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Journal Article > Commentary

A call to bridge the diagnostic gap: diagnostic solutions for neonatal sepsis in low- and middle-income countries

Gleeson B, Ferreyra C, Palamountain K, Jacob ST, Spotswood N, Kissoon N, Nisar YB, Fitzgerald F, Murless-Collins S, Okomo U, Cross JH, Molyneux E, Piriou E, Iloh KK, Santorino D, Goldfarb D, Stevenson A, Kirby R, Nichols BE, Blumel B, Kelly-Cirino C, Walsh T, Lloyd L, Liaghati-Mobarhan S
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Summary Points
  • Low- and middle-income countries (LMICs) bear the greatest burden of neonatal mortality, with sepsis being a major contributor.
  • Non-specificity of signs, and the absence of a definitive diagnostic, present a challenge to the identification of sepsis and can lead to underdiagnosis or overdiagnosis, both of which can have harmful consequences.
  • As early intervention can be life-saving, sepsis protocols, which commonly include empiric therapies, result in the overuse of antibiotics and the development of antimicrobial resistance.
  • Affordable and accurate diagnostic tests that can detect neonatal sepsis at or near the point of care could contribute to reduced sepsis-related mortality in LMICs and support antimicrobial stewardship.
  • A screening test to guide referral to hospital from primary care, and an in-hospital test to guide treatment decisions, are high priorities.
  • Considerable investment will be needed to support the development of these diagnostics.
Subject Area
diagnosticspediatricsneonatal healthsepsis
DOI
10.1136/bmjgh-2024-015862
Published Date
10-Sep-2024
PubMed ID
39260829
Languages
English
Journal
BMJ Global Health
Volume / Issue / Pages
Volume 9, Issue 9, Pages e015862
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