- Book Chapter
- 10.1017/9781911623496.033
Perinatal Mental Health Service Development and Delivery
- Apr 30, 2026
- Roch Cantwell + 1 more +1
Publications from 2021 to 2026
Showing 10 of 201 papers
Perinatal Mental Health Service Development and Delivery
Maternal Suicide, Deliberate Self-Harm and Other Mental Health Related Causes of Maternal Death
Genomic profiling in low and intermediate-risk neuroblastoma to refine treatment stratification and improve patient outcome. LINES: a SIOPEN trial (was selected for Fire-session)
Goat milk-based formulas as part of healthy infant nutrition: Clinical efficacy and tolerability
Introduction . Breast milk is the “gold standard” for infant feeding; however, hypogalactia or other objective reasons make it impossible to continue on with breastfeeding. Forced transition of an infant to formula feeding often provokes the development of functional gastrointestinal (GI) disorders, which calls for finding products with maximum tolerability and digestibility. Aim . To compare the efficacy and tolerability of goat- and cow milk-based formulas. Materials and methods . A total of 44 infants switched to formula feeding were included in the study conducted at Lapino Clinical Hospital (Mother and Child). The children showed symptoms of minimal digestive dysfunction that developed due to weaning from breastfeeding, such as infant colic, functional constipation, regurgitation, decreased appetite, and sleep disturbances. The study compared tolerability and digestibility of formulas: 32 children (the treatment group) received a goat milk-based formula (Kabrita), while 12 children (the comparator group) received a standard formula containing cow milk. Anthropometric parameters, as well as changes in gastrointestinal symptoms and sleep status, were assessed. Results and discussion . In the treatment group, physiological weight gain was achieved in 96.8% of infants (versus 83.3% in the comparator group). The incidence of constipation with Kabrita formula was significantly lower (12.5% vs 41.6%), as were sleep disturbances (9.4% vs 33.3%). A more rapid relief of infant colic and regurgitation was reported. Conclusions . If the breastfeeding is impossible, goat milk-based formulas may be an effective alternative. Due to their specific protein composition (A2 milk), fat profile, and presence of oligosaccharides, similar to those found in breast milk, they contribute to optimization of digestion, elimination of functional gastrointestinal disorders, and improvement of infant sleep.
Read morePsychomotor development at 9 months of age in infants with perinatal asphyxia at the Mother and Child University Hospital of Libreville (Gabon) in 2023
Background: Perinatal asphyxia (PNA) is a common condition in neonatology. Objective of the study was to describe the short- and medium-term outcome of newborns presenting with PNA at the Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori (CHUME-FJE) in 2022. Methods: A prospective longitudinal and analytical study was conducted over a 16-month period. Newborns were included, regardless of gestational age, had presented with PNA. The statistical significance threshold was set at p<0.05. Results: 96/464 newborns hospitalized for PNA (20.7%). The sex ratio was 1.26. The mean resuscitation time was 9.1±7.1 min. Neurological complications accounted for 73.3% (n=63), with an AEI classified as Sarnat II (27.0%) and Sarnat III (22.2%). The mean hospital stay was 12.6 days. The overall death rate was 32.6%. During the course of the study, 50.0% of infants recovered to normal weight for their age at 9 months and a proportion of 7.7% presented with PML developmental delay and 11.5% with PCVM taking into account the corrected age for preterm newborns. Conclusion: APN remains a public health problem in sub-Saharan countries with high neonatal mortality and long-term neurodevelopmental sequelae. Prevention of this condition relies on better monitoring of pregnancy and delivery and a training program for healthcare personnel in newborn resuscitation in the delivery room.
