Implementation of the ANISA Protocol in Sylhet, Bangladesh: Challenges and Solutions

Dipak K. Mitra, Arif Mahmud, Nazma Begum, Iftekhar Rafiqullah, Arunangshu Roy, Syed Mamun Ibne Moin, Maksuda Islam, Md Abdul Quaiyum, Jannatul Ferdous, Jennifer A. Applegate, Samir K. Saha, Abdullah Baqui

Research output: Contribution to journalArticle

Abstract

Background: Despite the high rate of deaths in young infants (0-59 days) attributable to infections in resource-poor countries, data on bacterial and viral etiologies of community-acquired infections in this age group are limited. These data are needed to develop appropriate preventive strategies and suitable antibiotic treatment regimens for reducing the number of young infant deaths from infections. The Aetiology of Neonatal Infection in South Asia (ANISA) study is designed to generate these critical data and is being implemented in Bangladesh, India and Pakistan. The Sylhet site in Bangladesh was selected because neonatal mortality is high in this country and particularly in Sylhet District. In this article, we describe the contextual challenges in implementing the ANISA study in Sylhet, as well as the strategies developed by our team to address these challenges. Contextual Challenges: The major challenge in implementing the ANISA protocol in Sylhet is conducting the first postnatal visit within 24 hours of birth. This problem stems from several social, cultural and geographical characteristics of the study population and its demographic profile. In this area, most births take place at home, referral compliance for newborn illness to health facilities is low and the blood culture contamination rate is high. Community mobilization, cellphone-based birth notification by families, delivery of quality services at study hospitals and referral support to families in need were some of the strategies adopted by the Sylhet site team for overcoming these challenges during study implementation. Quality control in specimen collection, transportation and processing also plays a role in ensuring satisfactory performance. Conclusion: Our research team, with support from the ANISA coordination center, has successfully addressed these challenges and is implementing the study protocol while maintaining the high quality benchmark set by the coordination center.

Original languageEnglish (US)
Pages (from-to)S55-S59
JournalPediatric Infectious Disease Journal
Volume35
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Bangladesh
Infection
Parturition
Referral and Consultation
Cultural Characteristics
Specimen Handling
Community-Acquired Infections
Benchmarking
Health Facilities
Pakistan
Infant Mortality
Quality Control
Compliance
India
Age Groups
Demography
Newborn Infant
Anti-Bacterial Agents
Mortality
Research

Keywords

  • ANISA
  • community based
  • neonatal
  • pSBI
  • referral compliance
  • Sylhet

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Implementation of the ANISA Protocol in Sylhet, Bangladesh : Challenges and Solutions. / Mitra, Dipak K.; Mahmud, Arif; Begum, Nazma; Rafiqullah, Iftekhar; Roy, Arunangshu; Moin, Syed Mamun Ibne; Islam, Maksuda; Quaiyum, Md Abdul; Ferdous, Jannatul; Applegate, Jennifer A.; Saha, Samir K.; Baqui, Abdullah.

In: Pediatric Infectious Disease Journal, Vol. 35, No. 5, 01.05.2016, p. S55-S59.

Research output: Contribution to journalArticle

Mitra, DK, Mahmud, A, Begum, N, Rafiqullah, I, Roy, A, Moin, SMI, Islam, M, Quaiyum, MA, Ferdous, J, Applegate, JA, Saha, SK & Baqui, A 2016, 'Implementation of the ANISA Protocol in Sylhet, Bangladesh: Challenges and Solutions', Pediatric Infectious Disease Journal, vol. 35, no. 5, pp. S55-S59. https://doi.org/10.1097/INF.0000000000001108
Mitra, Dipak K. ; Mahmud, Arif ; Begum, Nazma ; Rafiqullah, Iftekhar ; Roy, Arunangshu ; Moin, Syed Mamun Ibne ; Islam, Maksuda ; Quaiyum, Md Abdul ; Ferdous, Jannatul ; Applegate, Jennifer A. ; Saha, Samir K. ; Baqui, Abdullah. / Implementation of the ANISA Protocol in Sylhet, Bangladesh : Challenges and Solutions. In: Pediatric Infectious Disease Journal. 2016 ; Vol. 35, No. 5. pp. S55-S59.
@article{c4a61c5ddbd84910868ef7fa8e207e1d,
title = "Implementation of the ANISA Protocol in Sylhet, Bangladesh: Challenges and Solutions",
abstract = "Background: Despite the high rate of deaths in young infants (0-59 days) attributable to infections in resource-poor countries, data on bacterial and viral etiologies of community-acquired infections in this age group are limited. These data are needed to develop appropriate preventive strategies and suitable antibiotic treatment regimens for reducing the number of young infant deaths from infections. The Aetiology of Neonatal Infection in South Asia (ANISA) study is designed to generate these critical data and is being implemented in Bangladesh, India and Pakistan. The Sylhet site in Bangladesh was selected because neonatal mortality is high in this country and particularly in Sylhet District. In this article, we describe the contextual challenges in implementing the ANISA study in Sylhet, as well as the strategies developed by our team to address these challenges. Contextual Challenges: The major challenge in implementing the ANISA protocol in Sylhet is conducting the first postnatal visit within 24 hours of birth. This problem stems from several social, cultural and geographical characteristics of the study population and its demographic profile. In this area, most births take place at home, referral compliance for newborn illness to health facilities is low and the blood culture contamination rate is high. Community mobilization, cellphone-based birth notification by families, delivery of quality services at study hospitals and referral support to families in need were some of the strategies adopted by the Sylhet site team for overcoming these challenges during study implementation. Quality control in specimen collection, transportation and processing also plays a role in ensuring satisfactory performance. Conclusion: Our research team, with support from the ANISA coordination center, has successfully addressed these challenges and is implementing the study protocol while maintaining the high quality benchmark set by the coordination center.",
keywords = "ANISA, community based, neonatal, pSBI, referral compliance, Sylhet",
author = "Mitra, {Dipak K.} and Arif Mahmud and Nazma Begum and Iftekhar Rafiqullah and Arunangshu Roy and Moin, {Syed Mamun Ibne} and Maksuda Islam and Quaiyum, {Md Abdul} and Jannatul Ferdous and Applegate, {Jennifer A.} and Saha, {Samir K.} and Abdullah Baqui",
year = "2016",
month = "5",
day = "1",
doi = "10.1097/INF.0000000000001108",
language = "English (US)",
volume = "35",
pages = "S55--S59",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Implementation of the ANISA Protocol in Sylhet, Bangladesh

