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What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome?
Over 25 years ago, the World Health Organization (WHO) acknowledged the importance of effective prevention, detection and treatment of neonatal hypoglycaemia, and declared it to be a global priority. Neonatal hypoglycaemia is common, linked to poor neurosensory outcomes and, if untreated, can cause...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233914/ https://www.ncbi.nlm.nih.gov/pubmed/37259172 http://dx.doi.org/10.1186/s40748-023-00162-4 |
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author | Irvine, Lauren M Harris, Deborah L |
author_facet | Irvine, Lauren M Harris, Deborah L |
author_sort | Irvine, Lauren M |
collection | PubMed |
description | Over 25 years ago, the World Health Organization (WHO) acknowledged the importance of effective prevention, detection and treatment of neonatal hypoglycaemia, and declared it to be a global priority. Neonatal hypoglycaemia is common, linked to poor neurosensory outcomes and, if untreated, can cause seizures and death. Neonatal mortality in low and lower-middle income countries constitutes an estimated 89% of overall neonatal deaths. Factors contributing to high mortality rates include malnutrition, infectious diseases, poor maternal wellbeing and resource constraints on both equipment and staff, leading to delayed diagnosis and treatment. The incidence of neonatal hypoglycaemia in low and lower-middle income countries remains unclear, as data are not collected. Data from high-resource settings shows that half of all at-risk babies will develop hypoglycaemia, using accepted clinical thresholds for treatment. Most at-risk babies are screened and treated, with treatment aiming to increase blood glucose concentration and, therefore, available cerebral fuel. The introduction of buccal dextrose gel as a first-line treatment for neonatal hypoglycaemia has changed the care of millions of babies and families in high-resource settings. Dextrose gel has now also been shown to prevent neonatal hypoglycaemia. In low and lower-middle income countries, there are considerable barriers to resources which prevent access to reliable blood glucose screening, diagnosis, and treatment, leading to inequitable health outcomes when compared with developed countries. Babies born in low-resource settings do not have access to basic health care and are more likely to suffer from unrecognised neonatal hypoglycaemia, which contributes to the burden of neurosensory delay and death. |
format | Online Article Text |
id | pubmed-10233914 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102339142023-06-02 What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? Irvine, Lauren M Harris, Deborah L Matern Health Neonatol Perinatol Review Over 25 years ago, the World Health Organization (WHO) acknowledged the importance of effective prevention, detection and treatment of neonatal hypoglycaemia, and declared it to be a global priority. Neonatal hypoglycaemia is common, linked to poor neurosensory outcomes and, if untreated, can cause seizures and death. Neonatal mortality in low and lower-middle income countries constitutes an estimated 89% of overall neonatal deaths. Factors contributing to high mortality rates include malnutrition, infectious diseases, poor maternal wellbeing and resource constraints on both equipment and staff, leading to delayed diagnosis and treatment. The incidence of neonatal hypoglycaemia in low and lower-middle income countries remains unclear, as data are not collected. Data from high-resource settings shows that half of all at-risk babies will develop hypoglycaemia, using accepted clinical thresholds for treatment. Most at-risk babies are screened and treated, with treatment aiming to increase blood glucose concentration and, therefore, available cerebral fuel. The introduction of buccal dextrose gel as a first-line treatment for neonatal hypoglycaemia has changed the care of millions of babies and families in high-resource settings. Dextrose gel has now also been shown to prevent neonatal hypoglycaemia. In low and lower-middle income countries, there are considerable barriers to resources which prevent access to reliable blood glucose screening, diagnosis, and treatment, leading to inequitable health outcomes when compared with developed countries. Babies born in low-resource settings do not have access to basic health care and are more likely to suffer from unrecognised neonatal hypoglycaemia, which contributes to the burden of neurosensory delay and death. BioMed Central 2023-06-01 /pmc/articles/PMC10233914/ /pubmed/37259172 http://dx.doi.org/10.1186/s40748-023-00162-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Review Irvine, Lauren M Harris, Deborah L What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? |
title | What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? |
title_full | What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? |
title_fullStr | What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? |
title_full_unstemmed | What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? |
title_short | What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? |
title_sort | what are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome? |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233914/ https://www.ncbi.nlm.nih.gov/pubmed/37259172 http://dx.doi.org/10.1186/s40748-023-00162-4 |
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