An innovative multipartner research program to address detection, assessment and treatment of neonatal infections in low-resource settings.
BACKGROUND
In pursuit of innovative approaches for the management of severe infections in young infants, which is a major cause of mortality, a multipartner research program was conceptualized to provide right care in the right place. The primary objective was to generate evidence and identify a simple, safe and effective treatment regimen for young infants with severe infections that can be provided closer to home by trained health workers where referral is not possible.


METHODS
Published and nonpublished data on community-based approaches for the management of neonatal sepsis were critically reviewed by an independent expert panel convened in 2007 by the World Health Organization in collaboration with the United States Agency for International Development and Save the Children/Saving Newborn Lives. These stakeholders agreed to 1) undertake research to improve the specificity of a diagnostic algorithm and revise World Health Organization/United Nations International Children's Emergency Fund Integrated Management of Childhood Illness guidelines to identify sick young infants for referral, 2) develop research studies with common research designs (1 site in each Bangladesh and Pakistan and a multicentre site in Democratic Republic of Congo, Kenya and Nigeria) and oversight mechanisms to evaluate antibiotic regimens (when referral is not accepted by the family) that are safe and efficacious, appropriate to the severity of infection, and deployable on a large scale and 3) utilize existing program delivery structures incorporating community health workers, skilled health workers to deliver simple antibiotic treatment when referral is not possible.


CONCLUSIONS
This research program facilitated innovative research in different geographical, cultural and administrative milieus to generate recommendations for policy.
Department of Maternal Newborn Child and Adolescent Health, World Health Organization, Geneva, Switzerland. qazis@who.int
Shamim Ahmad
SA
Qazi
Steve
S
Wall
Neal
N
Brandes
Cyril
C
Engmann
Gary L
GL
Darmstadt
Rajiv
R
Bahl
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003153:Community Health Services; D003150:Community Health Workers; D003906:Developing Countries; D006297:Health Services Accessibility; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy; D014944:World Health Organization
D000900:Anti-Bacterial Agents