Treatment of Infections in Young Infants in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis of Frontline Health Worker Diagnosis and Antibiotic Access
Events
Loading … Spinner

Mendeley | Further Information

{"title"=>"Treatment of Infections in Young Infants in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis of Frontline Health Worker Diagnosis and Antibiotic Access", "type"=>"journal", "authors"=>[{"first_name"=>"Anne C.C.", "last_name"=>"Lee", "scopus_author_id"=>"27168008500"}, {"first_name"=>"Aruna", "last_name"=>"Chandran", "scopus_author_id"=>"10839034500"}, {"first_name"=>"Hadley K.", "last_name"=>"Herbert", "scopus_author_id"=>"36680094900"}, {"first_name"=>"Naoko", "last_name"=>"Kozuki", "scopus_author_id"=>"55087558000"}, {"first_name"=>"Perry", "last_name"=>"Markell", "scopus_author_id"=>"56398326300"}, {"first_name"=>"Rashed", "last_name"=>"Shah", "scopus_author_id"=>"55923348300"}, {"first_name"=>"Harry", "last_name"=>"Campbell", "scopus_author_id"=>"7202318417"}, {"first_name"=>"Igor", "last_name"=>"Rudan", "scopus_author_id"=>"7007138278"}, {"first_name"=>"Abdullah H.", "last_name"=>"Baqui", "scopus_author_id"=>"35404983600"}], "year"=>2014, "source"=>"PLoS Medicine", "identifiers"=>{"pmid"=>"25314011", "doi"=>"10.1371/journal.pmed.1001741", "sgr"=>"84908338940", "scopus"=>"2-s2.0-84908338940", "issn"=>"15491676", "pui"=>"600310712"}, "id"=>"8c37b340-0039-3a2c-8cf0-ae22a5c65e3f", "abstract"=>"BACKGROUND: Inadequate illness recognition and access to antibiotics contribute to high case fatality from infections in young infants (<2 months) in low- and middle-income countries (LMICs). We aimed to address three questions regarding access to treatment for young infant infections in LMICs: (1) Can frontline health workers accurately diagnose possible bacterial infection (pBI)?; (2) How available and affordable are antibiotics?; (3) How often are antibiotics procured without a prescription?\\n\\nMETHODS AND FINDINGS: We searched PubMed, Embase, WHO/Health Action International (HAI), databases, service provision assessments (SPAs), Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and grey literature with no date restriction until May 2014. Data were identified from 37 published studies, 46 HAI national surveys, and eight SPAs. For study question 1, meta-analysis showed that clinical sign-based algorithms predicted bacterial infection in young infants with high sensitivity (87%, 95% CI 82%-91%) and lower specificity (62%, 95% CI 48%-75%) (six studies, n = 14,254). Frontline health workers diagnosed pBI in young infants with an average sensitivity of 82% (95% CI 76%-88%) and specificity of 69% (95% CI 54%-83%) (eight studies, n = 11,857) compared to physicians. For question 2, first-line injectable agents (ampicillin, gentamicin, and penicillin) had low variable availability in first-level health facilities in Africa and South Asia. Oral amoxicillin and cotrimoxazole were widely available at low cost in most regions. For question 3, no studies on young infants were identified, however 25% of pediatric antibiotic purchases in LMICs were obtained without a prescription (11 studies, 95% CI 18%-34%), with lower rates among infants <1 year. Study limitations included potential selection bias and lack of neonatal-specific data.\\n\\nCONCLUSIONS: Trained frontline health workers may screen for pBI in young infants with relatively high sensitivity and lower specificity. Availability of first-line injectable antibiotics appears low in many health facilities in Africa and Asia. Improved data and advocacy are needed to increase the availability and appropriate utilization of antibiotics for young infant infections in LMICs.\\n\\nREVIEW REGISTRATION: PROSPERO International prospective register of systematic reviews (CRD42013004586). Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/treatment-infections-young-infants-low-middleincome-countries-systematic-review-metaanalysis-frontli-8", "reader_count"=>11, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Researcher"=>4, "Student > Ph. D. Student"=>1, "Student > Master"=>3, "Other"=>1, "Student > Bachelor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Researcher"=>4, "Student > Ph. D. Student"=>1, "Student > Master"=>3, "Other"=>1, "Student > Bachelor"=>1}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>2, "Medicine and Dentistry"=>7, "Agricultural and Biological Sciences"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>7}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}}, "reader_count_by_country"=>{"France"=>1}, "group_count"=>3}

