title: Laboratory Methods for Determining Etiology of Neonatal Infection at Population-based Sites in South Asia: The ANISA Study.
abstract: BACKGROUND
  The Aetiology of Neonatal Infection in South Asia (ANISA) study aims to determine the etiology of neonatal infections in 5 population-based sites in Bangladesh, India and Pakistan.
  
  
  METHODS
  The main laboratory challenges in ANISA were selection and consistent implementation of laboratory methods at participating sites with varied infrastructure. The other specific challenges included (1) specimen collection and transport to designated study laboratories and timely processing in rural settings; (2) minimal or nonexistent laboratory facilities at the field sites; (3) obtaining sufficient volumes of blood from enrolled infants aged 0-59 days and (4) caregivers' concerns about collection of clinical specimens from young infants. An additional challenge was selecting an appropriate molecular platform from multiple available options, all with limited field validation, for use in determining infection in young infants.
  
  
  CONCLUSIONS
  This article describes how the challenges of specimen collection, transport and processing and implementation of laboratory methods have been addressed in the ANISA study. It also describes the measures taken to improve detection of microorganisms causing young infant infections by enhancing the sensitivity of existing laboratory methods for pathogen detection.
authors.affiliation: From the *Child Health Research Foundation, Dhaka, Bangladesh; †The Aga Khan University, Karachi, Pakistan; and ‡Respiratory Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
authors.forename: Mohammad Shahidul
authors.initials: MS
authors.lastname: Islam
authors.forename: Shahida M
authors.initials: SM
authors.lastname: Qureshi
authors.forename: Belal
authors.initials: B
authors.lastname: Hossain
authors.forename: Maksuda
authors.initials: M
authors.lastname: Islam
authors.forename: Anita K
authors.initials: AK
authors.lastname: Zaidi
authors.forename: Joyanta K
authors.initials: JK
authors.lastname: Modak
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Al-Emran
authors.forename: Maureen H
authors.initials: MH
authors.lastname: Diaz
authors.forename: Lesley
authors.initials: L
authors.lastname: McGee
authors.forename: Jonas M
authors.initials: JM
authors.lastname: Winchell
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003141:Communicable Diseases / Q000453:epidemiology / Q000209:etiology*; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000209:etiology*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D012424:Rural Population; D013048:Specimen Handling / Q000379:methods*; D014505:Urban Population