Hadley K. Herbert
Johns Hopkins University
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Pediatric Infectious Disease Journal | 2011
Aruna Chandran; Hadley K. Herbert; Derek Misurski; Mathuram Santosham
Background: Numerous sequelae have been noted in survivors of bacterial meningitis; however, few studies document sequelae for several years following a childhood episode of bacterial meningitis. In addition, studies generally focus on the more commonly found sequelae. To review the known information and highlight this gap, this article presents a comprehensive literature review of the long-term (≥5 years of follow-up) sequelae of childhood bacterial meningitis. Methods: A systematic literature search was conducted between December 2009 and February 2010. English-language articles published between January 1970 and January 2010 were selected for screening. Articles were included if the subjects were between the ages of 1 month and <18 years at the time of diagnoses of meningitis. Results: A total of 1433 children who were survivors of childhood bacterial meningitis were evaluated for sequelae after the time of discharge. Of these children, 705 (49.2%) were reported to have 1 or more long-term sequelae. A majority of reported sequelae were behavioral and/or intellectual disorders (n = 455, 45.0%). Hearing changes accounted for 6.7% (n = 68) of sequelae and gross neurologic deficits accounted for 14.3% (n = 145). Discussion: A majority of childhood bacterial meningitis survivors with long-term sequelae that are documented in the literature have academic and behavioral limitations. While neurologic deficits may resolve over time, subtle behavioral deficits may not be appreciated initially and may continue to affect survivors for many years. Further studies are needed to quantify the true societal and economic burden of long-term sequelae as well as fully understand the breadth of types of sequelae that survivors experience.
PLOS Medicine | 2012
Hadley K. Herbert; Anne C C Lee; Aruna Chandran; Igor Rudan; Abdullah H. Baqui
Hadley Herbert and colleagues systematically review newborn care-seeking behaviors by caregivers in low- and middle-income countries.
Traffic Injury Prevention | 2012
Abdulgafoor M. Bachani; Pranali Koradia; Hadley K. Herbert; Stephen Mogere; Daniel Akungah; Jackim Nyamari; Eric Osoro; William Maina; Kent A. Stevens
Background: Road traffic injuries (RTIs) contribute to a significant proportion of the burden of disease in Kenya. They also have a significant impact on the social and economic well-being of individuals, their families, and society. However, though estimates quantifying the burden of RTIs in Kenya do exist, most of these studies date back to the early 2000s—more than one decade ago. Objective: This article aims to present the current status of road safety in Kenya. Using data from the police and vital registration systems in Kenya, we present the current epidemiology of RTIs in the nation. We also sought to assess the status of 3 well-known risk factors for RTIs—speeding and the use of helmets and reflective clothing. Methods: Data for this study were collected in 2 steps. The first step involved the collection of secondary data from the Kenya traffic police as well as the National Vital Registration System to assess the current trends of RTIs in Kenya. Following this, observational studies were conducted in the Thika and Naivasha districts in Kenya to assess the current status of speeding among all vehicles and the use of helmets and reflective clothing among motorcyclists. Results: The overall RTI rate in Kenya was 59.96 per 100,000 population in 2009, with vehicle passengers being the most affected. Notably, injuries to motorcyclists increased at an annual rate of approximately 29 percent (95% confidence interval [CI]: 27–32; P < .001). The mean age of death due to road traffic crashes was 35 years. Fatalities due to RTIs increased at an annual rate of 7 percent (95% CI: 6–8; P < .001) for the period 2004 to 2009. Observational studies revealed that 69.45 percent of vehicles in Thika and 34.32 percent of vehicles in Naivasha were speeding. Helmets were used by less than one third of motorcycle drivers in both study districts, with prevalence rates ranging between 3 and 4 percent among passengers. Conclusions: This study highlights the significant burden of RTIs in Kenya. A renewed focus on addressing this burden is necessary. Focusing on increasing helmet and reflective clothing use and enforcement of speed limits has the potential to prevent a large number of road traffic crashes, injuries, and fatalities. However, it is difficult to demonstrate the magnitude of the injury problem to policymakers with minimal or inaccurate data, and this study illustrates the need for national continuous, systematic, and sustainable data collection efforts, echoing similar calls for action throughout the injury literature.
Annual Review of Public Health | 2012
Sarah Stewart de Ramirez; Adnan A. Hyder; Hadley K. Herbert; Kent A. Stevens
The World Health Organization estimates injuries accounted for more than 5 million deaths in 2004, significantly impacting the global burden of disease. Nearly 3.9 million of these deaths were due to unintentional injury, a cause also responsible for more than 138 million disability-adjusted life years (DALYs) lost in the same year. More than 90% of the DALYs lost occur in low- and middle-income countries (LMICs), highlighting the disproportionate burden that injuries place on developing countries. This article examines the health and social impact of injury, injury data availability, and injury prevention interventions. By proposing initiatives to minimize the magnitude of death and disability due to unintentional injuries, particularly in LMICs, this review serves as a call to action for further investment in injury surveillance, prevention interventions, and health systems strengthening.
