Browsing by Author "Sauve, Reg"

Now showing 1 - 9 of 9
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    Comprehensive Strategy to Decolonize Methicillin-Resistant Staphylococcus aureus in the Outpatient Setting: a Randomized Controlled Study
    (2013-10-03) Kim, Joseph; Henderson, Elizabeth; Conly, John; Louie, Thomas; Sauve, Reg; Zhang, Kunyan
    The objective of this study was to examine the efficacy of a comprehensive decolonization treatment in reducing methicillin-resistant Staphylococcus aureus (MRSA) carriage among an outpatient population. Patients colonized with MRSA were randomized to receive pharmacological decolonization treatment or no treatment. The primary outcome was detection of MRSA at 3 months. Occurrence of MRSA infection was assessed at 6 months. Molecular analyses were performed on all MRSA isolates. Of 205 patients, 15 (7%) were enrolled into the study (9 treatment; 6 control). At 3 months, 4/8 (50%) in the treatment group had eradication and none in the control group (0/4, 0%). Infection occurred in 5 patients (3 treatment; 2 control). All of the MRSA isolates were community-associated MRSA strain types with USA300 accounting for 87%. Among persistent CA-MRSA carriers, our decolonization treatment was well tolerated. However, enrollment was limited. Future studies with different enrollment strategies are required.
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    Developing and pre-testing a decision board to facilitate informed choice about delivery approach in uncomplicated pregnancy
    (BioMed Central, 2009-10-30) Milne, Jill; Gafni, Amiram; Lu, Diane; Wood, Stephen; Sauve, Reg; Ross, Susan J.
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    Does Integrated Management of Childhood Illness (IMCI) Training Improve the Skills of Health Workers? A Systematic Review and Meta-Analysis
    (PLoS, 2013-06-12) Nguyen, Duyen Thi Kim; Leung, Karen K.; McIntyre, Lynn; Ghali, William A.; Sauve, Reg
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    Does the Amount of Gestational Weight Gain Modify the Risk of Adverse Maternal and Neonatal Outcomes for Obese Women?
    (2017) Salmon, Charleen Nicole; Metcalfe, Amy Lynn; Sauve, Reg; LeJour, Caroline; Fenton, Tanis
    Background: Obesity during pregnancy is growing in prevalence. There has been a significant linear increase in the prevalence of obesity in American women from 35% (95% CI: 32 – 38) in 2005 to 40.5% (95% CI: 37.6 – 43.4) in 2014 (1). The increase in prevalence of obesity (body mass index (BMI) ≥ 30 kg/m2) is also seen in women of reproductive age (2). Previous studies suggested that the Institute of Medicine (IOM) gestational weight gain (GWG) guidelines needed modification by obesity severity. Objectives: The present study investigated whether the IOM guidelines for obese women needed modification for obesity severity by determining the risk of maternal, obstetric, and neonatal outcomes for class I, II and III obese pregnant women who either: lost weight during pregnancy, gained below the IOM guidelines, or gained above the IOM guidelines, compared to women who gained within the IOM guidelines (11-20 lbs). Methods: A cross-sectional study using 2014 U.S. birth certificate data (N=646,642). Chi-square tests examined associations between GWG categories and adverse outcomes. Log-binomial regression models were built to examine relative risks of adverse maternal, obstetric, and neonatal outcomes following adjustment for maternal age, education, marital status, race, insurance status, and parity. Results: The observed pattern of association was the same between all 3 obese classes indicating evidence for a single GWG recommendation for all 3 classes of obesity. Obese women who lost weight during pregnancy or gained below the IOM recommendations were at a significantly decreased risk for caesarean delivery (RR, 95% CI class I: 0.92, 0.90-0.94; II: 0.91, 0.89-0.93; III: 0.92, 0.90-0.93) and large-for-gestational age (LGA) births (class I: 0.80, 0.77-0.83; II: 0.76, 0.73-0.78; III: 0.73, 0.70-0.75) but had a significantly increased risk of small-for-gestational age (SGA) births (class I: 1.34, 1.26-1.43; II: 1.381.28-1.49; III: 1.35, 1.24-1.46) compared to women who had GWG within IOM guidelines. Obese women who gained above IOM guidelines were at an increased risk for caesarean delivery and LGA births but are at a decreased risk for SGA births. Conclusion: A single GWG recommendation for all obese women is possible, but 2009 IOM guidelines may need to be updated as current recommendations may be too high.
