Monday, November 25, 2024

For low-risk pregnancies, planned home births just as safe as birth center births, study shows

Oregon State University

CORVALLIS, Ore. – In low-risk pregnancies, mothers and children are just as safe with a planned home birth as they are with a planned birth center birth, a national study led by Oregon State University researchers has shown.

The findings, published in Medical Care, contradict doctors’ long-held concerns about home birth, including a recent opinion by the American College of Gynecologists and Obstetricians that describes hospitals and accredited birth centers as the safest places to have a baby. A birth center is a health care facility designed to provide a more natural and home-like environment than a hospital.

OSU scientists analyzed two national registries for community births – planned birth either at home or in a birth center for low-risk pregnancies – in the largest study to examine how the settings compared to each other in terms of health outcomes.

A low-risk pregnancy is defined as a single baby being carried to full term (at least 37 weeks) and positioned with its head down, with no major maternal complications such as diabetes or pre-eclampsia. At least 70% of pregnancies are low risk, said Marit Bovbjerg, an associate professor in the Oregon State College of Health.

Combined, the two registries documented more than 110,000 births from 2012 to 2019, representing all 50 U.S. states, and the data showed no safety difference between home birth and birth center birth.

“Historically, physicians in the U.S. have objected to planned home births but not planned birth center births, even though from both settings you would need to transfer the birthing person to a hospital for any major complications,” Bovbjerg said. “Until now, we’ve had no evidence about home versus birth center outcomes. Our study is the first to provide evidence that these two birth settings are equally safe.”

Bovbjerg and Melissa Cheyney, a professor in the OSU College of Liberal Arts and a licensed midwife, did not directly compare the safety of community settings to hospitals but they note that the bulk of evidence globally, including a U.S. National Academies of Science, Engineering and Medicine report published in 2020, supports the idea that planned community birth is a safe alternative to hospital birth.

“That means that within the U.S., we already had evidence that birth centers were comparable to hospitals for low-risk births,” said Bovbjerg, who with Cheyney co-directs Oregon State’s Uplift Lab. “Our study compared home to birth center and suggests that both community settings are a reasonable choice for low-risk birthing people.”

The scientists note that the rate of home birth in the United States has been increasing over the last two decades, and that 2% of births in the U.S. happen in one of the two types of community settings, which have similar attendants and interventions available but different practice standards, regulatory guidelines and levels of health systems integration.

They added that planned home birth resulted in a lower rate of transfer to hospital than planned birth center birth for reasons that could relate to concern over negative hospital experiences.

“They might fear a loss of continuity of care provider, as well as possible mistreatment and judgment upon arrival at the hospital,” Cheyney said, citing a national care-experience study in which many participants reported mistreatment, including being ignored, scolded, shouted at or subject to an invasive procedure without consent.

“That was especially true for Black and Indigenous people who transferred to a hospital from a planned home birth,” she said. “If previous hostile transfer experiences contribute to a reluctance to transfer, we obviously need to work together to improve the transfer experience. Transfer from community settings is often necessary, and anything that discourages a necessary transfer likely causes harm.”

The collaboration also included researchers from the American Association of Birth Centers, Georgia State University, Frontier Nursing University, the University of Denver and the University of British Columbia.

Journal

Medical Care

DOI

10.1097/MLR.0000000000002074

Method of Research

Data/statistical analysis

Subject of Research

People

Article Publication Date

14-Nov-2024

Edible bird's nest-infused beverage: A new weapon in the fight against hypertension

Zhejiang University

A recent study highlights the health benefits of a cocoa-flavored, soy-based powder drink mix enriched with hydrolysates from edible bird's nests. This innovative functional beverage shows promise in managing hypertension and inflammation, along with improving glycemic control and prolonging satiety. The study focuses on the drink's angiotensin-converting enzyme (ACE) inhibition and red blood cell membrane stabilization effects, suggesting a fresh approach to dietary management of chronic health issues.

As consumer demand for functional foods rises, powdered drink mixes (PDMs) have gained popularity due to their convenience and health benefits. This shift reflects an increasing preference for plant-based or specialty beverages addressing dietary concerns like lactose intolerance and calorie control. Low-glycemic foods are especially valued for managing blood glucose levels and enhancing satiety, making them beneficial for diabetes care and weight management. Given these demands, there is a growing need for research to create new health-promoting PDMs that meet evolving dietary needs.

