The goals of the current research were to (i) identify the clinical manifestations of EONS in an isolated South East Asian refugee population and (ii) to try to establish the aetiology for EONS and, more specifically, to determine whether GBS is a significant pathogen within the region.
There are a few limitations in laboratories, the difficulty of collecting enough blood from a newborn and the inhibition of bacterial growth in culture with antibiotics administered during labor [88. But, the information about the prevalence of a specific pathogen is only derived from studies that are based on microbiological diagnoses. A recent review of pathogens responsible for infection among infants in the developing world found that for infants who were less than 7 days old (early term neonatal sepsis (EONS)) Gram positive organisms dominated essay in an ratio of 2:1 with Escherichia Coli being the most often isolated pathogen. There are many reasons why microbiological verification is not possible especially in developing countries. The authors suggested the reason why Gram negative pathogens were predominant in EONS was due to them being in the environment as a result of unsanitary birth practices [99.
This includes the lack of lab facilities, difficulties in getting enough blood from an infant and the suppression of bacterial growth in culture through the use of antibiotics during labour [88. Historically, the infection associated with GBS is reported to be very rare in developing countries [11. A recent study of pathogens that cause infections in infants across the developing world revealed that in infants younger than 7 days old (early neonatal sepsis at the onset (EONS)) Gram-negative organisms were the most prevalent, with the ratio of 2:1, with Escherichia-coli being the most frequently isolated pathogen. There are a variety of reasons, including lesser maternal carriers and less highly virulent forms of GBS and also research design [1010. The researchers suggested that the reason Gram negative organisms dominated EONS is due to the fact that they were exposed to the environment through unsanitary birth practices [99. EONS GBS disease is often seen very early in life, with 90 percent in cases of sepsis being diagnosed within 12 hours of birth [11-1211-12.
In the past, infection with GBS has been found to be very uncommon in the developing world [11. Therefore, studies that study EONS in babies born in the community that are admitted to hospitals will be biased as babies with EONS GBS have a greater probability that they will die in their home environment or when they go to the hospital. The reasons for this are lower maternal burden of less harmful strains of GBS as well as study design [1010. In addition, a recent systematic review showed that studies that report there is a need for intrapartum antibiotics (IAP) have been reported are associated with lower incidences of EO GBS diseases .
The EONS GBS illness is seen at an early age, with 90 percent instances of sepsis appearing within 12 hours after birth [11,1212]. In recent years, African studies have shown higher rates of early-onset neonatal GBS infection [14-18and 18-18. Thus, research studies that examine EONS in infants born in the community who are admitted to hospitals could be biased since infants suffering from EONS GBS are at a higher chance to die at home, or while traveling to the hospital.
A review article by Seale and co. states that these higher incidents result from more sensitive designs for studies that concentrate on infants who are born in hospitals who suffer from early onset sepsis. A recent systematic review has shown that studies where IAP are used as an intrapartum treatment (IAP) are mentioned have lower rates of EO GBS-related disease . This is not the case for outpatient referrals [1919. Recent African studies have revealed more frequent onset of neonatal GBS infection [14-1814-18. Mortality due to neonatal sepsis, due to any reason, is very high even when it is treated.
A review study by Seale and colleagues. concluding that the higher instances result from more sensitive designs for studies which focus on babies born in hospitals, who are at risk of developing early-onset sepsis, not outpatient referrals [1919. The rate of fatality for cases is 5 to 60% are stated, with the highest death rate occurring in the developing world [6,206,20. The risk of dying from neonatal sepsis regardless of the reason, is extremely high even if it is treated. A large multicentre case-controlled study carried out by the USA between 1995 and 1996 found the prevalence in EONS that was 3.5 per 1,000 live births and 16percent of infants being killed [2121. Rates of death from cases ranging from 5 to 60% have been documented, with the highest mortality rates being reported in countries with poorer infrastructure [6,206.20]. The goals of the current research were to (i) identify the clinical manifestations of EONS in an isolated South East Asian refugee population and (ii) to try to establish the aetiology for EONS and, more specifically, to determine whether GBS is a significant pathogen within the region.
A multicentre, case-controlled study conducted within the USA between 1995 and 1996 revealed the prevalence in EONS in the range of 3.5 per 1000 live births , with one-third of the newborns passing away [2121. Methods. The objectives of the present study was to: (i) define the prevalence of clinically diagnosed EONS in the rural South East Asian refugee population and (ii) to try to identify the cause of EONS specifically to determine if GBS is a major pathogen in this region. Study of the population. Methods.
Maela is a crowded camp for refugees from Myanmar located on the northwestern frontier of Thailand. Study the population. About 50,000 refugees reside within the area of 4 square km and the majority of refugees belong to Myanmar’s Karen people of the Karen ethnicity.
Maela is a crowded camp for people who have been displaced from Myanmar situated on the north-western border with Thailand. Shoklo Malaria Research Unit (SMRU) provides onsite medical and obstetrical services for women in Maela in the year 1986. Around 50,000 refugees reside in an area of 4 square kilometers and the majority of them are members of those belonging to the Karen ethnic minority.