Scopus | Further Information

{"@_fa"=>"true", "link"=>[{"@_fa"=>"true", "@ref"=>"self", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84908338940"}, {"@_fa"=>"true", "@ref"=>"author-affiliation", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84908338940?field=author,affiliation"}, {"@_fa"=>"true", "@ref"=>"scopus", "@href"=>"https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84908338940&origin=inward"}, {"@_fa"=>"true", "@ref"=>"scopus-citedby", "@href"=>"https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84908338940&origin=inward"}], "prism:url"=>"https://api.elsevier.com/content/abstract/scopus_id/84908338940", "dc:identifier"=>"SCOPUS_ID:84908338940", "eid"=>"2-s2.0-84908338940", "dc:title"=>"Treatment of Infections in Young Infants in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis of Frontline Health Worker Diagnosis and Antibiotic Access", "dc:creator"=>"Lee A.C.C.", "prism:publicationName"=>"PLoS Medicine", "prism:issn"=>"15491277", "prism:eIssn"=>"15491676", "prism:volume"=>"11", "prism:issueIdentifier"=>"10", "prism:pageRange"=>nil, "prism:coverDate"=>"2014-01-01", "prism:coverDisplayDate"=>"2014", "prism:doi"=>"10.1371/journal.pmed.1001741", "citedby-count"=>"24", "affiliation"=>[{"@_fa"=>"true", "affilname"=>"Brigham and Women's Hospital", "affiliation-city"=>"Boston", "affiliation-country"=>"United States"}, {"@_fa"=>"true", "affilname"=>"Johns Hopkins Bloomberg School of Public Health", "affiliation-city"=>"Baltimore", "affiliation-country"=>"United States"}], "pubmed-id"=>"25314011", "prism:aggregationType"=>"Journal", "subtype"=>"ar", "subtypeDescription"=>"Article", "source-id"=>"144840", "openaccess"=>"1", "openaccessFlag"=>true}

Facebook

  • {"url"=>"http%3A%2F%2Fjournals.plos.org%2Fplosmedicine%2Farticle%3Fid%3D10.1371%252Fjournal.pmed.1001741", "share_count"=>0, "like_count"=>0, "comment_count"=>0, "click_count"=>0, "total_count"=>0}

