Evidence map›Paper›PMID 19289979›Full record

Trial reportThe Pediatric infectious disease journal2009

Effectiveness of home-based management of newborn infections by community health workers in rural Bangladesh.

Abdullah H Baqui, Shams E Arifeen, Emma K Williams, Saifuddin Ahmed, Ishtiaq Mannan, Syed M Rahman, Nazma Begum, Habibur R Seraji, Peter J Winch, Mathuram Santosham and 2 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Pediatric infectious disease journal, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03032276 (Impact and Operational Assessment of an Integrated Safe Motherhood and Newborn Health Promotion Package), which is not on this map. Cited by 80 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 9 pooled it
10.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03032276 naunknown statusnot on this mapstarted 2016, after this paper: background citation

Impact and Operational Assessment of an Integrated Safe Motherhood and Newborn Health Promotion Package: a Community-based Cluster Randomized Controlled Trial

TypeinterventionalSponsorInternational Centre for Diarrhoeal Disease Research, BangladeshRan2016 to 2022Enrolled50,400ConditionsNeonatal Death, Maternal DeathArmsSafe motherhood and newborn health promotion package
3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 9 syntheses or guidelines pooled it, 136 citations in OpenAlex.

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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 3 countries.

Abdullah H BaquiInternational Center for Advancing Neonatal Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. abaqui@jhsph.edu
Shams E Arifeen
Emma K Williams
Saifuddin Ahmed
Ishtiaq Mannan
Syed M Rahman
Nazma Begum
Habibur R Seraji
Peter J Winch
Mathuram Santosham
Robert E Black
Gary L Darmstadt
Johns Hopkins University · USInternational Centre for Diarrhoeal Disease Research · BDFlinders University · AU

Funding

Research Training on Infectious Diseases in Mothers and Children in BangladeshD43TW007587 · FIC · JOHNS HOPKINS UNIVERSITY · PI BAQUI, ABDULLAH HEL, BLACK, ROBERT E. · 2007 to 2017
$1.9M
FIC NIH HHS D43 TW007587
6 · The paper itself

Abstract

background: Infections account for about half of neonatal deaths in low-resource settings. Limited evidence supports home-based treatment of newborn infections by community health workers (CHW).

methods: In one study arm of a cluster randomized controlled trial, CHWs assessed neonates at home, using a 20-sign clinical algorithm and classified sick neonates as having very severe disease or possible very severe disease. Over a 2-year period, 10,585 live births were recorded in the study area. CHWs assessed 8474 (80%) of the neonates within the first week of life and referred neonates with signs of severe disease. If referral failed but parents consented to home treatment, CHWs treated neonates with very severe disease or possible very severe disease with multiple signs, using injectable antibiotics.

results: For very severe disease, referral compliance was 34% (162/478 cases), and home treatment acceptance was 43% (204/478 cases). The case fatality rate was 4.4% (9/204) for CHW treatment, 14.2% (23/162) for treatment by qualified medical providers, and 28.5% (32/112) for those who received no treatment or who were treated by other unqualified providers. After controlling for differences in background characteristics and illness signs among treatment groups, newborns treated by CHWs had a hazard ratio of 0.22 (95% confidence interval [CI] = 0.07-0.71) for death during the neonatal period and those treated by qualified providers had a hazard ratio of 0.61 (95% CI = 0.37-0.99), compared with newborns who received no treatment or were treated by untrained providers. Significantly increased hazards ratios of death were observed for neonates with convulsions (hazard ratio [HR] = 6.54; 95% CI = 3.98-10.76), chest in-drawing (HR = 2.38, 95% CI = 1.29-4.39), temperature <35.3 degrees C (HR = 3.47, 95% CI = 1.30-9.24), and unconsciousness (HR = 7.92, 95% CI = 3.13-20.04).

conclusions: Home treatment of very severe disease in neonates by CHWs was effective and acceptable in a low-resource setting in Bangladesh.

Indexed as

Disease ManagementAlgorithmsBangladeshCluster AnalysisCommunity Health WorkersFemaleHome Care ServicesHumansInfant, NewbornInfectionsMalePatient Acceptance of Health CareProportional Hazards ModelsReferral and ConsultationRural HealthRural Population

Identifiers

PMID19289979
PMCPMC2929171
OpenAlexW2029354710

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.