This study (DOI: 10.1093/fqsafe/fyae044) was conducted by a research team from Universiti Kebangsaan Malaysia and was published in the Journal of Food Quality and Safety on October 3, 2024. Researchers investigated the effects of edible bird’s nest hydrolysates (EBNH) in a cocoa-flavored soy PDM, designed to maximize health benefits. Key results showed enhanced angiotensin-converting enzyme (ACE) inhibitory activity and red blood cell membrane stabilization, both of which are linked to antihypertensive and anti-inflammatory effects. The drink’s formulation also features a low glycemic index and prolonged satiety, making it particularly effective for managing blood sugar levels and appetite.

The research team developed a novel soy-based PDM fortified with EBNH, known for its bioactive properties. Tests showed that the drink effectively inhibits ACE activity, suggesting antihypertensive potential by blocking compounds that raise blood pressure. In human trials, the drink demonstrated a low glycemic index, helping to keep postprandial blood glucose levels stable. Participants reported feeling full for up to 2.5 hours after consuming the drink, attributed to its high protein and fiber content. With 3% EBNH, the formulation delivers notable antioxidant effects that help stabilize red blood cells and reduce inflammation, key for managing hypertension and diabetes. Additionally, this low-calorie, high-fiber PDM offers a valuable dietary choice for those with specific health needs or dietary restrictions, underscoring EBNH’s potential in developing functional foods for chronic health management.

Dr. Zalifah Mohd Kasim, lead researcher and senior lecturer at Universiti Kebangsaan Malaysia, commented on the impact of the findings: “The incorporation of EBNH into powdered drink mixes offers a novel way to enhance everyday nutrition with bioactive benefits. This fortified drink mix could serve as an effective dietary option for individuals managing hypertension and diabetes, or anyone looking for sustained energy and satiety. Our findings support the increasing interest in functional foods that address hunger while promoting better health outcomes.”

The enriched cocoa-flavored soy drink holds promise as a dietary supplement for individuals looking for functional foods to support blood pressure, blood sugar, and appetite control. Its high protein, low-calorie, and low glycemic profile aligns well with dietary recommendations for diabetes care and weight management. As consumer demand for therapeutic, plant-based foods grows, this product provides a convenient, health-focused option.

###

References

DOI

10.1093/fqsafe/fyae044

Original Source URL

https://doi.org/10.1093/fqsafe/fyae044

Funding information

The authors would like to thank Universiti Kebangsaan Malaysia (UKM) for providing financial support through the research project grants GUP-2018-059.

About Food Quality and Safety

Food Quality and Safety (FQS) is an open access, international, peer-reviewed journal providing a platform to highlight emerging and innovative science and technology in the agro-food field, publishing up-to-date research in the areas of food quality, food safety, food nutrition and human health. It is covered by SCI-E and the 2023 Impact Factor (IF)=3.0, 5-yr IF=4.7.

Journal

Food Quality and Safety

DOI

10.1093/fqsafe/fyae044

Subject of Research

Not applicable

Article Title

Anti-hypertensive, anti-inflammatory, glycemic and satiety impact of cocoa flavoured soy-based powder drink mix enriched with bioactive hydrolysates from nests of Aerodramus fuciphagus

New clinical study confirms the anti-obesity effects of kimchi

Regular consumption reduces body fat and boosts gut health

National Research Council of Science & Technology

image:
Diagrammatic representation of the results of the clinical trial on the anti-obesity effects of kimchi
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Credit: World Institute of Kimchi (WiKim)

Approximately 16% of the global population, or about 890 million people, suffer from obesity. The World Health Organization (WHO) has recognized obesity as a significant health issue and highlighted its impact on the quality of life and overall health of individuals across the world. In response to this, the World Institute of Kimchi, South Korea, has been publishing a series of articles on the anti-obesity effects of kimchi in international journals. These articles, based on research studies on the subject, indicate that the regular consumption of kimchi, a traditional Korean fermented food, is effective in reducing body fat and may serve as a promising dietary strategy to combat obesity.

