Research suggests new method to reduce infant deaths, pressure on hospitals

A research has suggested a new method to address possible serious bacterial infection among young infants to reduce deaths and pressure on hospitals, including in Bangladesh.

Key findings revealed that young infants with any low-mortality-risk sign can be safely treated with outpatient care, simplifying care for families while maintaining effectiveness.

Young infants with moderate-mortality-risk signs who respond well to 48-hour courses of injectable antibiotics can benefit from switch therapy (early discharge on oral antibiotic therapy at home).

The findings come from a dissemination programme on “Optimizing Place of Treatment and Antibiotic Regimens for Young Infants with Possible Serious Bacterial Infection (PSBI)” held in a Dhaka city hotel on Monday.

The meeting was hosted by the Ministry of Health and Family Welfare and Projahnmo Research Foundation (PRF).

Prof Mohammod Shahidullah, Principal Investigator of PSBI trials, explained that when a young infant (up to 28 days of age) develops any infection, two things happen—either parents take them to a hospital or take treatment at home due to financial constraints and lack of access to healthcare. In that scenario, the World Health Organization (WHO) wants to determine if it is mandatory to send all infants to hospitals.

The study explored three approaches, including one showing that infants with low infection and lower death risk achieve similar results with outpatient and inpatient treatment.

According to the research, the trials prove that infants with PSBI could be safely and effectively treated with first-generation antibiotics, such as amoxicillin, ampicillin, and gentamicin.

The trials are crucial for resource-limited countries like Bangladesh, where limited hospital beds and challenges in referring young infants hinder neonatal care.

“This could reduce the pressure on hospitals. Furthermore, young infants could be infected from the patients around them in the hospital,” Prof Shahidullah said.

Globally, an estimated 60-70 per cent of under-five deaths occur within the first two months of life. In Bangladesh, neonatal mortality stands at 20 per 1,000 live births, with infections accounting for 20-40 per cent of these deaths.

Approximately 8-10 per cent of infants experience at least one episode of PSBl in their first two months of life.

WHO coordinated two clinical trials concurrently across six countries, including Bangladesh, Ethiopia, India, Nigeria, Pakistan, and Tanzania, with funding from the Bill and Melinda Gates Foundation.

In Bangladesh, PRF and Johns Hopkins University, USA, led these trials in collaboration with WHO and the Ministry of Health and Family Welfare, Government of Bangladesh, in Sylhet district.

Study findings were shared by Dr Salahuddin Ahmed, Executive Director of Projahnmo Research Foundation.

Dr Shamim Ahmed Qazi and Dr Yasir Bin Nisar from WHO; Abdullah H Baqui, professor of Johns Hopkins University; Prof Dr Sayedur Rahman, Special Assistant to the Chief Adviser; Prof Dr Md Abu Jafor, Director General of the Directorate General of Health Services; among others, spoke at the event.

[email protected]