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Tetanus remains a significant cause of mortality among undervaccinated mothers and their infants after unhygienic deliveries, especially in low-income countries. The strategies of the maternal and neonatal tetanus elimination (MNTE) initiative, which targets 59 priority countries, include strengthening antenatal vaccination of pregnant women with tetanus toxoid-containing vaccines (TTCVs), conducting TTCV supplementary immunization activities (SIAs) for women of reproductive age in high-risk districts, optimizing access to skilled birth attendants (SBAs) to ensure clean deliveries and clean umbilical cord care practices and identifying and investigating suspected cases of neonatal tetanus (NT). This report updates a previous report and describes progress towards achieving MNTE during 2000-2022. By December 2022, 47 (80%) of 59 priority countries were validated as having achieved MNTE. In 2022, of the 50 countries that reported coverage with [greater than or equal to]2 doses of TTCV (TTCV2+) among pregnant women, 16 (32%) reported coverage of [greater than or equal to]80%; and, of the 47 validated countries, 26 (55%) reported that [greater than or equal to]70% of births were assisted by SBAs. The number of NT cases reported worldwide decreased by 89%, from 17 935 in 2000 to 1995 in 2021, and the estimated number of deaths due to NT decreased by 84%, from 46 898 to 7719. Global disruption of routine vaccination due to the coronavirus disease 2019 (COVID-19) pandemic, however, slowed progress. Since 2020, the reported number of NT cases has increased in 18 (31%) priority countries. To achieve and sustain global elimination, MNTE strategies should be integrated into countries' national immunization programmes. Le tetanos demeure une cause importante de mortalite chez les meres sous-vaccinees et leurs nourrissons apres des accouchements ne respectant pas les regles d'hygiene, en particulier dans les pays a faible revenu. Les strategies de l'initiative pour l'elimination du tetanos maternel et neonatal, qui cible 59 pays prioritaires, consistent a renforcer la vaccination prenatale des femmes enceintes contre le tetanos, a mener des activites de vaccination supplementaire (AVS) avec le vaccin antitetanique pour les femmes en age de procreer dans les districts a haut risque, a optimiser l'acces a des professionnels qualifies pour assister les parturientes afin de garantir des accouchements et des soins du cordon ombilical conformes aux regles d'hygiene, et a identifier les cas suspects de tetanos neonatal et mener des enquetes sur ces cas. Le present rapport actualise les informations fournies dans le rapport precedent et decrit les progres accomplis vers l'elimination du tetanos maternel et neonatal (TMN) au cours de la periode 2000-2022. En decembre 2022, l'elimination du TMN avait ete validee dans 47/59 (80%) pays prioritaires. En 2022, 16/50 (32%) pays qui avaient administre [greater than or equal to]2 doses de vaccin antitetanique aux femmes enceintes ont rapporte une couverture [greater than or equal to]80%; sur les 47 pays oU l'elimination du TMN a ete validee, 26 (55%) ont indique que [greater than or equal to]70% des accouchements avaient ete assistes par un professionnel qualifie. Entre 2000 et 2021, le nombre de cas de tetanos neonatal notifies dans le monde a diminue de 89%, passant de 17 935 a 1995, et le nombre estime de deces dus au tetanos neonatal a diminue de 84%, passant de 46 898 a 7719. Mais la pandemie de maladie a coronavirus 2019 (COVID-19), qui a perturbe les activites de vaccination systematique a l'echelle mondiale, a ralenti cette progression. Depuis 2020, le nombre de cas de tetanos neonatal notifies a augmente dans 18 (31%) pays prioritaires. Pour realiser et maintenir l'elimination a l'echelle mondiale, les strategies d'elimination du TMN doivent etre integrees dans les programmes nationaux de vaccination des pays prioritaires., Introduction Maternal and neonatal tetanus (1) remains a substantial cause of mortality among undervaccinated mothers and their infants after unhygienic delivery, especially in low-income countries. (2) In 1989, the World [...]

During humanitarian emergencies, women and newborns face severe disparities and heightened vulnerabilities, increasing their risk of illness and death. Humanitarian crises--caused by conflict, climate-related disasters, or forced displacement--disrupt health systems, [...]

Objective To investigate the perinatal outcomes in Brazilian, Peruvian, and Colombian women in a Brazilian reference maternity hospital based at Amazon triple border region. Method A cross-sectional case study of data from 3242 live birth certificates issued at the Tabatinga public maternity hospital, in the countryside of Amazonas, in the period between January 2015 and December 2017. Maternal and perinatal independent variables were analysed based on central tendency and variability, and frequency distribution for categorical variables. The Pearson's Chi-Square test and univariate analyses were performed to estimate probability ratios (Odds Ratio-OR). Results Significant differences were found in the education level in the three population groups, as well as in the number of previous pregnancies, antenatal consultations, month of initial prenatal care, and type of delivery. Brazilian pregnant women had more prenatal consultations, caesarean sections, and premature births. Peruvian and Colombian women started antenatal care later, and those with high-risk pregnancies tended to deliver in their home country. Conclusion for Practice Our findings show some singularities in the care of women and infants in the Amazonian triple border region. The Brazilian Unified Health Care System performs an important role in the guarantee of free access to health services, and ensures comprehensive care for women and infants, promoting human rights in border regions regardless of nationality., Author(s): Camila Soares Teixeira [sup.1] , Tiótrefis Gomes Fernandes [sup.2] , Marcos Augusto Bastos Dias [sup.3] , Milene da Silva Morais das Neves [sup.1] , Julio César Schweickardt [sup.1] , [...]