Recent investigations exploring the effects of kimchi on obesity have yielded compelling evidence supporting its efficacy. Notably, preclinical experiments in animal models of obesity revealed a substantial 31.8% reduction in body fat among those fed a kimchi diet1).

Additionally, an extensive analysis of data collected over 13 years from the Korea Genome and Epidemiology Study (KoGES), a large population-based study, found that appropriate kimchi intake is associated with a 15% reduction in body mass index (BMI) and a 12% decrease in obesity incidence among middle-aged males2). This study was published in Food & Function2), BMJ Open3) (a British medical journal published by a subsidiary of the British Medical Association) and was also reported in the U.S based NBC News4).
1) (Article) Kimchi Intake Alleviates Obesity-Induced Neuroinflammation by Modulating the Gut-Brain Axis (Food Res Int., IF 7.425) DOI: https://doi.org/10.1016/j.foodres.2022.111533
2) (Article) Effect of Kimchi Intake on Body Weight of General Community Dwellers: a Prospective Cohort Study (Food & Function, IF 6.317), DOI: https://doi.org/10.1039/D2FO03900A
3) (Article) Association between kimchi consumption and obesity by BMI and abdominal obesity in Korean adults a cross-sectional analysis of the Health Examinees study (BMJ open, IF 2.9), DOI: https://doi.org/10.1136/bmjopen-2023-076650
4) (News article) https://www.nbcnews.com/news/asian-america/kimchi-lower-obesity-risk-midriff-bulge-korean-classic-rcna136445

Continuing this line of inquiry, a research study conducted by a team led by Dr. Sung-Wook Hong from the Kimchi Functionality Research Group at the World Institute of Kimchi, in collaboration with the Pusan National University Hospital, South Korea, focused on the anti-obesity effects of kimchi and its impact on gut microbiomes. This study investigated the changes in anthropometric measurements, blood biomarkers, and gut microbiomes of 55 overweight adults, comprising both males and females, with a BMI ranging from 23 to 30 kg/m². The participants consumed 3 kimchi capsules per meal (60g of kimchi per day) for 3 months. The kimchi capsules contained kimchi powder produced by freeze-drying cabbage kimchi fermented at 4℃ for 2 weeks. The research team analyzed the changes in the body fat composition of the participants and found that the group that consumed kimchi showed a 2.6% decrease in body fat, but the control group that did not take the kimchi capsules exhibited a 4.7% increase in body fat, showing a statistically significant difference between the two groups.

Further, the analysis of the microbiomes of the participants revealed that kimchi consumption resulted in an increase in the abundance of the beneficial gut bacterium, Akkermansia muciniphila*, and a reduction in the number of Proteobacteria, which are associated with obesity.
※ Akkermansia muciniphila: This is a species of gut bacterium that has been reported to reduce inflammation and improve the markers of metabolic syndrome and obesity through the production of short-chain fatty acids (SCFAs).

The successful completion of this clinical trial on the body fat-reducing effects of kimchi indicates that a steady consumption of kimchi is effective in alleviating obesity symptoms through the modulation of the gut microbiota.

Dr. Hae-Choon Chang, Director of the World Institute of Kimchi, said, “The results of a preclinical study and a clinical trial have systematically verified the anti-obesity effects of kimchi, and present scientific evidence that would help to make the excellent properties of kimchi widely known, thereby laying the foundation for the growth of kimchi as a health food well recognized around the world.” She also said, “We will continue to devote our time, effort, and resources towards scientific research to reinforce the health-functional properties of kimchi, in improving gastrointestinal health in addition to its immune-enhancing and anti-cancer effects, thus firmly establishing the role of kimchi as a global health food.”

The clinical trial on the anti-obesity effects of kimchi was published in the October 2024 issue of the ‘Journal of Functional Foods.’

Meanwhile, in Korea, the country where kimchi originated, November 22 was officially designated as a national commemorative day for kimchi and named Kimchi Day in 2020. Kimchi is the first Korean food to be recognized in this manner for its unique health properties. Since then, Kimchi Festivals have been celebrated on Kimchi Day in the U.S., U.K., Argentina, and Brazil on November 22.

