Understanding neonatal infectious diseases in low- and middle-income countries: New insights from a 30-year study

Researchers from Peking University have conducted an in-depth study on the epidemic status, secular trends, and risk factors of 15 common neonatal infectious diseases across low- and middle-income countries (LMICs) from 1990 to 2019. The study, published in Health Data Science, provides a comprehensive overview of the changes in incidence and mortality rates, identifying key trends and potential areas for targeted public health interventions to improve neonatal health outcomes.

Neonatal infectious diseases remain a significant cause of morbidity and mortality in LMICs, where newborns are particularly vulnerable to infections due to underdeveloped immune systems and poor healthcare infrastructure. The study, led by Chenyuan Qin, a PhD candidate at the School of Public Health, Peking University, and corresponding author Jue Liu, a Senior Research Fellow at the same institution, analyzed data from the Global Burden of Disease 2019 to understand the burden of 15 types of neonatal infectious diseases. These diseases include neonatal sepsis, enteric infections, upper respiratory infections (URIs), lower respiratory infections (LRIs), and others.

"Our study provides critical insights into the trends and disparities of neonatal infectious diseases in LMICs over the past three decades," said Liu. "We observed that while there has been a general decline in mortality rates from neonatal infections, the incidence rates of certain infections, such as neonatal sepsis and otitis media, have shown slight increases across all regions."

The study utilized data from 131 LMICs, covering 15 common neonatal infectious diseases, and examined changes in incidence and mortality rates from 1990 to 2019. The researchers used standardized tools and regression models to calculate estimated annual percentage changes (EAPCs) and 95% uncertainty intervals to ensure statistical robustness. The findings revealed that while diseases like tetanus and tuberculosis showed substantial declines in incidence, neonatal sepsis and other neonatal infections demonstrated slight increases.

The highest incidence rates in 2019 were for enteric infections and URIs, with substantial variation across regions. LICs experienced higher rates of enteric infections, while UMCs reported higher rates of URIs. Mortality rates also showed regional differences, with neonatal sepsis and LRIs remaining the leading causes of death. Interestingly, the study found that higher socio-demographic index (SDI) and universal health coverage index (UHCI) were generally associated with reduced disease burden, although some exceptions, such as neonatal sepsis, were observed.

Moving forward, the team aims to explore the underlying reasons for the observed trends in disease burden and develop targeted strategies to reduce the incidence and mortality of neonatal infections in LMICs. "Our ultimate goal is to provide evidence-based recommendations to guide public health policies and resource allocation to improve neonatal health outcomes," added Qin.