Candida auris is a multidrug-resistant yeast that causes invasive infections with high associated mortality in acute and long-term healthcare facilities worldwide (2,2). Although C. auris was initially described in 2009 [...]

Maternal, newborn, and child health delivery services are critical, and many improvements in health outcomes have been achieved globally in the past decade (1). However, those gains likely were negatively [...]

Objective Ongoing health care challenges, low breast milk intake, and the need for rehospitalization are common during the first year of life after hospital discharge for very low birth weight (VLBW) infants. This retrospective cohort study examined breast milk intake, growth, emergency department (ED) visits, and non-surgical rehospitalizations for VLBW infants who received specialized post-discharge follow-up in western Canada, compared to VLBW infants who received standard follow-up in central Canada. Design Data were collected from two neonatal follow-up programs for VLBW babies (n = 150 specialized-care; n = 205 standard-care). Logistic regression was used to examine odds of breast milk intake and generalized estimating equations were used for odds of growth, ED visits and non-surgical rehospitalization by site. Results Specialized-care was associated with enhanced breast milk intake duration; the odds of receiving breastmilk at 4 months in the specialized-care cohort was 6 times that in the standard-care cohort. The specialized-care cohort had significantly more ED visits and rehospitalizations. However, for infants with oxygen use beyond 36 weeks compared to those with no oxygen use, the standard-care cohort had over 7 times the odds of rehospitalization where as the specialized-care cohort with no increased odds of rehospitalization. Conclusion Specialized neonatal nursing follow-up was associated with continued breastmilk intake beyond discharge. Infants in the specialized-care cohort used the ED and were hospitalized more often than the standard-care cohort with the exception of infants with long term oxygen needs., Author(s): Karen Lasby [sup.1] , Tammy Sherrow [sup.2] , Tanis Fenton [sup.3] , Jacqueline Jackson [sup.4] , Edmond N. Kelly [sup.5] , Victoria Stagg [sup.6] , Deborah A. McNeil [sup.7] [...]

Maternal and neonatal tetanus (MNT) (1) remains a major cause of neonatal mortality, with an 80-100% case-fatality rate among neonates born to insufficiently vaccinated mothers after unhygienic deliveries, especially in [...]

Background Clostridioides difficile (C. difficile) is the major pathogen causing antibiotic-associated diarrhea. There are a variety of symptoms associated with C. difficile infection (CDI) in adults, including self-limiting diarrhea, pseudomembranous colitis, toxic megacolon, septic shock, and even death from the infection. However, the infant's intestine appears to be completely resistant to the effects of C. difficile toxins A and B with rare development of clinical symptoms. Case presentation In this study, we reported a 1-month-old girl with CDI who was born with neonatal hypoglycemia and necrotizing enterocolitis. Her symptom of diarrhea occurred after extensive use of broad-spectrum antibiotics during hospitalization and was accompanied by elevated white blood cell, platelet, and C-reactive protein levels, and repeated routine stool examinations were abnormal. She was recovered by norvancomycin (an analogue of vancomycin) and probiotic treatment. The results of 16 S rRNA gene sequencing also demonstrated the recovery of intestinal microbiota with the enrichment of Firmicutes and Lactobacillus. Conclusions Based on the literature review and this case report, clinicians should also pay attention to diarrhea caused by C. difficile in infants and young children. More strong evidence is needed to explain the true prevalence of CDI in this population and to better understand the C. difficile-associated diarrhea in infants. Keywords: Clostridioides difficile, CDI, Antibiotic-associated diarrhea, Intestinal microbiota, Infant, Author(s): Zhirong Li[sup.1], Ning Dong[sup.1], Jihong Hao[sup.2], Zirou Ouyang[sup.1], Cuixin Qiang[sup.1], Ying Yang[sup.1], Chaoyi Mi[sup.3], Yanan Niu[sup.1], Jing Yang[sup.1], Baojiang Wen[sup.1], Liwei Wang[sup.5], Shaodan Zhang[sup.4,6] and Jianhong Zhao[sup.1,2,6] Introduction Clostridioides [...]

