Publications by authors named "Gary L Darmstadt"

Introduction: The WHO's Integrated Management of Childhood Illness (IMCI) in young infants <2 months of age includes the identification and management of signs of possible serious bacterial infection (PSBI). However, equal importance is given to all the PSBI signs, which signal the need for referral and hospital management, except for fast breathing in infants aged 7-59 days, for which outpatient treatment by clinical staff working at a health facility is recommended. Moreover, studies to validate the importance of clinical signs of PSBI have mostly used the need for hospitalisation as the outcome.

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Background: Congenital and acquired heart disease affects ∼1% of children globally, with right ventricular (RV) dysfunction being a common and complex issue due to conditions like congenital heart disease (CHD), pulmonary hypertension (PH), and prematurity. Accurate RV assessment is challenging due to its unique geometry, interventricular interactions, and morphological variability in pediatric patients. Fractional area change (FAC), a key echocardiographic measure, correlates strongly with disease severity, aiding in timely intervention and prognosis.

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Background: Aid sanctions are a type of financial punishment imposed on a country by other countries or international organisations in response to a political coup, armed conflict, or human rights abuses. Humanitarian catastrophes in Burkina Faso, Sudan, and Myanmar have brought aid sanctions to the centre of the foreign affairs strategy debate because of their inadvertent negative effects on human health. Our analysis investigates the effects of aid sanctions from 1990 to 2019 on maternal and child mortality.

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Background: The World Health Organization (WHO) has developed guidance for community health workers (CHWs) in identifying sick young infants based on clinical signs. We conducted a prospective, observational cohort study to characterise mortality risk of young infants based on their clinical signs.

Methods: We conducted a population-based, prospective observational cohort study at five sites in Bangladesh (Sylhet, November 01, 2011-December 31, 2013), India (Vellore and Odisha, September 01, 2013-February 28, 2015), and Pakistan (Karachi, January 01, 2012-December 31, 2013; Matiari, March 01, 2012-December 31, 2013) to identify newborn infants who were followed-up by CHWs through 10 scheduled home visits over the first 60 completed days after birth to identify signs of possible serious bacterial infection (PSBI).

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Background: Preterm birth (PTB) is a serious health problem. PTB complications is the main cause of death in infants under five years of age worldwide. The ability to accurately predict risk for PTB during early pregnancy would allow early monitoring and interventions to provide personalized care, and hence improve outcomes for the mother and infant.

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Coronavirus disease 2019 (COVID-19) has affected not only individual lives but also the world and global systems, both natural and human-made. Besides millions of deaths and environmental challenges, the rapid spread of the infection and its very high socioeconomic impact have affected healthcare, economic status and wealth, and mental health across the globe. To better appreciate the pandemic's influence, multidisciplinary and interdisciplinary approaches are needed.

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Introduction: surgical site infection is associated with longer postoperative hospital stays. We explored factors associated with longer postoperative hospital stays among patients in the surgical ward of a primary rural hospital in Ethiopia, where laboratory facilities for microbiological confirmation of surgical site infections were not available.

Methods: an observational study was performed for patients ≥ 18 years of age who underwent elective or emergency surgery from 22 June 2017 to 19 July 2018.

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Article Synopsis
  • Extreme hyperbilirubinemia in newborns is a major issue in low- and middle-income countries like Bangladesh, leading to significant health risks, especially since many births occur at home without screening or treatment.
  • A cluster randomized trial will involve 530 pregnant women in rural Bangladesh, where community health workers (CHWs) will screen and provide home treatment for newborns with jaundice, comparing results to traditional care methods.
  • The study aims to determine if CHW-led home phototherapy can effectively increase treatment rates for neonatal hyperbilirubinemia, potentially allowing for similar programs in other low-income settings to improve newborn health outcomes.
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Background: Maternal empowerment - the capacity to make decisions within households - is linked to better child feeding and nutritional outcomes, but few studies have considered the mediating role of caregiver knowledge. Further, existing literature centres primarily on the husband-wife dyad while overlooking grandmothers as important childcare decision-makers.