Read moreStrengthening Neonatology in Ethiopia: From Survey Data to System Improvement
Introduction: Neonatal care in low-resource settings is hindered by shortages of trained staff, inadequate infrastructure, and limited equipment and medications that compromise the management of common neonatal conditions and reduce the quality of care. Our aim was to describe the collaborative efforts between the Italian Agency for Development Cooperation (AICS), the Union of European Neonatal and Perinatal Societies (UENPS), Doctors with Africa Collegio Universitario Aspiranti Medici Missionari (CUAMM), the Ethiopian Pediatrics Society (EPS), and the Ethiopian Federal Ministry of Health (FMoH) to assess resuscitation and respiratory care practices in Ethiopian neonatal intensive care unit (NICU)s, identify gaps, and guide targeted interventions. Methods: A 50-item survey was distributed to 48 Ethiopian NICUs. Based on the survey results, a national workshop in Addis Ababa and a neonatal resuscitation “Train the Trainers” course were scheduled. In parallel, funds were allocated to initiate renovations and equipment upgrade at two selected sites. Results: The survey showed that most units lacked essential resuscitation equipment. Noninvasive respiratory support mainly relied on homemade continuous positive airway pressure systems; mechanical ventilators were available in <40% of units. Caffeine was rarely used, and surfactant was unavailable. The national workshop led to a document shared with the FMoH outlining priorities for subsequent training and resource strengthening. Newly trained instructors conducted four local neonatal resuscitation courses, training 150 healthcare providers. Facility upgrades addressed water, power, medical gas systems, and refurbishment of deteriorated areas. Conclusions: The survey revealed major gaps in neonatal care in Ethiopia. Collaborative efforts by AICS, UENPS, CUAMM, EPS, and FMoH helped reinforce key infrastructures and promote delivery room and respiratory care.
Read moreSub-regional networking in neuro-oncology: Towards a West African collaborative platform.
Central nervous system tumors present significant diagnostic and therapeutic challenges, as WHO histomolecular prognostic criteria are not always optimal. Decision-making increasingly relies on multidisciplinary team meetings (MDTs), which require highly qualified specialists. We aimed to assess available human resources and propose a framework for subregional collaboration through a West African neuro-oncology MDT. A multicenter descriptive study was conducted via an online questionnaire from April 13 to June 15, 2025, involving 35 healthcare professionals from nine West African countries. Participants included 45.7% neurosurgeons, over 57% with <3 years' experience. Most managed <100 patients/year, and 90% performed <100 tumor excisions. Awake surgery and stereotactic biopsy were rare. Access to chemotherapy, pathology, immunohistochemistry, and molecular biology was reported by 83%, 80%, 51%, and 14% of respondents, respectively. Median turnaround time was about 3 weeks for histopathology and about 1 month for immunohistochemistry. Clinical trial access was available to 26%. Neurosurgeon density was <1 per million inhabitants, peaking in Senegal (1 per 700,000). Only 34% reported functional MDTs. Nearly all participants (95%) supported establishing a subregional network with regular online MDTs (monthly or bimonthly) and a specialized interuniversity degree. MDTs are essential in neuro-oncology, enabling individualized therapeutic planning. Given critical workforce shortages in West Africa, a subregional collaborative MDT network could optimize patient care, enhance resource sharing, and standardize management across the region.
Read moreHubungan Antara Ketajaman Visual dan Prestasi Belajar
Good vision is essential for students to be able to perform academically and achieve their educational goals. This paper is focused on how visual clarity affects learning improvement among ninth-grade students (14-16 years old) at an Islamic boarding school. The research focused on a quasi-experimental methodology involving a single group with a pre-test and post-test paradigm. Measuring learning achievement involves assessing standard academic test score differences pre-and post-intervention. These differences were then categorized into distinct ordinal classifications. Participants’ vision acuity was assessed using a Snellen chart and categorized into three different levels: good, moderate, and poor. Descriptive statistics were employed to analyze the data. From the study, it was concluded that visual acuity and learning achievement were unrelated (χ² = 6.34; df = 4; p = 0.1751). Descriptively, students with good visual acuity actually showed higher learning improvement compared to students with poor vision. Although the result is not statistically significant, the result shows that good vision should be in students for them to perform academically. For students to perform academically, it means supporting students with available resources. Affordable resources include routine vision test evaluation and the provision of glasses if needed.