T2 - Challenges and Solutions

AU - Mitra, Dipak K.

AU - Mahmud, Arif

AU - Begum, Nazma

AU - Rafiqullah, Iftekhar

AU - Roy, Arunangshu

AU - Moin, Syed Mamun Ibne

AU - Islam, Maksuda

AU - Quaiyum, Md Abdul

AU - Ferdous, Jannatul

AU - Applegate, Jennifer A.

AU - Saha, Samir K.

AU - Baqui, Abdullah

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: Despite the high rate of deaths in young infants (0-59 days) attributable to infections in resource-poor countries, data on bacterial and viral etiologies of community-acquired infections in this age group are limited. These data are needed to develop appropriate preventive strategies and suitable antibiotic treatment regimens for reducing the number of young infant deaths from infections. The Aetiology of Neonatal Infection in South Asia (ANISA) study is designed to generate these critical data and is being implemented in Bangladesh, India and Pakistan. The Sylhet site in Bangladesh was selected because neonatal mortality is high in this country and particularly in Sylhet District. In this article, we describe the contextual challenges in implementing the ANISA study in Sylhet, as well as the strategies developed by our team to address these challenges. Contextual Challenges: The major challenge in implementing the ANISA protocol in Sylhet is conducting the first postnatal visit within 24 hours of birth. This problem stems from several social, cultural and geographical characteristics of the study population and its demographic profile. In this area, most births take place at home, referral compliance for newborn illness to health facilities is low and the blood culture contamination rate is high. Community mobilization, cellphone-based birth notification by families, delivery of quality services at study hospitals and referral support to families in need were some of the strategies adopted by the Sylhet site team for overcoming these challenges during study implementation. Quality control in specimen collection, transportation and processing also plays a role in ensuring satisfactory performance. Conclusion: Our research team, with support from the ANISA coordination center, has successfully addressed these challenges and is implementing the study protocol while maintaining the high quality benchmark set by the coordination center.

AB - Background: Despite the high rate of deaths in young infants (0-59 days) attributable to infections in resource-poor countries, data on bacterial and viral etiologies of community-acquired infections in this age group are limited. These data are needed to develop appropriate preventive strategies and suitable antibiotic treatment regimens for reducing the number of young infant deaths from infections. The Aetiology of Neonatal Infection in South Asia (ANISA) study is designed to generate these critical data and is being implemented in Bangladesh, India and Pakistan. The Sylhet site in Bangladesh was selected because neonatal mortality is high in this country and particularly in Sylhet District. In this article, we describe the contextual challenges in implementing the ANISA study in Sylhet, as well as the strategies developed by our team to address these challenges. Contextual Challenges: The major challenge in implementing the ANISA protocol in Sylhet is conducting the first postnatal visit within 24 hours of birth. This problem stems from several social, cultural and geographical characteristics of the study population and its demographic profile. In this area, most births take place at home, referral compliance for newborn illness to health facilities is low and the blood culture contamination rate is high. Community mobilization, cellphone-based birth notification by families, delivery of quality services at study hospitals and referral support to families in need were some of the strategies adopted by the Sylhet site team for overcoming these challenges during study implementation. Quality control in specimen collection, transportation and processing also plays a role in ensuring satisfactory performance. Conclusion: Our research team, with support from the ANISA coordination center, has successfully addressed these challenges and is implementing the study protocol while maintaining the high quality benchmark set by the coordination center.

KW - ANISA

KW - community based

KW - neonatal

KW - pSBI

KW - referral compliance

KW - Sylhet

UR - http://www.scopus.com/inward/record.url?scp=84965112792&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84965112792&partnerID=8YFLogxK

U2 - 10.1097/INF.0000000000001108

DO - 10.1097/INF.0000000000001108

M3 - Article

C2 - 27070066

AN - SCOPUS:84965112792

VL - 35

SP - S55-S59

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 5

ER -