Methods: We collected primary data through household surveys in 2019 and 2021 from 1190 households with infants zero to six months living in rural western China.

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Preterm birth (PTB) is a leading cause of morbidity and mortality in children aged under 5 years globally, especially in low-resource settings. It remains a challenge in many low-income and middle-income countries to accurately measure the true burden of PTB due to limited availability of accurate measures of gestational age (GA), first trimester ultrasound dating being the gold standard. Metabolomics biomarkers are a promising area of research that could provide tools for both early identification of high-risk pregnancies and for the estimation of GA and preterm status of newborns postnatally.

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Preterm birth (PTB) is the leading cause of morbidity and mortality in children globally, yet its prevalence has been difficult to accurately estimate due to unreliable methods of gestational age dating, heterogeneity in counting, and insufficient data. The estimated global PTB rate in 2020 was 9.9% (95% confidence interval: 9.

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Background: Preterm birth (birth before 37 completed weeks of pregnancy) is the leading cause of neonatal and child under-five mortality globally, both of which are highest regionally in sub-Saharan Africa. The skin barrier plays a critical role in neonatal health and increasing evidence supports the use of topical emollient therapy to promote postnatal growth and reduce hospital-acquired infections in preterm infants. The World Health Organization (WHO) currently recommends emollient therapy in preterm or low birthweight infants globally but calls for further research on impacts of emollient use, especially in Africa.

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To achieve Sustainable Development Goal 5 for gender equality by 2030, it is crucial for health and development professionals and governmental officials to understand how legal systems empower or oppress populations on the basis of gender worldwide, including opportunities and challenges of statutory provisions created by legal pluralism. Using Ethiopia as a case study, this paper examines how local laws applied in Sharia and Customary Dispute Resolution courts impact gender equality and the health of women and girls inspite of the inculcation of human rights statutes into national legislation, including the Constitution. We identify several key issues with the substantive law and its enforcement.

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Objective: There is widespread overuse of antibiotics in neonatal intensive care units (NICUs). The objective of this study was to safely reduce antibiotic use in participating NICUs by targeting early-onset sepsis (EOS) management.

Study Design: Twenty-eight NICUs participated in this statewide multicenter antibiotic stewardship quality improvement collaborative.

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Article Synopsis
  • * A study in rural Bangladesh, which involved 23 newborns, explored how feasible and acceptable a CHW-led home phototherapy intervention was for families, revealing that it was seen as convenient and cost-saving.
  • * Despite some concerns about CHWs’ skills and power supply reliability, both families and CHWs rated the home phototherapy positively, suggesting further research is needed to assess its impact on treatment rates and health outcomes.
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Introduction: In 2018, the American College of Obstetricians and Gynecologists recommended low-dose aspirin to prevent the onset of pre-eclampsia among women who were at high risk. Factors influencing women's acceptance of this recommendation span multiple sectors and levels. Understanding how these factors interact will help stakeholders design effective population-level intervention strategies.

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Background: Gender mainstreaming has been central to the development agenda for advancing gender equality globally for nearly three decades. We examined key learning across gender mainstreaming models and experiences and assess key successes and challenges in actualising gender mainstreaming's transformative potential, in order to inform future research agendas.

Methods: We reviewed 27 years of peer-reviewed literature on gender mainstreaming (1995-2022) and described scholarly publishing trends on the topic based on a set of 528 articles and bibliographic data retrieved from the Scopus database and supplemental coding.

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Breastfeeding self-efficacy (BSE), defined as a mother's confidence in her ability to breastfeed, has been confirmed to predict the uptake of exclusive breastfeeding (EBF). Early experiences during the birth hospital stay, especially in-hospital formula feeding (IHFF), can impact both EBF and maternal breastfeeding confidence. Therefore, our objective was to examine the association between IHFF and EBF outcomes and investigate whether this association is influenced by BSE.

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