Kimchi, a traditional fermented Korean food

Credit

World Institute of Kimchi (WiKim)

Front View of the World Institute of Kimchi

Journal

Journal of Functional Foods

DOI

10.1016/j.jff.2024.106401

Article Title

Effects of kimchi consumption on body fat and intestinal microbiota in overweight participants: A randomized, double-blind, placebo-controlled, single-center clinical trial

How can brands address growing consumer scepticism?

Transparency and effective communication are critical for brands to gain and keep consumer trust according to new research.

University of Adelaide

Transparency and effective communication are critical for brands to gain and keep consumer trust according to new research.

The University of Adelaide’s Dr Kate Sansome, from the Adelaide Business School has led a study which suggests that consumers want brands to be transparent about topics that impact them.

“As sociopolitical issues become topical in the news and social media, brands are expected to be transparent about them; for example, as consumers face cost-of-living pressures, they will expect brands to be transparent about this issue,” says Dr Sansome, who conducted the study with the Professor Jodie Conduit and Dr Dean Wilkie from the Adelaide Business School.

“Our research shows that it’s not just about brands sharing extensive information, but about being open, clear, timely, and providing well-explained, evidence-based information. Open dialogue and answering consumers’ questions are important for transparency, even on sensitive or negative issues, particularly for brands in industries with a negative reputation.”

Dr Sansome says that being transparent means communicating in a simple and easy-to-understand manner, being upfront before external pressure, and backing up claims with statistics, facts, and visual evidence. The study suggests that brands that use tools like infographics or storytelling to explain their decisions give consumers a better understanding of their intentions and reasons behind their actions.

“Consumers are becoming more uncertain of brand communication due to misinformation, deep fakes, misleading claims, and perceived hypocrisy,” Dr Sansome says.

“Scepticism is growing, where a majority of young people believe a brand is hiding something if it avoids certain topics.

“Consumers’ perceptions of certain brands or product categories can influence how they interpret brand transparency. Our research shows that in stigmatised industries like mining or fast fashion, consumer scepticism can make it difficult for people to recognise a brand's efforts to be transparent, regardless of its intentions.”

Dr Sansome says her study highlights a need for brands to improve how they communicate transparency to consumers in order for them to make informed decisions.

The study provides a deeper insight than traditional research, which mainly views transparency through a managerial or governance lens and focuses on information to meet regulatory requirements or supply chain or pricing information. Unlike these approaches, Dr Sansome’s research accounts for the subjectivity in how consumers evaluate brand communication and the topics of relevance to consumers.

“For brands and businesses, these findings provide insight into consumers' need for brands to be transparent on topics beyond pricing and supply chain information and presented in a way that meets their expectations,” Dr Sansome explains.

“Providing exhaustive information in PDF form on a website is insufficient. Transparency is a continuous, evolving dialogue with consumers, with clear, timely, evidence-based and explanatory communication.”

Dr Sansome says further research is needed to explore strategies enabling brands to share their sustainability progress transparently without compromising brand equity or facing significant reputational risks.

“With the rise of regulations targeting ‘greenwashing,’ brands increasingly practise ‘greenhushing,’ opting for silence rather than risking scrutiny or backlash,” Dr Sansome says. “As consumers become more discerning, brands must prepare for scrutiny and scepticism and challenges particularly for brands in stigmatised industries in communicating progress towards sustainability.”

The study was published in European Journal of Marketing and was conducted through qualitative interviews with experts, such as brand managers, government officials, third-party accreditors, and in-depth consumer interviews.

Journal

European Journal of Marketing

DOI

10.1108/EJM-12-2022-0885

Method of Research

Survey

Subject of Research

People

Article Title

Consumerbased conceptualisation of brand transparency: scope, characteristics and contextual determinants

Perovskite research boosts solar cell efficiency and product life

University of Surrey

image:
Image of Perovskite cell
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Credit: University of Surrey

Perovskite research boosts solar cell efficiency and product life

An international team led by the University of Surrey with Imperial College London have identified a strategy to improve both the performance and stability for solar cells made out of the 'miracle material' perovskite by mitigating a previously hidden degradation pathway.

