BMC Pediatr
The INCLEN Trust International, New Delhi, 110020, India.
Published: November 2021
Background: Information on exact causes of death and stillbirth are limited in low and middle income countries. Minimally invasive tissue sampling (MITS) is increasingly practiced in place of autopsy across several settings. A formative research documented the experiences of counselling and consenting for MITS in north India.
Methods: This exploratory qualitative study was conducted at a tertiary care hospital in Delhi. During the early implementation of MITS, observations of the counselling and consenting process (n = 13) for under-five child death and stillbirths were conducted. In-depth interviews with MITS team members (n = 3) were also conducted. Observation and interview data were transcribed and inductively analysed using thematic content analysis to identify emerging themes and codes.
Results: The MITS team participated in daily ward rounds for familiarisation with parents/families. Following death declaration the counselling was done in counselling corner of the ward or adjacent corridor. Mostly the counselling was targeted at the father and family members present, using verbal explanation and the consent document in local language. The key concerns raised by parents/family were possible disfigurement, time needed and possible benefits. Most of the parents consulted family members before consent. Among those who consented, desire for next pregnancy, previous pregnancy or neonatal loss and participation of treating senior doctor were the key factors. The negative experience of hospital care, poor comprehension and distance from residence were the factors for consent refusal. Lesser number of parents of deceased children consented for MITS compared to the neonates and stillbirths.
Conclusions: The initial experiences of obtaining consent for MITS were encouraging. Consent for MITS may be improved with active involvement of the treating doctors and nurses, better bereavement support, private counselling area along with improvement in quality of care and communication during hospitalisation. Special efforts and refinement in counselling are needed to improve consent for MITS in older children.
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http://dx.doi.org/10.1186/s12887-021-02993-6 | DOI Listing |
J Pediatric Infect Dis Soc
December 2024
Bill & Melinda Gates Foundation, Seattle, WA, USA.
In low-to-middle income countries, acute lower respiratory infection (ALRI) remains the leading infectious cause of death among infants and children under 5 years old. Case-control studies based on upper respiratory sampling have informed current understandings of ALRI etiologies; in contrast, minimally-invasive tissue sampling (MITS) offers a method of directly interrogating lower respiratory tract pathogens to establish etiologic distributions. This study performed in the post-mortem setting used MITS and a Determination of Cause of Death (DeCoDe) panel to elucidate causes of fatal pneumonia in the community in Lusaka, Zambia.
View Article and Find Full Text PDFSci Rep
December 2024
Civil Engineering Department, Kampala International University, Kampala, Uganda.
The present research incorporates five AI methods to enhance and forecast the characteristics of building envelopes. In this study, Response Surface Methodology (RSM), Support Vector Machine (SVM), Gradient Boosting (GB), Artificial Neural Networks (ANN), and Random Forest (RF) machine learning method for optimization and predicting the mechanical properties of natural fiber addition incorporated with construction and demolition waste (CDW) as replacement of Fine Aggregate in Paver blocks. In this study, factors considered were cement content, natural fine aggregate, CDW, and coconut fibre, while the resulting measure was the machinal properties of the paver blocks.
View Article and Find Full Text PDFBackground: It is crucial to consider cultural, religious, and socio-behavioural factors that may influence the acceptability of Minimally Invasive Tissues Sampling (MITS). MITS is being used to understand the causes of child death and conducted in nine countries within Africa and South Asia with the highest child mortality. Progress has been made in the development of laboratory infrastructures and training for physicians to do MITS, but many communities are concerned about the religious acceptability of taking samples from deceased children.
View Article and Find Full Text PDFBMC Health Serv Res
December 2023
Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Background: Minimally invasive tissue sampling (MITS) has increasingly been used to improve the diagnosis of disease and identification of the cause of death, particularly in underserved areas. However, there are multiple barriers to accessing those who die within the community, our study aimed to explore the perceptions and insights of community members and healthcare providers regarding the feasibility of implementing MITS in community settings.
Methods: A qualitative exploratory study was conducted.
PLoS One
June 2023
Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
Background: In Mozambique, the Countrywide Mortality Surveillance for Action (COMSA) Program implemented a child mortality surveillance to strengthen vital events registration (pregnancies, births, and deaths) and investigate causes of death using verbal autopsies. In Quelimane district, in addition to the abovementioned cause of death determination approaches, minimally invasive tissue sampling (MITS) was performed on deceased children <5years of age. This study focused on understanding deceased children parents' and caretakers' experiences of the consent process to perform MITS in order to contribute to the improvement of approaches to cause of death investigation and inform efforts to maximize acceptability of mortality surveillance activities.
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