Publications by authors named "Mohammod Shahidullah"

Article Synopsis
  • Rising antimicrobial resistance (AMR) in Salmonella Typhi poses a significant threat to typhoid treatment, especially in high-burden countries like Bangladesh, where long-term data is lacking.
  • The study analyzed typhoid cases in Dhaka from 1999 to 2022, finding a decrease in multidrug resistance (MDR) from 38% to 17% and a drop in cotrimoxazole consumption, while resistance to ciprofloxacin remained high (>90%).
  • With a noted decline in MDR, the research suggests that first-line antibiotics may be safely reintroduced for treating typhoid fever, pending further decreases in resistance rates.
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  • Extreme hyperbilirubinemia in newborns is a major issue in low- and middle-income countries like Bangladesh, leading to significant health risks, especially since many births occur at home without screening or treatment.
  • A cluster randomized trial will involve 530 pregnant women in rural Bangladesh, where community health workers (CHWs) will screen and provide home treatment for newborns with jaundice, comparing results to traditional care methods.
  • The study aims to determine if CHW-led home phototherapy can effectively increase treatment rates for neonatal hyperbilirubinemia, potentially allowing for similar programs in other low-income settings to improve newborn health outcomes.
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Background: According to Bangladesh Demographic and Health Survey (2022), neonatal mortality, comprising 67% of under-5 deaths in Bangladesh, is significantly attributed to prematurity and low birth weight (LBW), accounting for 32% of neonatal deaths. Respiratory distress syndrome (RDS) is a prevalent concern among preterm and LBW infants, leading to substantial mortality. The World Health Organization (WHO) recommends bubble continuous positive airway pressure (bCPAP) therapy, but the affordability and accessibility of conventional bCPAP devices for a large number of patients become major hurdles in Bangladesh due to high costs and resource intensiveness.

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Article Synopsis
  • * A study in rural Bangladesh, which involved 23 newborns, explored how feasible and acceptable a CHW-led home phototherapy intervention was for families, revealing that it was seen as convenient and cost-saving.
  • * Despite some concerns about CHWs’ skills and power supply reliability, both families and CHWs rated the home phototherapy positively, suggesting further research is needed to assess its impact on treatment rates and health outcomes.
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Introduction: The aims of the study are to: (1) determine the short-term reactogenicity of WHO-approved COVID-19 vaccines (i.e., Pfizer-BioNTech, Moderna, Sinovac, Oxford-AstraZeneca, Johnson and Johnson, Covaxin) amongst lactating women and their children, and 2) evaluate lactation-related outcomes following the same vaccines in Bangladesh.

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Background: Effect of duration of birth depression on neurodevelopmental outcomes in low- and middle-income countries (LMICs) is not known. We examined the association of birth depression with brain injury, neurodevelopmental outcomes, and hypothermia after hypoxic ischemic encephalopathy (HIE) in south Asia.

Methods: We compared cerebral magnetic resonance (MR) at 2 weeks, and adverse outcomes (death or moderate or severe disability) at 18 months in 408 babies with moderate or severe HIE who had long birth depression (positive pressure ventilation (PPV) >10 min or Apgar score<6 at 10 min or cord pH < 7.

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Background: Typhoid and paratyphoid remain common bloodstream infections in areas with suboptimal water and sanitation infrastructure. Paratyphoid, caused by Salmonella Paratyphi A, is less prevalent than typhoid and its antimicrobial resistance (AMR) trends are less documented. Empirical treatment for paratyphoid is commonly based on the knowledge of susceptibility of Salmonella Typhi, which causes typhoid.

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Background: We aimed to define clinical and cost-effectiveness of a Day Care Approach (DCA) alternative to Usual Care (UC, comparison group) within the Bangladesh health system to manage severe childhood pneumonia.

Methods: This was a cluster randomised controlled trial in urban Dhaka and rural Bangladesh between November 1, 2015 and March 23, 2019. Children aged 2-59 months with severe pneumonia with or without malnutrition received DCA or UC.

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Article Synopsis
  • The study investigates the relationship between the place of birth (inborn vs. outborn) and the effectiveness of whole-body hypothermia in protecting against brain injury in neonates suffering from hypoxic-ischemic encephalopathy (HIE) in low- and middle-income countries.
  • Conducted in seven neonatal intensive care units across India, Sri Lanka, and Bangladesh, the research followed 408 neonates born after 36 weeks of gestation who were randomized into hypothermia and control groups, tracking various brain injury indicators over time.
  • Results indicate that inborn neonates were generally smaller and had different delivery methods compared to outborn neonates, raising questions about how birthplace impacts treatment outcomes for HIE in this demographic
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Background: Universal screening for neonatal hyperbilirubinemia risk assessment is recommended by the American Academy of Pediatrics to reduce related morbidity. In Bangladesh and in many low- and middle-income countries, there is no screening for neonatal hyperbilirubinemia. Furthermore, neonatal hyperbilirubinemia may not be recognized as a medically significant condition by caregivers and community members.