Twitter

Counter

  • {"month"=>"10", "year"=>"2014", "pdf_views"=>"170", "xml_views"=>"19", "html_views"=>"3901"}
  • {"month"=>"11", "year"=>"2014", "pdf_views"=>"57", "xml_views"=>"5", "html_views"=>"2948"}
  • {"month"=>"12", "year"=>"2014", "pdf_views"=>"29", "xml_views"=>"5", "html_views"=>"1337"}
  • {"month"=>"1", "year"=>"2015", "pdf_views"=>"17", "xml_views"=>"2", "html_views"=>"123"}
  • {"month"=>"2", "year"=>"2015", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"62"}
  • {"month"=>"3", "year"=>"2015", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"38"}
  • {"month"=>"4", "year"=>"2015", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"58"}
  • {"month"=>"5", "year"=>"2015", "pdf_views"=>"5", "xml_views"=>"1", "html_views"=>"41"}
  • {"month"=>"6", "year"=>"2015", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"50"}
  • {"month"=>"7", "year"=>"2015", "pdf_views"=>"6", "xml_views"=>"0", "html_views"=>"41"}
  • {"month"=>"8", "year"=>"2015", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"55"}
  • {"month"=>"9", "year"=>"2015", "pdf_views"=>"25", "xml_views"=>"1", "html_views"=>"67"}
  • {"month"=>"10", "year"=>"2015", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"72"}
  • {"month"=>"11", "year"=>"2015", "pdf_views"=>"15", "xml_views"=>"1", "html_views"=>"45"}
  • {"month"=>"12", "year"=>"2015", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"74"}
  • {"month"=>"1", "year"=>"2016", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"34"}
  • {"month"=>"2", "year"=>"2016", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"44"}
  • {"month"=>"3", "year"=>"2016", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"86"}
  • {"month"=>"4", "year"=>"2016", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"38"}
  • {"month"=>"5", "year"=>"2016", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"42"}
  • {"month"=>"6", "year"=>"2016", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"22"}
  • {"month"=>"7", "year"=>"2016", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"36"}
  • {"month"=>"8", "year"=>"2016", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"37"}
  • {"month"=>"9", "year"=>"2016", "pdf_views"=>"14", "xml_views"=>"0", "html_views"=>"74"}
  • {"month"=>"10", "year"=>"2016", "pdf_views"=>"9", "xml_views"=>"0", "html_views"=>"49"}
  • {"month"=>"11", "year"=>"2016", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"51"}
  • {"month"=>"12", "year"=>"2016", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"31"}
  • {"month"=>"1", "year"=>"2017", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"71"}
  • {"month"=>"2", "year"=>"2017", "pdf_views"=>"17", "xml_views"=>"3", "html_views"=>"96"}
  • {"month"=>"3", "year"=>"2017", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"93"}
  • {"month"=>"4", "year"=>"2017", "pdf_views"=>"11", "xml_views"=>"2", "html_views"=>"99"}
  • {"month"=>"5", "year"=>"2017", "pdf_views"=>"11", "xml_views"=>"2", "html_views"=>"123"}
  • {"month"=>"6", "year"=>"2017", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"108"}
  • {"month"=>"7", "year"=>"2017", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"79"}
  • {"month"=>"8", "year"=>"2017", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"96"}
