John A F Zupancic1,2, Jochen Profit3,4, Claus Klingenberg5,6, Sahil K Tembulkar3,4, Anna Lavizzari7, Charles C Roehr8,9, Danielle E Y Ehret10,11, Nestor Eduardo Vain12, Gonzalo Luis Mariani13, Omer Erdeve14, Victor Javier Lara-Diaz15, Sithembiso Velaphi16, Hon Kin Cheong17, Surender Singh Bisht18, Khawaja Ahmad Irfan Waheed19, Alexander G Stevenson20, Nisreen Al-Kafi21, Jean-Michel Roue22, Alejandra Barrero-Castillero23,24, Eleanor J Molloy25,26,27. 1. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. jzupanci@bidmc.harvard.edu. 2. Department of Pediatrics, Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA. jzupanci@bidmc.harvard.edu. 3. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. 4. California Perinatal Quality Care Collaborative, Palo Alto, CA, USA. 5. Paediatric Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromso, Norway. 6. Department of Paediatric and Adolescent Medicine, University Hospital of North Norway, Tromso, Norway. 7. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy. 8. Newborn Services, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 9. National Perinatal Epidemiology Unit, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK. 10. Department of Pediatrics, Robert Larner MD College of Medicine, University of Vermont, Burlington, VT, USA. 11. Vermont Oxford Network, Burlington, VT, USA. 12. Newborn Medicine, Hospitals Sanatorio Trinidad, Buenos Aires, Argentina. 13. Department of Pediatrics, Division of Neonatology, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 14. Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey. 15. Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL, Mexico. 16. Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 17. Department of Paediatrics, KPJ Ipoh, KPJ Healthcare Berhad, Kuala Lumpur, Malaysia. 18. Neonatal Intensive Care Unit, Swami Dayanand Hospital, Delhi, India. 19. The Children's Hospital & The Institute of Child Health, Lahore, Pakistan. 20. Department of Paediatrics and Child Health, University of Zimbabwe, Harare, Zimbabwe. 21. Division of Neonatology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. 22. Department of Pediatrics, Division of Neonatal and Pediatric Critical Care Medicine, University Hospital of Brest, Brest, France. 23. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. 24. Department of Pediatrics, Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA. 25. Paediatrics, Academic Centre, Children's Hospital Ireland at Tallaght, Trinity College, the University of Dublin, Dublin, Ireland. 26. Trinity Translational Medicine Institute & Trinity Research in Childhood Centre, Dublin, Ireland. 27. Department of Neonatology, Coombe Women and Infants' University Hospital, Dublin, Ireland.
Abstract
OBJECTIVE: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. STUDY DESIGN: Cross-sectional, web-based survey administered between May and June, 2020. RESULTS: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making. CONCLUSIONS: Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.
OBJECTIVE: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. STUDY DESIGN: Cross-sectional, web-based survey administered between May and June, 2020. RESULTS: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infectedinfants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making. CONCLUSIONS: Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.
Authors: Patrick G T Walker; Charles Whittaker; Oliver J Watson; Marc Baguelin; Peter Winskill; Arran Hamlet; Bimandra A Djafaara; Zulma Cucunubá; Daniela Olivera Mesa; Will Green; Hayley Thompson; Shevanthi Nayagam; Kylie E C Ainslie; Sangeeta Bhatia; Samir Bhatt; Adhiratha Boonyasiri; Olivia Boyd; Nicholas F Brazeau; Lorenzo Cattarino; Gina Cuomo-Dannenburg; Amy Dighe; Christl A Donnelly; Ilaria Dorigatti; Sabine L van Elsland; Rich FitzJohn; Han Fu; Katy A M Gaythorpe; Lily Geidelberg; Nicholas Grassly; David Haw; Sarah Hayes; Wes Hinsley; Natsuko Imai; David Jorgensen; Edward Knock; Daniel Laydon; Swapnil Mishra; Gemma Nedjati-Gilani; Lucy C Okell; H Juliette Unwin; Robert Verity; Michaela Vollmer; Caroline E Walters; Haowei Wang; Yuanrong Wang; Xiaoyue Xi; David G Lalloo; Neil M Ferguson; Azra C Ghani Journal: Science Date: 2020-06-12 Impact factor: 47.728
Authors: L Ryan; Frans B Plötz; Agnes van den Hoogen; Jos M Latour; Marina Degtyareva; Maya Keuning; Claus Klingenberg; Irwin K M Reiss; Eric Giannoni; Charles Roehr; Christopher Gale; Eleanor J Molloy Journal: Pediatr Res Date: 2021-12-28 Impact factor: 3.953
Authors: Anna Hedstrom; Paul Mubiri; James Nyonyintono; Josephine Nakakande; Brooke Magnusson; Madeline Vaughan; Peter Waiswa; Maneesh Batra Journal: PLoS One Date: 2021-12-16 Impact factor: 3.240