Read moreInstitutional Practices Drive Antibiotic Variability in Neonatal Intensive Care Units: Baseline Evidence to Inform National Stewardship Interventions in Oman
Background: Antibiotic overuse in Neonatal Intensive Care Units (NICUs) is a major contributor to antimicrobial resistance and adverse neonatal outcomes. This study aims to evaluate baseline antibiotic utilization (AU), identify factors influencing variability, and assess the impact of neonatal characteristics and sepsis incidence. Methods: A multicenter retrospective analysis examined AU in seven NICUs from 2019 to 2023, involving 25,532 neonatal admissions during national antibiotic stewardship program implementation. Data encompassed neonatal clinical parameters, sepsis incidence, and AU metrics, including days of therapy (DOT) per 1000 patient-days. Statistical analyses included correlation assessments and multivariate regression to identify determinants of antibiotic use. Results: Overall, 43.8% of neonates received antimicrobials, with individual NICUs ranging from 24% to 73% (p < 0.001). Antimicrobial-exposed neonates had a mean gestational age of 35.1 weeks [SD ± 4.4] and a mean birth weight of 2360 g [SD ± 970]. Antimicrobial-exposed neonates were generally more premature [35.1 (±4.4) weeks vs. 37.5 (±2.5) weeks (p < 0.001)] and had lower mean birth weight [2360 g (±971) vs. 2817 g (±686) (p < 0.001)] compared to those not exposed to antimicrobials. Total antimicrobial days varied markedly (8761 to 37,683 days), with DOT per 1000 patient-days ranging from 322 to 1031. Antimicrobial use for culture-negative sepsis varied widely among centers, from 23% to 73%. Antimicrobial-exposed neonates had higher all-cause mortality compared to those who did not [(7.5% vs. 3.2%), (p < 0.001)]. Multivariate analysis revealed individual NICU practice patterns remained significant predictors after adjusting for neonatal characteristics. Conclusions: Neonatal antimicrobial use varied significantly among NICUs, driven primarily by institutional practices rather than neonatal demographics. These findings provide nationally representative baseline data to inform neonatal antimicrobial stewardship interventions and offer transferable lessons for other countries seeking to optimize antibiotic use in NICUs amid rising global antimicrobial resistance.
Read moreEpidemioclinical Aspect of Otorhinolaryngology Pathologies in Children Aged 0 to 15 Years at the Mother-child University Hospital of N&apos;Djamena
Introduction: ENT pathologies are all diseases in the ENT sphere, in developing countries, such as Chad, due to poverty and promiscuity; ENT diseases therefore remain a real public health problem. The aim of this work was to identify the epidemio-clinical aspects of ENT diseases in children and to analyse primary prevention measures. Method and material: this is a prospective descriptive study carried out in the ENT-HNS department of the mother and children hospital of N&apos;Djamena (Tchad) from January 1, 2024 to June 30, 2024. All patients received in ENT consultations aged 0 to 15 years were included. Results: We were able to collect 328 cases dominated by boys, 181 cases (55.2%) against 147 girls (44.8%) with a sex ratio of 1.23 in favor of boys. Children under 5 years of age were the most represented, 195 cases or 59.5%; 215 cases or 65.5% were up to date with vaccination against 113 cases or 34.5% not up to date with vaccination. The oral-pharyngo-laryngeal region was affected in 44.2% followed by the nasosinusal, cervical and atrial regions which respectively accounted for 20.2%; 18,7%; and 17.1%. Odynophagia was the most common reason for consultation, with 96 cases (29.3%); The most common condition was tonsillitis, which accounted for 95 cases (29.0%). Infections and/or inflammations accounted for 280 cases, or 85.4%. Conclusion: ENT pathologies in children are frequent in consultations, they are dominated by infections and or inflammation. Simple preventive measures could help reduce their incidence, in particular rigorous monitoring of the vaccination schedule and raising awareness among parents and other public actors of the population on the rules of children&apos;s lifestyle.
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