Purpose Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects newborns who need oxygen therapy, and high-concentration oxygen therapy may cause neonatal morbidity and mortality in newborns. E26 oncogene homologue 1 (ETS1) and transglutaminase 2 (TGM2) have been reported to be associated with lung cell injury. However, the mechanism of ETS1 in regulating BPD is still unclear. Methods Hyperoxia-induced A549 cells to simulate hyperoxia-induced alveolar epithelial cell injury. MTT assays and colony formation assays were performed to investigate the proliferation of A549 cells. Flow cytometry was carried out to quantify the apoptosis of A549 cells. The expression levels of ETS1 and TGM2 were quantified by qRT-PCR. The protein expression levels of ETS1, TGM2, [beta]-catenin, c-Jun and MET were measured by western blot. Overexpression of ETS1, overexpression of TGM2, overexpression of ETS1 with downregulation of TGM2 and overexpression of TGM2 with inhibition of Wnt/[beta]-catenin pathway were performed to investigate the role of ETS1, TGM2 and Wnt/[beta]-catenin pathways in hyperoxia-induced alveolar epithelial cell injury. Results Hyperoxia decreased the proliferation and promoted the apoptosis of cells in a time-dependent manner. Moreover, overexpression of ETS1 rescued the effect of hyperoxia on proliferation and apoptosis. In addition, overexpression of TGM2 participated in the regulation of hyperoxia-induced proliferation and apoptosis. ETS1 regulated hyperoxia-induced alveolar epithelial cell injury through the Wnt/[beta]-catenin pathway via TGM2. Conclusion ETS1 ameliorates hyperoxia-induced alveolar epithelial cell injury through the TGM2-mediated Wnt/[beta]-catenin pathway., Author(s): Min Yang [sup.1], Xi-Rong Gao [sup.2], Yan-Ni Meng [sup.1], Fang Shen [sup.3], Yan-Ping Chen [sup.1] Author Affiliations: (1) grid.440223.3, 0000 0004 1772 5147, Department of Respiratory, Hunan Children's Hospital, [...]

Objectives Circumcision of newborn males is left to parental preference, as medical necessity has not been demonstrated. For medical providers seeking to help parents make decisions and provide informed consent, there is little information regarding how parents gather and process information about circumcision. This study aimed to characterize the comprehensive range of parental attitudes, gaps in knowledge, and decision-making regarding circumcision. Methods Qualitative data was obtained from semi-structured open-ended interviews conducted during the postpartum hospitalization. Interviews were recorded, transcribed, and coded by multiple independent reviewers. A grounded theory approach was used to identify emergent themes regarding attitudes towards, sources of information about, and decision-making surrounding circumcision. Results Ten mothers were interviewed, of whom six planned to circumcise and four did not. Major themes emerged: the importance of cultural norms, limited yet influential discussions, and the lack of, but desire for, more knowledge. Discussions with medical providers were often limited, though when physician conversation was more extensive, provider input was highly influential. Parents lacked evidence-based knowledge of the risks and benefits of the procedure. They uniformly desire more information and counseling from their medical providers. Conclusions for Practice This study affirms the importance of sociocultural factors and identified a discrepancy between parents' desire for empiric information and the counsel offered by providers, identifying a need for improved parent counseling. The qualitative themes that emerged from this work enabled the development of a comprehensive conceptual model that can be further tested to develop a decision aid for circumcision of the newborn., Author(s): Allison M. Morgan [sup.1] , Yue-Yung Hu [sup.1] [sup.2] [sup.3] , Andrea Benin [sup.3] , Gina M. Lockwood [sup.3] [sup.4] Author Affiliations: (1) grid.16753.36, 0000 0001 2299 3507, Surgical [...]

Background Cesarean has been suggested to decrease neonatal iron stores at birth. However, few studies have differentiated the effect induced by cesarean operation from that related to medical indications. Objectives We aimed to estimate the association of cesarean delivery on maternal request (CDMR), a subtype of cesarean without any medical indications, with a spectrum of indicators reflecting iron stores at birth. Methods This prospective cohort study involved 288 term singleton neonates born to women without any complications by CDMR or spontaneous vaginal delivery (SVD). Measured hematological iron-related indicators in cord blood included serum ferritin (SF), hemoglobin (Hb), red blood cell (RBC), and hematocrit (Hct). Blood flow volume (BFV) of cord vein when clamping was measured to reflect placental transfusion status during birth. Quantile regression was used to assess the association between delivery mode and the iron store indicators. Results CDMR (n = 154) versus SVD group (n = 134) had lower conditional median cord blood SF (-34.80; 95% CI -64.70, -4.90 [mu]g/L; P = 0.02), Hb (-10.67; 95% CI -18.87, -2.47 g/L; P = 0.01), RBC (-0.30; 95% CI -0.48, -0.12 ×10.sup.12/L; P = 0.002), and Hct (-3.06; 95% CI -6.08, -0.04 %; P = 0.047). The BFV was higher in CDMR than SVD group at the 25th centile (0.51; 95% CI 0.19, 0.82 ml/cm.sup.3; P = 0.002), median (0.49; 95% CI 0.04, 0.95 ml/cm.sup.3; P = 0.03) and the 75th centile (0.54; 95% CI 0.06, 1.03 ml/cm.sup.3; P = 0.03). Conclusions The cesarean operation per se likely hampered placental transfusion from mother to neonate and decreased iron stores at birth., Author(s): Zijun Liao [sup.1] [sup.2] [sup.3] , Yubo Zhou [sup.1] [sup.2] , Aiju Liu [sup.4] , Hongtian Li [sup.1] [sup.2] , Rachel L. Peters [sup.5] [sup.6] , Jianmeng Liu [sup.1] [...]