Neosonics in developing countries

VALUE OF NEOSONICS IN DEVELOPING COUNTRIES

Bacterial Meningitis (BM) is associated with high case fatality rates (20-50%), causing around 60,000 annual newborn deaths, further 180.000 annual deaths in older children (1-59 months), and significant sequelae among survivors.

 

In under-resourced regions, diagnostic dilemmas are common in patients with suspected BM, because history and physical examination alone are insufficient to confirm/exclude the diagnosis. Lumbar puncture (LP) to draw a sample of cerebrospinal fluid (CSF) is an essential investigation, but difficult to perform and potentially hazardous for the sick child. Moreover, CSF processing requires specific laboratory infrastructures seldom available in poor settings.

 

Clearly and in this context, effectively detecting new meningitis episodes is a challenge that has not yet been adequately resolved. Indeed, the majority of meningitis episodes are either directly missed, or often only detected after they have caused the death of the patient, or at such an advanced stage that adverse outcomes are difficult to prevent. In such settings, BM associated case fatality rates have been estimated to approach 50%, and the number of survivors with sequelae is also dramatically high. Moreover, in the absence of adequate laboratory support, clinicians often opt for not conducting LPs, which makes meningitis cases diagnosed the tip of the iceberg of all occurring episodes. Neonatal mortality and morbidity is raised in this context by factors like hygiene but also by under-diagnosis and misdiagnosis of the disease. Thus, Neosonics can be used to recognize the disease, administer appropriate medication and help saving lives.

 

 

Manhiça’s Health Research Centre (CISM) in Mozambique was founded with the support of Spanish Government, Hospital Clinic Foundation (Barcelona) and ISGlobal Barcelona to provide clinical, research support and training to the Manhiça District Hospital. Thanks to this support they can now perform LPs and analyze the sample but still many neonatal cases are overlooked due to the inespecificity of the disease in the youngest and most vulnerable. Neosonics could be used to rapidly screen those infants with meningeal signs and make a fast recognition of the risk level of these patients.

 

Manhiça’s inhabitants are now more aware of the devastating effects of infectious diseases, including sepsis and meningitis, thanks to the work done by ISGlobal. Such initiatives intend to have a local impact on society and health that serves as a benchmark model to be escalated throughout the African continent.