Effectiveness of Home-Based Management of Newborn Infections by Community Health Workers in Rural Bangladesh

• DOI: 10.1097/inf.0b013e31819069e8
• Publication Date: 2009-05-21T14:27:14Z
• Authors: 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; Robert E. Black; Gary L. Darmstadt
• Keywords: Case fatality rate

: Infections account for about half of neonatal deaths in low-resource settings. Limited evidence supports home-based treatment newborn infections by community health workers (CHW).: In one study arm a cluster randomized controlled trial, CHWs assessed neonates at home, using 20-sign clinical algorithm and classified sick as having very severe disease or possible disease. Over 2-year period, 10,585 live births were recorded the area. 8474 (80%) within first week life referred with signs If referral failed but parents consented to home treatment, treated multiple signs, injectable antibiotics.: For disease, compliance was 34% (162/478 cases), acceptance 43% (204/478 cases). The case fatality rate 4.4% (9/204) CHW 14.2% (23/162) qualified medical providers, 28.5% (32/112) those who received no other unqualified providers. After controlling differences background characteristics illness among groups, newborns had hazard ratio 0.22 (95% confidence interval [CI] = 0.07-0.71) death during period providers 0.61 CI 0.37-0.99), compared untrained Significantly increased hazards ratios observed convulsions (hazard [HR] 6.54; 95% 3.98-10.76), chest in-drawing (HR 2.38, 1.29-4.39), temperature <35.3 degrees C 3.47, 1.30-9.24), unconsciousness 7.92, 3.13-20.04).: Home effective acceptable setting Bangladesh.