Hospital-based birth defects surveillance in Kampala, Uganda

乌干达坎帕拉的医院出生缺陷监测

• 批准号: 9768286
• 负责人: Philippa Musoke
• 金额: $ 12.5万
• 依托单位: MU-JHU CARE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2021-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9768286
• 关键词: Hospital; based; birth; defects; surveillance

ABSTRACT Every year there are an estimated 7.9 million children born with a serious birth defect and 3.3 million of these are children under five years of age who die from factors related to their birth defect. Comprehensive, reliable data on birth defects are not available for most developing countries. In many resource-poor settings, the baseline prevalence of birth defects is not known and systematic monitoring for birth defects is difficult or non- existent. Antiretroviral treatment (ART) in pregnancy can maximally reduce the risk of vertical transmission of HIV, and therefore it is recommended that all pregnant women with HIV receive effective ART regimens to prevent the transmission of HIV to their infants. However, there have been concerns about the possibility of women on ART at conception or during the first trimester having an increased risk of delivering an infant with a birth defect. The goal of this proposal is to establish a birth defect hospital based surveillance program in Kampala, Uganda and to determine the prevalence of major external birth defects and association of maternal risk factors including antiretroviral therapy to these defects. Four hospitals in Kampala, Uganda will be included in the surveillance system with approximately 48,000 deliveries per year. Informative births (live and stillborn) regardless of gestational age that are born at the four hospitals will be included in the surveillance project for a duration of five years. Informative births are those in which the newborn is formed well enough to ascertain whether or not there is a birth defect. Each newborn will be examined as soon as possible after birth. Infant measurements (weight, head circumference and length) will be obtained and all newborns will be examined for major external birth defects by trained midwives. Newborns with major external birth defects will be photographed after obtaining consent and the photographs will be used to classify the diagnosis. As needed, the photos and verbatim descriptions will be sent to birth defect experts for confirmation of diagnoses and for coding of the birth defect using ICD-10 disease classification criteria. Demographic information, HIV status and obstetric information (parity status, previous live and still births, presence of physical defects of births of previous children) will be collected for all mothers. Every mother of an infant identified with a major external birth defect of interest will be asked to participate in a case-control study. Three controls will be selected for each case matched on hospital of delivery. After consenting, each mother will be asked to respond to questions regarding, types of medications taken during pregnancy including antiretroviral drugs and cotrimoxazole, medical history and more detailed demographic information. The surveillance program will provide crucial current data on the baseline prevalence of birth defects in Uganda while the case-control study will allow examination of the possible effects of antiretroviral treatment on infant outcomes while also screening for other common known causes of birth defects.

抽象的 每年估计有790万儿童出生有严重的先天缺陷，其中330万儿童 是五岁以下的儿童死于与先天缺陷有关的因素。全面，可靠 大多数发展中国家无法获得有关先天缺陷的数据。在许多资源贫乏的设置中 先天缺陷的基线患病率尚不清楚，对先天缺陷的系统监测很困难或非 - 存在。怀孕的抗逆转录病毒治疗（ART）可以最大程度地降低垂直传播的风险 艾滋病毒，因此建议所有患有艾滋病毒的孕妇接受有效的艺术方案 防止艾滋病毒向婴儿传播。但是，人们一直担心 妇女在受孕中或妊娠中期的妇女有增加婴儿的风险 先天缺陷。该提案的目的是建立基于先天缺陷的医院监视计划 在乌干达的坎帕拉，并确定主要外部出生缺陷的流行和关联 母体危险因素，包括抗逆转录病毒治疗的这些缺陷。乌干达坎帕拉的四家医院 每年约有48,000次交付的监视系统中。翔实的出生（Live） 不管在四家医院出生的胎龄如何，都将包括在监视中 项目持续了五年。信息丰富的出生是新生儿形成足够好的出生 确定是否存在先天缺陷。出生后将尽快检查每个新生儿。 将获得婴儿测量（重量，头围和长度），所有新生儿将是 检查了受过训练的助产士的主要外部出生缺陷。具有重大外部出生缺陷的新生儿将 在获得同意后拍照，并将照片用于对诊断进行分类。根据需要 照片和逐字描述将被发送到出生缺陷专家，以确认诊断和 使用ICD-10疾病分类标准编码出生缺陷。人口统计信息，艾滋病毒状况和 产科信息（均等状态，先前的生物和静物，出生的存在 儿童）将为所有母亲收集。婴儿的每个母亲都有主要的外部出生缺陷 有趣的是，将要求参加一项病例对照研究。每种情况将选择三个控件 在分娩医院匹配。同意后，将要求每个母亲回答有关， 怀孕期间服用的药物类型，包括抗逆转录病毒药物和共瑞唑唑，病史 以及更多详细的人口统计信息。监视计划将提供有关关键的当前数据 乌干达先生缺陷的基线患病率，而病例对照研究将允许检查可能 抗逆转录病毒治疗对婴儿结局的影响，同时还筛选其他常见的已知原因 出生缺陷。