, 95% CI 2.57 to 11.72) and being diagnosed with pneumonia (6 studies n=4573 RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies n=5146 RR 5.50, 95% CI 1.12 to 27.12). Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies n=7637 RR 1.86, 95% CI 1.12 to 3.08) be born preterm (7 studies n=6233 RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies n=6071 RR 2.92, 95% CI 1.88 to 4.54) and to be born low birth weight (12 studies n=11 930 RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias. This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.
Location: Kenya
No related grants have been discovered for Dickens Onyango.