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A Prospective Study of Causes of Illness and Death in Preterm Infants in Ethiopia: The SIP Study Protocol
Background
With nearly 15 million annual preterm births globally, preterm birth is the most common cause of neonatal death. Forty to 60 % of neonatal deaths are directly or indirectly associated with preterm mortality. As countries aim to meet the Sustainable Development Goals to reduce neonatal mortality, significant reductions in preterm mortality are needed. This study aims to identify the common causes of preterm illness and their contribution to preterm mortality in low-resource settings. This article will describe the methods used to undertake the study.
Methods
This is a prospective, multi-centre, descriptive clinical study. Socio-demographic, obstetric, and maternal factors, and clinical and laboratory findings will be documented. The major causes of preterm mortality will be identified using clinical, laboratory, imaging, and autopsy methods and use the national Ethiopian guidelines on management of preterm infants including required investigations to reach final diagnoses. The study will document the clinical and management protocols followed in these settings. The approach consists of clinical examinations and monitoring, laboratory investigations, and determination of primary and contributory causes of mortality through both clinical means and by post-mortem examinations. An independent panel of experts will validate the primary and contributory causes of mortality.
To obtain the estimated sample size of 5000 preterm births, the study will be undertaken in five hospitals in three regions of Ethiopia, which are geographically distributed across the country. All preterm infants who are either born or transferred to these hospitals will be eligible for the study. Three methods (last menstrual period, physical examination using the New Ballard Score, and ultrasound) will be used to determine gestational age.
All clinical procedures will be conducted per hospital protocol and informed consent will be taken from parents or caretakers prior to their participation in the study as well as for autopsy if the infant dies.
Discussion
This study will determine the major causes of death and illness among hospitalized preterm infants in a low-resource setting. The result will inform policy makers and implementers of areas that can be prioritized in order to contribute to a significant reduction in neonatal mortality
Additional file 1: of Establishment of reference intervals of thyroid function tests from cord blood of neonates in two selected hospitals, Addis Ababa, Ethiopia
TSH, fT4 and fT3 results of Study participants. (XLSX 15 kb
Hair Washing Formulations from Aloe elegans Todaro Gel: The Potential for Making Hair Shampoo
This study aimed to describe the gross phytochemical constituents of Aloe elegans Todaro gel and evaluate the characteristics and quality of lab-made hair washing formulations prepared from the gel to show its potential in formulating hair washing shampoos. A. elegans gel mass was prepared from mature, healthy leaves collected from natural stand. Samples of 100% methanol extract of the gel were subjected to standard phytochemical screening and gas chromatography-mass spectroscopy (GC-MS) analysis. Five hair washing formulations (Fs) were, likewise, prepared by mixing 4.0–10.0 mL of gel with one (0.05 mL) to two (0.10 mL) drops of six synthetic and natural ingredients, namely, coconut oil, jojoba oil, olive oil, pure glycerin oil, lemon juice, and vitamin E. The gel to the total ingredient ratios (v/v) of the five formulations were 93 : 7 (F1), 94.5 : 5.5 (F2), 96.4 : 3.6 (F3), and 96.6 : 3.4 (F4 and F5). The formulations were evaluated using sensory inspection and common physicochemical methods. The phytochemical screening and GC-MS analysis revealed that A. elegans gel is the source of important chemical constituents used in the formulation of shampoos and similar products including saponins, capric acid, lauric acid, myristic acid, palmitic acid, linoleic acid, stearic acid, and phytol. Lab-made A. elegans hair washing formulations, especially those with 96.4–96.6% gel, were found to have similar characteristics and qualities with a common marketed shampoo. All the formulations were turbid with characteristic odor as the marketed shampoo. The pH values of the hair washing formulations (6.4–4.6) were comparable to those of the marketed shampoo (6.7). Formulations with higher proportion of gel had better foam stability, higher solid content (26–29%), higher surface tension (33–38 dynes/cm), shorter wetting time (150–160 sec), equivalent viscosities (26.45–26.73 poise), and conditioning performance than the marketed shampoo. These findings demonstrate that A. elegans gel mass can be used in the formulation of good-quality hair washing shampoos. We recommend future studies that aim to develop the phytochemical profile of the plant and a refined protocol of hair washing shampoo formulation
Major causes of death in preterm infants in selected hospitals in Ethiopia (SIP): a prospective, cross-sectional, observational study
Neonatal deaths now account for 47% of all deaths in children younger than 5 years globally. More than a third of newborn deaths are due to preterm birth complications, which is the leading cause of death. Understanding the causes and factors contributing to neonatal deaths is needed to identify interventions that will reduce mortality. We aimed to establish the major causes of preterm mortality in preterm infants in the first 28 days of life in Ethiopia