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    Late initiation and low utilization of postnatal care services among women in the rural setting in Northwest Tanzania: a community-based study using a mixed method approach
    (2021-07-02) Konje, Eveline T.; Hatfield, Jennifer; Sauve, Reg; Kuhn, Susan; Magoma, Moke; Dewey, Deborah
    Abstract Background Maternal and newborn mortality is high immediately after childbirth and up to 42 days postnatally despite the availability of interventions. Postnatal care is crucial in preventing mortality and improving the health of women and newborns. This prospective cohort study investigated the initiation and utilization of postnatal care at health facilities and explored users’ and providers’ perspectives on utilization of postnatal care services. Methods A sequential explanatory mixed method was used involving women who were followed from the 3rd trimester of pregnancy to 3–4 months postnatally in Northwest, Tanzania. From January to December 2018, a door-to-door survey was conducted 3–4 months postnatally among 1385 of these women. A convenience sample of women and community health workers participated in focus group discussions, and traditional birth attendants and nurses participated in key informant interviews to complement quantitative data. Data analyses were conducted using STATA version 13 and NVIVO version 12. Study findings Approximately, one half of participants attended postnatal care within 42 days after delivery. Postnatal care seeking within 48 h after delivery was reported by 14.6 % of the participants. Women who attended antenatal care at least four times, delivered at health facilities or experienced delivery-related complications were more likely to seek postnatal care. Limited knowledge on the postnatal care services and obstetric complications after childbirth, and not being scheduled for postnatal care by health providers negatively influenced services uptake. Overwhelming workload and shortages of supplies were reported to hinder the provision of postnatal care services. Conclusions Utilization of postnatal care services remains low in this setting as a result of a number of disparate and complex factors that influence women’s choices. Provision of effective postnatal care is hindered by lack of supplies, staffing, and inadequate infrastructure. To ensure accessibility and availability of quality services in this setting, both demand and supply sides factors need to be addressed.
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    Need for Supplemental Oxygen at Discharge in Infants with Bronchopulmonary Dysplasia Is Not Associated with Worse Neurodevelopmental Outcomes at 3 Years Corrected Age
    (Public Library of Science, 2014-03-19) Lodha, Abhay; Sauve, Reg; Bhandari, Vineet; Tang, Selphee; Christianson, Heather; Bhandari, Anita; Amin, Harish; Singhal, Nalini
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    Prevalence, Risk Factors and Short Term Outcomes of Hypophosphatemia among Very Low Birth Weight Infants: An Exploratory Pilot Study
    (2017) Al-Wassia, Haydi; Fenton, Tanis; Sauve, Reg; Lyon, Andrew; Rose, Sarah
    Background: Health care professionals face challenges in improving survival rates among very low birth infants who are at risk of hypophosphatemia. We aimed to identify the prevalence and predictive factors of hypophosphatemia. Methods: Prospective, exploratory pilot study of 106 infants admitted to intensive care unit at Foothills Hospital, Calgary between October 1, 2011 and June 1, 2012. Results: The prevalence of hypophosphatemia was 77%. Hypophosphatemic infants had significantly lower birth weight (p< 0.001) and gestational age (p< 0.001). Furthermore, respiratory distress syndrome (RDS) (p = 0.002), intraventricular hemorrhage (IVH) ≥ grade III (p =0.020), and hyperglycemia (p = 0.013) were more frequent among hypophosphatemic infants. Birth weight modified the association between RDS, IVH, hyperglycemia and hypophosphatemia. Conclusion: Hypophosphatemia is common in premature infants. Further research should determine whether premature birth and the associated metabolic consequences as well as the severity of the accompanying comorbidities increase the risk of hypophosphatemia.
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    The Context of Maternal and Child Health Services in Northwest Tanzania: Missed Opportunities for Preventing Maternal and Perinatal Mortality in Rural Communities
    (2020-08-10) Konje, Eveline; Dewey, Deborah; Magoma, Moke Tito Nyambita; Hatfield, Jennifer; Kuhn, Susan; Sauve, Reg
    The problem: In low- and middle-income countries, women and newborns are faced with premature death due to the lack of safe and timely antenatal, natal, postnatal and newborn care. In Tanzania, maternal and newborn mortality remains high. Health care across the maternal and child continuum of care is recognized to improve survival among women and newborns; however, there are significant differences between rural and urban areas in quality of services and utilization. The overall aim of this dissertation was to investigate the context of maternal and child health services for preventing maternal and perinatal mortality in rural communities in Geita district Northwest Tanzania. Methods: We conducted a prospective population-based study that involved 1714 pregnant women in their third trimester and followed them to 3-4 months postnatally. A mixed methods study design was utilized to capture quantitative and qualitative data. Different stakeholders, namely women, male partners, traditional birth attendants, community health workers, and nurses in charge of reproductive and child health units participated in focus group discussions and key informant interviews. STATA versions 13 and 15 were used to analyze quantitative data while NVIVO 12 was used for qualitative data. Conclusions: Maternal and child mortality rates in this rural area of Tanzania remained high and delivery at a health care facility is not associated with improved perinatal mortality. Early initiation and uptake of antenatal, natal, and postnatal care are not commonly practiced in this setting due to a complex set of factors at the individual, community, and health facility levels. Accessibility, availability, affordability, and acceptability of effective maternal health care remains a challenge among women in rural Geita district, Tanzania. Provision of effective services across the maternal continuum of care is hindered by lack of supplies, staffing, and inadequate infrastructure as well as sociocultural constructs related to gender roles and normative beliefs surrounding pregnancy and childbirth. These findings suggest that in this rural district in Tanzania there are missed opportunities to prevent maternal and infant mortality and morbidity, and improve maternal and child health outcomes, which could partly explain persisting high mortality among women and newborns.
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    Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant
    (BioMed Central, 2013-06-11) Fenton, Tanis R; Nasser, Roseann; Eliasziw, Misha; Kim, Jae H; Bilan, Denise; Sauve, Reg