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Background: Hospital referral and admission in many- low and middle-income countries are not feasible for many young infants with sepsis/possible serious bacterial infection (PSBI). The effectiveness of simplified antibiotic regimens when referral to a hospital was not feasible has been shown before. We analysed the pooled data from the previous trials to compare the risk of poor clinical outcome for young infants with PSBI with the two regimens containing injectable procaine penicillin and gentamicin with the oral amoxicillin plus gentamicin regimen currently recommended by the World Health Organization (WHO) when referral is not feasible.

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Background: Bangladesh reported its first COVID-19 case on March 8, 2020. Despite lockdowns and promoting behavioural interventions, as of December 31, 2021, Bangladesh reported 1.5 million confirmed cases and 27 904 COVID-19-related deaths.

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Introduction: The WHO's Integrated Management of Childhood Illnesses (IMCI) algorithm for diagnosis of child pneumonia relies on counting respiratory rate and observing respiratory distress to diagnose childhood pneumonia. IMCI case defination for pneumonia performs with high sensitivity but low specificity, leading to overdiagnosis of child pneumonia and unnecessary antibiotic use. Including lung auscultation in IMCI could improve specificity of pneumonia diagnosis.

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Objective: To describe the implementation, coverage and performance of the national kangaroo mother care programme in Bangladesh.

Methods: Kangaroo mother care services for clinically stable babies with birth weight under 2000 g were set up in government-run health-care facilities in rural and urban areas of Bangladesh. Each facility provided counselling on kangaroo mother care, ensured adequate nutrition, and followed up mothers and babies.

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Background: Although therapeutic hypothermia reduces death or disability after neonatal encephalopathy in high-income countries, its safety and efficacy in low-income and middle-income countries is unclear. We aimed to examine whether therapeutic hypothermia alongside optimal supportive intensive care reduces death or moderate or severe disability after neonatal encephalopathy in south Asia.

Methods: We did a multicountry open-label, randomised controlled trial in seven tertiary neonatal intensive care units in India, Sri Lanka, and Bangladesh.

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Background: Exchange transfusion in newborns is recommended as emergency management of hyperbilirubinemia to prevent bilirubin encephalopathy and kernicterus.

Aim: This study aimed to determine the frequency and document common side effects of exchange transfusion and outcomes of newborns requiring exchange transfusion.

Materials And Methods: This prospective study was done in the Neonatal Intensive Care Unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from January 2016 to December 2019.

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Majority of under-five children with developmental disabilities live in low- and middle-income countries (LMIC). A considerable proportion of disabilities results from perinatal adversities. The neonatal and infant mortality rates in India, Bangladesh, and Sri Lanka have improved over the last two decades, implying survival of infants at risk for developmental impairments.

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Background: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain.

Methods: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo.

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Article Synopsis
  • The study examines the effects of SARS-CoV-2 on neonates in Bangladesh, revealing a significant number of infections among hospitalized babies, most of whom had non-SARS-CoV-2 related health issues.
  • Out of 83 tested neonates, 26 were positive for the virus, with several developing serious health complications; follow-up showed a concerning mortality rate among those infected.
  • The findings highlight the pressing need to improve understanding and treatment of COVID-19 in neonates within low- and middle-income countries, as existing healthcare challenges may worsen health outcomes.
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Introduction: There is a set of globally accepted and nationally adapted signal functions for categorising health facilities for maternal services. Newborn resuscitation is the only newborn intervention which is included in the WHO recommended list of emergency obstetric care signal functions. This is not enough to comprehensively assess the readiness of a health facility for providing newborn services.

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Article Synopsis
  • A new diagnostic test using whole blood gene analysis may help identify encephalopathic babies at risk of poor neurodevelopmental outcomes within 18 months after birth.
  • Researchers performed next-generation sequencing on blood samples from 45 encephalopathic infants, identifying 855 genes with significant differences between those with good and adverse outcomes.
  • The findings suggest that transcriptomic profiling could enhance risk assessment in neonatal encephalopathy and reveal potential new treatments for protecting brain health.
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Background: Neonatal infections remain a leading cause of newborn deaths globally. In 2015, WHO issued guidelines for managing possible serious bacterial infection (PSBI) in young infants (0-59 days) using simplified antibiotic regimens when compliance with hospital referral is not feasible. Bangladesh was one of the first countries to adopt WHO's guidelines for implementation.

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Article Synopsis
  • Many families in rural Bangladesh struggle to access hospital treatment for infants with possible serious bacterial infections (PSBI) due to financial and logistical issues; thus, WHO guidelines introduced simpler outpatient antibiotic treatments in 2015.* -
  • A study conducted on 192 PSBI cases at 19 health centers revealed that a significant percentage (83.3%) found hospital referrals unfeasible, yet caregivers showed high acceptance for the simplified antibiotic treatment guidelines.* -
  • While 80% of infants with severe infections returned for follow-up treatments, challenges such as previous negative experiences with local hospitals and economic barriers highlighted the need for ongoing support in managing PSBI cases outside of hospital settings.*
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