• Characteristics and mortality of neonates in an emergency obstetric and neonatal care facility, rural Burundi

      Zuniga, I; Van den Bergh, R; Ndelema, B; Bulckaert, D; Manzi, M; Lambert, V; Zachariah, R; Reid, A J; Harries, A D (International Union Against TB and Lung Disease, 2013-12)
    • How Do Low Birth Weight Neonates Fare Two Years After Discharge from a Low-Technology Neonatal Care Unit in a Rural District Hospital in Burundi?

      van den Boogaard, W; Zuniga, I; Manzi, M; Van den Bergh, R; Lefevre, A; Nanan-N'zeth, K; Duchenne, B; Etienne, W; Juma, N; Ndelema, B; et al. (Wiley-Blackwell, 2017-01-31)
      As neonatal care is being scaled up in economically poor settings, there is a need to know more on post-hospital discharge and longer-term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in low-birth-weight neonates (LBW, <2500 grams). Getting a better handle on these parameters might justify and guide support interventions. Two years after hospital discharge, we thus assessed: mortality, developmental impairments, and nutritional status of LBW children.
    • Low-Tech, High Impact: Care for Premature Neonates in a District Hospital in Burundi. A Way Forward to Decrease Neonatal Mortality

      Ndelema, B; Van den Bergh, R; Manzi, M; van den Boogaard, W; Kosgei, R J; Zuniga, I; Juvenal, M; Reid, A (Springer Link, 2016-01-16)
      Death among premature neonates contributes significantly to neonatal mortality which in turn represents approximately 40 % of paediatric mortality. Care for premature neonates is usually provided at the tertiary care level, and premature infants in rural areas often remain bereft of care. Here, we describe the characteristics and outcomes of premature neonates admitted to neonatal services in a district hospital in rural Burundi that also provided comprehensive emergency obstetric care. These services included a Neonatal Intensive Care Unit (NICU) and Kangaroo Mother Care (KMC) ward, and did not rely on high-tech interventions or specialist medical staff.
    • Where Technology Does Not Go: Specialised Neonatal Care in Resource-Poor and Conflict-Affected Contexts

      Dörnemann, J; van den Boogaard, W; Van den Bergh, R; Takarinda, K; Martinez, P; Bekouanebandi, J; Javed, I; Ndelema, B; Lefèvre, A; Khalid, G; et al. (International Union Against Tuberculosis and Lung Disease, 2017-06-21)
      Setting: Although neonatal mortality is gradually decreasing worldwide, 98% of neonatal deaths occur in low- and middle-income countries, where hospital care for sick and premature neonates is often unavailable. Médecins Sans Frontières Operational Centre Brussels (MSF-OCB) managed eight specialised neonatal care units (SNCUs) at district level in low-resource and conflict-affected settings in seven countries. Objective: To assess the performance of the MSF SNCU model across different settings in Africa and Southern Asia, and to describe the set-up of eight SNCUs, neonate characteristics and clinical outcomes among neonates from 2012 to 2015. Design: Multicentric descriptive study. Results: The MSF SNCU model was characterised by an absence of high-tech equipment and an emphasis on dedicated nursing and medical care. Focus was on the management of hypothermia, hypoglycaemia, feeding support and early identification/treatment of infection. Overall, 11 970 neonates were admitted, 41% of whom had low birthweight (<2500 g). The main diagnoses were low birthweight, asphyxia and neonatal infections. Overall mortality was 17%, with consistency across the sites. Chances of survival increased with higher birthweight. Conclusion: The standardised SNCU model was implemented across different contexts and showed in-patient outcomes within acceptable limits. Low-tech medical care for sick and premature neonates can and should be implemented at district hospital level in low-resource settings.