Journal of Trauma-injury Infection and Critical Care | 2012
Hadley K. Herbert; Arjan Bastiaan van As; Abdulgafoor M. Bachani; Pp Mtambeka; Kent A. Stevens; Alastair J. W. Millar; Adnan A. Hyder
BACKGROUND Pediatric injuries are associated with significant morbidity and mortality, especially in low- and middle-income countries. Despite the magnitude of this burden, there is lack of data to characterize the etiology and risk factors associated with childhood injuries, especially in low- and middle-income countries. The aim of this article is to describe the demographics, mechanisms, and severity of injuries during a 10-year time period using hospital-based data in Cape Town, South Africa. METHODS Data from Childsafe South Africa’s registry were used to study injured children younger than 13 years who presented with either intentional or unintentional injuries to the Trauma Unit of the Red Cross War Memorial Children’s Hospital’s (RCH) Causality Department between 1996 and 2007. Univariate and bivariate analyses were performed for demographic characteristics and injury mechanisms. Poisson regression analysis was used to analyze the age-adjusted annual incidence of injury presenting to RCH. RESULTS Between 1997 and 2006, 62,782 children with a total of 68,883 injuries presented to RCH. The mean age was 5.4 years (standard deviation ± 3.5 years) and 61.7% were male. Mechanism of injury included falls (39.8%), road traffic injuries (15.7%), burns (8.8%), and assault (7.4%). The majority of injuries occurred in and around the home. Abbreviated injury severity scoring showed 60.2% of injuries were minor, 36.6% were moderate, and 3.2% were severe. Sixty-six deaths occurred in the trauma casualty department. Thirty-one percent of patients were admitted to the hospital; children who suffered burn and head injuries were more likely to require admission. CONCLUSION Age, gender, mechanism, and severity of injury in pediatric populations have not been described elsewhere in South African national or sub-Saharan regional data. This retrospective, observational study uses Level II evidence to suggest the need for targeted interventions to address risk factors for pediatric injuries, emphasizing the importance of pediatric surveillance systems as a tool to study injuries in developing countries. LEVEL OF EVIDENCE Prognostic study, level II.
Infectious Disease Clinics of North America | 2011
Hadley K. Herbert; Adnan A. Hyder; Alexander Butchart; Robyn Norton
Injury and violence rank among the leading causes of death worldwide, with more than 5 million deaths annually, representing a significant portion of the global burden of disease. This article examines how injury and violence relate to global health using recent global burden of disease data and selected key studies and databases, and further explores risk factors and intervention initiatives that address unintentional and intentional injuries. The article serves as a call to action to enhance understanding of the growing burden of injury and violence, especially in low-income and middle-income countries, where more than 90% of injuries occur.
European Journal of Public Health | 2010
Raimundas Lunevicius; Hadley K. Herbert; Adnan A. Hyder
BACKGROUND This article highlights the epidemiology of road traffic injury (RTI) in Lithuania between 1998 and 2007. The purpose of this study is to explore the incidence of RTI, age-standardized mortality rates (ASMR), gender-specific rates and the RTI profile of different user groups. In doing so, this analysis attempts to emphasize the need for RTI prevention policies and programmes. METHODS Six databases were analysed using ICD-10 codes V01-V99, pertaining to the causes of road traffic crashes. Data between 1998 and 2007 were obtained from these databases to identify and calculate RTI incidence and mortality rates. This was then analysed with regard to ASMR, gender, user groups and the use of alcohol. RESULTS In 2007, RTI incidence in Lithuania was reported as 270/100,000 people, 10.7% higher than in 1998. ASMR declined from 28 deaths per 100,000 in 1998 to 25 deaths per 100,000 in 2007. Between 1998 and 2007, the male ASMR declined from 46 to 40 deaths per 100,000 and the female ASMR decreased from 13 to 11 deaths per 100,000. Car occupant and pedestrian fatalities comprised 87% of all RTI deaths. Thirty-four percent of those injured and 21% of the dead were under influence of alcohol. CONCLUSIONS From 1998 to 2007, the incidence of RTI has worsened and mortality rates remain high in Lithuania. Alcohol remains a prominent risk factor of traffic injury and death. The need to develop effective prevention programmes to address traffic injury is essential.
Injury Prevention | 2012
Adnan A. Hyder; Manjul Joshipura; J. Raczak; Hadley K. Herbert; Kent A. Stevens
This workshop will focus on trauma care system s in low- and middle-income countries and demonstrate that established interventions can make a significant impact on injury prevention and public health. Fundamental elements in strengthening the care of the injured patient will be highlighted, including defining the epidemiology of trauma care injuries, implementing evidence-based trauma care interventions, and assessing the overall impact of these interventions. Enhancing trauma care systems can be achieved through three key functions: 1) Describing trauma systems profiles: Comprehensive baseline needs assessments of formal and informal trauma care systems must be described through an interdisciplinary review of m ultiple data sources; 2) Implementing targeted evidence-based interventions: Building on the baseline description of current trauma systems, interventions can be developed and implemented to meet the needs of national and local systems; and 3) Evaluating impact: Interventions can be assessed in term s of the overall change in health, economic, and social outcomes. Through this workshop, we will provide an overview of this approach and four case studies that used these functions as tools to describe trauma care systems in low- and middle-income countries. The strengths of these tools lie in 1) the development of a core set of methods to describe both prehospital and hospital based trauma care systems; 2) the ability to approach trauma care systems development in an evidence-based, scientifically valid, yet practical manner; and 3) the application of systematic monitoring and evaluation methods.
PLOS Medicine | 2014
Anne C C Lee; Aruna Chandran; Hadley K. Herbert; Naoko Kozuki; Perry Markell; Rashed Shah; Harry Campbell; Igor Rudan; Abdullah H. Baqui
BMC Research Notes | 2011
Aruna Chandran; Hadley K. Herbert; Anne C C Lee; Igor Rudan; Abdullah H. Baqui