New insights into aetiology of neonatal infections

Saha SK, Schrag SJ, El Arifeen S, Mullany LC, Shahidul Islam M, Shang N, Qazi SA, Zaidi AKM, Bhutta ZA, Bose A, Panigrahi P, Soofi SB, Connor NE, Mitra DK, Isaac R, Winchell JM, Arvay ML, Islam M, Shafiq Y, Nisar I, Baloch B, Kabir F, Ali M, Diaz MH, Satpathy R, Nanda P, Padhi BK, Parida S, Hotwani A, Hasanuzzaman M, Ahmed S, Belal Hossain M, Ariff S, Ahmed I, Ibne Moin SM, Mahmud A, Waller JL, Rafiqullah I, Quaiyum MA, Begum N, Balaji V, Halen J, Nawshad Uddin Ahmed ASM, Weber MW, Hamer DH, Hibberd PL, Sadeq-Ur Rahman Q, Mogan VR, Hossain T, McGee L, Anandan S, Liu A, Panigrahi K, Abraham AM, Baqui AH. Causes and incidence of community-acquired serious infections among young children in south Asia (ANISA): an observational cohort study. Lancet. 2018 Jul 14;392(10142):145-159. doi: 10.1016/S0140-6736(18)31127-9. Epub 2018 Jul 6.


Aetiology of Neonatal Infections in South Asia (ANISA) study is a prospective case-control study at five sites in Bangladesh, India and Pakistan. This study showed that the causal attribution among babies with possible serious bacterial infections (pSBI) episodes was 28% (16% bacterial and 12% viral). The leading pathogen in the first two months of life was respiratory syncytial virus with 5.4 (4.8-6.3) episodes per 1000 live births, followed by Ureaplasma spp with 2.4 (1.6-3.2) episodes per 1000 livebirths. Among babies who died, a cause could be attributed in 46% of pSBI episodes, among which 92% were bacterial. However, interpretation of this study should take into consideration of the following aspects: (i) There is a substantial percentage (72%) of pSBI episodes and (54%) fatal pSBI deaths without attribution of a cause; (ii) There could be other organisms beyond the 28 agents under study; (iii) The definition of pSBI has relatively low specificity.

Abstract on Pubmed.