In a new study published in Energy and Environmental Science, Surrey's Advanced Technology Institute (ATI) details how they, together with their collaborators, were able to produce lead-tin perovskite solar cells that reach more than 23% power conversion efficiency (PCE) – one of the best results achieved with this material and importantly, a design strategy which improves the lifetime of these devices by 66%. PCE refers to the amount of sunlight a cell can convert to usable electricity.

While silicon solar panels are used on many rooftops today, perovskite/silicon solar panels are emerging on the market, with fully “all-perovskite” panels with even higher efficiencies being anticipated to be the next big step with the technology. However, for this technology to be commercially viable, scientists need to tackle the challenge of improving both the stability and efficiency, especially around the lead-tin perovskite cell used in this design. This collaborative study initiated by the University of Surrey identifies previously hidden mechanisms that contribute to both efficiency and stability losses and addresses these challenges, helping the scientific community to advance this technology.

Hashini Perera, Ph.D. student and lead author of the study from the Advanced Technology Institute at the University of Surrey, said:

"The understanding we have developed from this work has allowed us to identify a strategy that improves the efficiency and extends the operational lifetime of these devices when exposed to ambient conditions. This advancement is a major step towards high efficiency, long-lasting solar panels which will give more people access to affordable clean energy while reducing the reliance on fossil fuels and global carbon emissions.”

To achieve these improvements, the research team focused on understanding the efficiency and stability losses induced by the hole transport layer which plays an important role in the solar cell performance. They introduced an iodine-reducing agent to inhibit the chemical reactions that cause the cells to degrade over time. This approach not only increased the efficiency of the lead-tin solar cells but also extended their lifespan, making them more practical and cost-effective for long-term use.

Dr Imalka Jayawardena, co-author of the study from Advanced Technology Institute at the University of Surrey, said:

"By significantly enhancing the efficiency of our perovskite-based solar cells, we are moving closer to producing cheaper and more sustainable solar panels. We are already working on refining these materials, processes and the device architecture to tackle the remaining challenges.

Professor Ravi Silva, Director of the Advanced Technology Institute at the University of Surrey, said:

“This research brings us closer to panels that not only generate more power over their lifetime but are also longer lasting. Greater efficiency and fewer replacements mean more green energy with less waste. The University of Surrey are in the process of building a 12.5MW solar farm, where we can test some of these modules. We’re confident that our innovative perovskite research will accelerate the widespread commercial adoption of perovskite-based solar panels.”

This research helps promote the UN Sustainable Development Goals 7 (affordable and clean energy), 9 (industry, innovation and infrastructure) and 13 (climate action).

[ENDS]

Ravi Silva, Imalka Jayawardena and W Hashini K Perera are available for interview, please contact mediarelations@surrey.ac.uk to arrange.

The full paper is available in Energy and Environmental Science

Images of the perovskite cells are attached

Journal

Energy & Environmental Science

DOI

10.1039/D4EE03001J

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

23.2% efficient low band gap perovskite solar cells with cyanogen management

University of Limerick, Ireland researchers develop new method of generating eco-friendly energy

Researchers at University of Limerick in Ireland have developed a new method of growing organic crystals that can be used for energy-harvesting applications.

University of Limerick

UL researchers develop new method of generating eco-friendly energy — image:
*PhD student Tara Ryan, Associate Professor Sarah Guerin, PhD student Krishna Hari and Dr Suman Bhattacharya pictured in the Bernal Institute at University of Limerick*
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Credit: University of Limerick

University of Limerick, Ireland researchers develop new method of generating eco-friendly energy

Press release (19/11/24)

***REPRO free image attached

Researchers at University of Limerick in Ireland have developed a new method of growing organic crystals that can be used for energy-harvesting applications.

The energy that is being harvested as part of this research is being generated by squeezing amino acid molecules, the building blocks of proteins that exist in the human body.

Piezoelectricity, which translates from Greek to mean pressing electricity, usually found in ceramics or polymers, is also present in human biomolecules.

