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- Drake, TM, et al.
(författare)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Tidskriftsartikel (refereegranskat)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
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- Chowdhury, Mohammad Rocky Khan, et al.
(författare)
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Does household food insecurity influence nutritional practice of children age 6 to 23 months in Bangladesh?
- 2016
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Ingår i: South East Asia Journal Of Public Health. - : Bangladesh Journals Online (JOL). - 2220-9476 .- 2313-531X. ; 6:2, s. 53-60
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Tidskriftsartikel (refereegranskat)abstract
- To examine the prevalence of household food insecurity (HHFI) among children aged between 6-23 months in Bangladesh. This paper also aims to identify the individual, household and community levels determinants of HHFI and the association between nutritional behavior and HHFI. Bangladesh Demographic Health Survey (BDHS), 2011 was used for this research. A total of 2,344 children were selected for analysis. Statistical analysis and tests were guided by the nature of the variables. Finally, logistic regression analysis was used to find out the association between independent variables and outcome. The overall prevalence of HHFI was 36.3% (95% CI: 33.6-39.0) among the participants (children). The prevalence of HHFI was significantly higher among children who did not receive nutritional items. In contrast, HHFI was more prevalent among children who were breastfed (37.0%) as compared to non-breastfed. Binary logistic regression analysis showed that children of illiterate mothers (adjusted OR: 2.20, 95% CI: 1.17-4.10), illiterate fathers (adjusted OR: 2.27, 95% CI: 1.41-3.66) and socio-economically poor families (adjusted OR: 11.35, 95% CI: 7.20-17.91) were more at risk of experiencing HHFI, whereas, rural children (adjusted OR: 0.72, 95% CI: 0.57-0.93) were more protective. In the adjusted logistic regression model, children who did not receive juice (adjusted OR: 1.54, 95% CI: 1.09-2.16) had experienced HHFI. The prevalence of HHFI among children is still high in Bangladesh. Therefore, to achieve the Millennium Development Goals, the Government of Bangladesh should priorities HHFI as a major public health issue. Strong collaborations among various stakeholders are also crucial to improve the situation.South East Asia Journal of Public Health Vol.6(2) 2016: 53-60
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