The research team from the Actuate Lab in the Department of Chemical Sciences and Bernal Institute at UL, have previously utilised predictive computer models that allow them to identify how much electricity a biological material will generate when you squeeze it – making this material suitable to power sensors in consumer electronics and medical devices.

This latest breakthrough, published in the journal Physical Review Letters, will allow the researchers to shape the crystals they make using silicon moulds into discs or any custom shape required depending on the application, for example, a medical device element versus a phone microphone or car sensor.

Tapping these discs and plates generates useful voltage that if amplified could be used to charge electronic devices using everyday forces.

Discussing the significance of the development, lead author of the paper and PhD student at UL Krishna Hari explained: “The versatile moulding technique that we have developed is a low-cost, low-temperature growth method that opens the path to phase in biomolecular piezoelectrics as high-performance, eco-friendly alternatives to currently used ceramics.”

The research project Pb-FREE: Piezoelectric Biomolecules for Lead-Free, Reliable, Eco-Friendly Electronics is being funded by a European Research Council (ERC) starting grant awarded to Associate Professor Sarah Guerin.

The UL lecturer and researcher, who was named Research Ireland (SFI) Early Career Researcher of the Year in 2023, said she was optimistic about what this latest development could mean for solid-state chemistry.

“We hope it will be a gamechanger for the whole field because there are many scientists trying to grow biological crystals that are still behaving in a chaotic way. I am excited to see if this takes off as a methodology for other people working in sustainable piezoelectrics,” explained Associate Professor Guerin.

If successful, the research undertaken by the team at UL also has the potential to remove environmentally damaging materials such as lead from consumer electronics.

“There are EU regulations around the use of lead, but piezoelectrics are one of the last remaining mainstream technologies allowed to contain this substance because there is no high-performance alternative,” Associate Professor Guerin explained.

“There are about 4,000 tons of lead-based electronic waste generated from these sensors every year, and this research has the potential to remove this waste from the manufacturing process.”

ENDS

The study, ‘Molded, Solid-State Biomolecular Assemblies with Programmable Electromechanical Properties’, by Krishna Hari, Tara Ryan, Suman Bhattacharya, and Sarah Guerin, has been published in the journal Physical Review of Letters.

Caption for image: PhD student Tara Ryan, Associate Professor Sarah Guerin, PhD student Krishna Hari and Dr Suman Bhattacharya pictured in the Bernal Institute at University of Limerick

For further information, please contact:

Alan Owens

Communications Manager

University of Limerick

alan.owens@ul.ie

About University of Limerick:

University of Limerick is a research-led, independent, internationally focused university with almost 18,000 students and 2,000 staff. It is a young, energetic and enterprising University with a proud record of innovation in education and excellence in research and scholarship.

More information is available at www.ul.ie.

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Journal

Physical Review Letters

DOI

10.1103/PhysRevLett.133.137001

Method of Research

Imaging analysis

Subject of Research

Not applicable

Article Title

Molded, Solid-State Biomolecular Assemblies with Programmable Electromechanical Properties

Meningitis has a much greater impact on child mortality than previously thought

New study by the CHAMPS network reveals high rates of antibiotic-resistant bacteria in hospital-associated cases of meningitis in children under five years of age

Barcelona Institute for Global Health (ISGlobal)

Meningitis contributes to higher child mortality rates than estimated by the WHO, according to a new study by the CHAMPS network and led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by “la Caixa” Foundation. The study, published in Journal of Infection, reveals a high prevalence of drug-resistant bacteria in hospital cases, highlighting the need for earlier suspicion and faster diagnosis and appropriate treatment to reduce mortality.

Meningitis remains a serious condition, especially for young children, with high death rates and lasting neurological effects in survivors. Vaccines can protect against the most common types of meningitis-causing bacteria, such as Haemophilus influenzae type B (Hib), Streptococcus pneumoniae, and Neisseria meningitidis. Yet, reaching the World Health Organization’s (WHO) goal to eliminate meningitis by 2030 requires a clearer understanding of the global impact of this disease and the specific pathogens involved.

“Meningitis poses a diagnostic challenge due to its non-specific symptoms, which often resemble those of other serious illnesses,” explains senior author Quique Bassat, ICREA researcher and General Director at ISGlobal. “Identifying the specific pathogens behind meningitis cases would allow us to make a better use of resources and guide the development of new highly-awaited vaccines,” he adds.

The study draws on data from the CHAMPS network, which is conducting an in-depth investigation into causes of childhood deaths in seven countries: Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa. Using a technique called MITS (minimally invasive tissue sampling), researchers perform biopsies to obtain samples of key organs or fluids, including cerebrospinal fluid, followed by histopathological examination, molecular testing for 126 pathogens, and microbiological cultures.

A significant contributor to death

The study found that meningitis was a contributing factor in 7% of the 3,857 deaths analysed. The highest proportions of child deaths due to meningitis were observed in South Africa (16.6%) and Ethiopia (15.6%), followed by Mali and Sierra Leone. Most of these deaths (66%) occurred in newborns, with the remaining cases diagnosed in older infants and young children. “The higher incidence among newborns may be due to the vertical transmission of pathogens infecting their mothers, and the lack of specific strategies to protect them during delivery. Additionally, their underdeveloped immune systems also confer a higher vulnerability,” says Sara Ajanovic, ISGlobal researcher and co-author of the study.

A shift towards antibiotic-resistant bacteria

The prevalence of pathogens associated with meningitis deaths in the hospital and in the community varied between regions. However, the most common pathogens were Acinetobacter baumannii and Klebsiella pneumoniae, particularly in deaths occurring in healthcare settings. These multi-drug resistant bacteria are often acquired in the hospital, which means that improving infection prevention practices in hospitals is essential for reducing meningitis cases. Worryingly, it also means that without the appropriate antibiotics, the risk of dying from meningitis remains high.

Almost half of meningitis deaths occurred at the community, likely due to limited access to healthcare. While vaccines have significantly reduced cases of Streptococcus pneumoniae, this bacterium still caused many of the community-acquired cases of meningitis.

These findings indicate a shift in the landscape of pathogens associated with meningitis, with an increase of pathogens like K. pneumoniae and A. baumannii, alongside a decline in S. pneumoniae and Hib due to vaccination efforts. This shift, the authors point out, “challenges the foundations of current empirical antibiotic guidelines.”

Implications for public health

CHAMPS' findings suggest that meningitis contributes to higher child mortality rates (7%) than the WHO’s estimate of 5.1%. Critically, many of these cases had not been recognized as meningitis before death, highlighting the need for faster diagnosis and treatment to prevent fatalities. “Less than a quarter of all confirmed meningitis cases had undergone a lumbar puncture -the gold standard technique for diagnosing meningitis - prior to death, highlighting the urgent need to deploy more actively this diagnostic approach to avoid missing cases of this life-threatening infection,” says Bassat.

"The changing landscape of the pathogens causing lethal meningitis in children in these settings underscores the positive effect of vaccine campaigns conducted in the last decades, which must be continued,” adds Ajanovic. However, the findings highlight an urgent need for developing new vaccines against emerging pathogens such as K. pneumoniae, and for updating clinical guidelines. This includes testing for these pathogens and their resistance patterns, as well as adjusting antibiotic regimens to ensure an effective treatment.

CHAMPS work recognised in Catalonia

On 26 October, the Catalan Society of Clinical Microbiology and Infectious Diseases awarded the Josep Barrio Infectious Diseases Prize to Quique Bassat for the best scientific paper published in 2023 by a member of the society. The paper was a study by the CHAMPS network showing that infectious diseases continue to cause most deaths in infants and children, often in conjunction with malnutrition.

Reference

Mahtab S, Madewell ZJ, Baillie V et al. Etiologies and Comorbidities of Meningitis Deaths in Chilren Under 5 Years in High-Mortality Settings: Insights from the CHAMPS Network in the Post-Pneumococcal Vaccine Era. J Infection. 10.1016/j.jinf.2024.106341

Journal

Journal of Infection

DOI

10.1016/j.jinf.2024.106341

Subject of Research

People

Article Title

Etiologies and Comorbidities of Meningitis Deaths in Chilren Under 5 Years in High-Mortality Settings: Insights from the CHAMPS Network in the Post-Pneumococcal Vaccine Era