  • {"month"=>"9", "year"=>"2017", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"89"}
  • {"month"=>"10", "year"=>"2017", "pdf_views"=>"9", "xml_views"=>"1", "html_views"=>"91"}
  • {"month"=>"11", "year"=>"2017", "pdf_views"=>"7", "xml_views"=>"1", "html_views"=>"75"}
  • {"month"=>"12", "year"=>"2017", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"64"}
  • {"month"=>"1", "year"=>"2018", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"40"}
  • {"month"=>"2", "year"=>"2018", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"37"}
  • {"month"=>"3", "year"=>"2018", "pdf_views"=>"9", "xml_views"=>"0", "html_views"=>"31"}
  • {"month"=>"4", "year"=>"2018", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"25"}
  • {"month"=>"5", "year"=>"2018", "pdf_views"=>"12", "xml_views"=>"1", "html_views"=>"31"}
  • {"month"=>"6", "year"=>"2018", "pdf_views"=>"14", "xml_views"=>"5", "html_views"=>"31"}
  • {"month"=>"7", "year"=>"2018", "pdf_views"=>"6", "xml_views"=>"5", "html_views"=>"21"}
  • {"month"=>"8", "year"=>"2018", "pdf_views"=>"21", "xml_views"=>"3", "html_views"=>"48"}
  • {"month"=>"9", "year"=>"2018", "pdf_views"=>"22", "xml_views"=>"1", "html_views"=>"38"}
  • {"month"=>"10", "year"=>"2018", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"28"}
  • {"month"=>"11", "year"=>"2018", "pdf_views"=>"9", "xml_views"=>"1", "html_views"=>"45"}
  • {"month"=>"12", "year"=>"2018", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"17"}
  • {"month"=>"1", "year"=>"2019", "pdf_views"=>"8", "xml_views"=>"2", "html_views"=>"21"}
  • {"month"=>"2", "year"=>"2019", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"30"}
  • {"month"=>"3", "year"=>"2019", "pdf_views"=>"11", "xml_views"=>"3", "html_views"=>"24"}
  • {"month"=>"4", "year"=>"2019", "pdf_views"=>"24", "xml_views"=>"0", "html_views"=>"33"}
  • {"month"=>"5", "year"=>"2019", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"20"}
  • {"month"=>"6", "year"=>"2019", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"18"}
  • {"month"=>"7", "year"=>"2019", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"30"}
  • {"month"=>"8", "year"=>"2019", "pdf_views"=>"19", "xml_views"=>"0", "html_views"=>"21"}
  • {"month"=>"9", "year"=>"2019", "pdf_views"=>"14", "xml_views"=>"0", "html_views"=>"23"}
  • {"month"=>"10", "year"=>"2019", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"25"}
  • {"month"=>"11", "year"=>"2019", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"27"}
  • {"month"=>"12", "year"=>"2019", "pdf_views"=>"9", "xml_views"=>"0", "html_views"=>"19"}
  • {"month"=>"1", "year"=>"2020", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"16"}
  • {"month"=>"2", "year"=>"2020", "pdf_views"=>"16", "xml_views"=>"1", "html_views"=>"16"}
  • {"month"=>"3", "year"=>"2020", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"26"}
  • {"month"=>"4", "year"=>"2020", "pdf_views"=>"39", "xml_views"=>"0", "html_views"=>"25"}
  • {"month"=>"5", "year"=>"2020", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"13"}
  • {"month"=>"6", "year"=>"2020", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"17"}
  • {"month"=>"7", "year"=>"2020", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"10"}
  • {"month"=>"8", "year"=>"2020", "pdf_views"=>"4", "xml_views"=>"1", "html_views"=>"2"}

Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1717496"], "description"=>"a<p>Some studies did not report the exact breakdown of the bacterial infection diagnoses, but reported more generally on the illnesses detected. Hence, the <i>n</i>'s here do not necessarily add up to the <i>n</i> of those diagnosed as a bacterial infection by the gold standard.</p>b<p>**Data extracted from English 2003, which evaluated the same population but did not have the same exact sample size <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001741#pmed.1001741-English2\" target=\"_blank\">[68]</a>.</p><p>ANM, auxiliary nurse midwife; AWW, Anganwadi worker; NS, not stated.</p><p>Literature review: studies of diagnosis of possible bacterial infection/severe disease in newborns and young infants (<59 days).</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204544, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.t001", "stats"=>{"downloads"=>3, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Literature_review_studies_of_diagnosis_of_possible_bacterial_infection_severe_disease_in_newborns_and_young_infants_lt_59_days_/1204544", "title"=>"Literature review: studies of diagnosis of possible bacterial infection/severe disease in newborns and young infants (<59 days).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717502"], "description"=>"<p>AFR, WHO African Region; AMR, Region of the Americas; EMR, Eastern Mediterranean Region; EUR, European Region; SEAR, Southeast Asia Region; WPR, Western Pacific Region.</p><p>Over-the-counter access to antibiotics for children.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204550, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.t007", "stats"=>{"downloads"=>6, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Over_the_counter_access_to_antibiotics_for_children_/1204550", "title"=>"Over-the-counter access to antibiotics for children.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717499"], "description"=>"<p>Availability defined as the percentage of medicine outlets surveyed with the particular antibiotic in stock at the time of the survey. Data are presented as median and range for data available from the respective WHO region. Data on procaine benzyl penicillin only available from 1 survey (Haiti).</p>a<p>Data based on national surveys from: AFR (<i>n</i> = 4), AMR (<i>n</i> = 1).</p>b<p>Data based on national surveys from: AFR (<i>n</i> = 4), AMR (<i>n</i> = 3), EMR (<i>n</i> = 1), SEAR (<i>n</i> = 2), WPR (<i>n</i> = 1).</p>c<p>Data based on national surveys from: AFR (<i>n</i> = 15), AMR (<i>n</i> = 9), EMR (<i>n</i> = 13), SEAR (<i>n</i> = 3), WPR (<i>n</i> = 4).</p>d<p>Data based on national surveys from: AFR (<i>n</i> = 8), AMR (<i>n</i> = 2), EMR (<i>n</i> = 9), SEAR (<i>n</i> = 4), WPR (<i>n</i> = 5).</p>e<p>Data based on national surveys from: AFR (<i>n</i> = 15), AMR (<i>n</i> = 9), EMR (<i>n</i> = 13), SEAR (<i>n</i> = 4), WPR (<i>n</i> = 5).</p><p>AFR, WHO African Region; AMR, Region of the Americas; EMR, Eastern Mediterranean Region; EUR, European Region; SEAR, Southeast Asia Region; WPR, Western Pacific Region.</p><p>WHO/HAI data on antibiotic availability by WHO region.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204547, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.t004", "stats"=>{"downloads"=>3, "page_views"=>17, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_WHO_HAI_data_on_antibiotic_availability_by_WHO_region_/1204547", "title"=>"WHO/HAI data on antibiotic availability by WHO region.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717480"], "description"=>"<p>Search strategy and results for literature review of published and grey literature.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204532, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.g002", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Search_strategy_and_results_for_literature_review_of_published_and_grey_literature_/1204532", "title"=>"Search strategy and results for literature review of published and grey literature.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717498"], "description"=>"<p>Percent indicates the percentage of facilities or pharmacies surveyed with the antibiotic in stock at the time of the survey.</p>a<p>Formulation of Penicillin was not provided.</p>b<p>Sulfamethoxazole and trimethoprim.</p><p>AFR, WHO African Region; AMR, Region of the Americas; EMR, Eastern Mediterranean Region; EUR, European Region; SEAR, Southeast Asia Region; WPR, Western Pacific Region.</p><p>Published literature on availability of first and second-line antimicrobials for treating neonatal infections.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204546, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.t003", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Published_literature_on_availability_of_first_and_second_line_antimicrobials_for_treating_neonatal_infections_/1204546", "title"=>"Published literature on availability of first and second-line antimicrobials for treating neonatal infections.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717488"], "description"=>"<p>Receiver operating curve of studies of diagnostic accuracy of frontline health worker diagnosis of pBI compared to physician diagnosis.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204540, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.g006", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Receiver_operating_curve_of_studies_of_diagnostic_accuracy_of_frontline_health_worker_diagnosis_of_pBI_compared_to_physician_diagnosis_/1204540", "title"=>"Receiver operating curve of studies of diagnostic accuracy of frontline health worker diagnosis of pBI compared to physician diagnosis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717506", "https://ndownloader.figshare.com/files/1717507", "https://ndownloader.figshare.com/files/1717508", "https://ndownloader.figshare.com/files/1717509", "https://ndownloader.figshare.com/files/1717510", "https://ndownloader.figshare.com/files/1717511", "https://ndownloader.figshare.com/files/1717512"], "description"=>"<div><p>Background</p><p>Inadequate illness recognition and access to antibiotics contribute to high case fatality from infections in young infants (<2 months) in low- and middle-income countries (LMICs). We aimed to address three questions regarding access to treatment for young infant infections in LMICs: (1) Can frontline health workers accurately diagnose possible bacterial infection (pBI)?; (2) How available and affordable are antibiotics?; (3) How often are antibiotics procured without a prescription?</p><p>Methods and Findings</p><p>We searched PubMed, Embase, WHO/Health Action International (HAI), databases, service provision assessments (SPAs), Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and grey literature with no date restriction until May 2014. Data were identified from 37 published studies, 46 HAI national surveys, and eight SPAs. For study question 1, meta-analysis showed that clinical sign-based algorithms predicted bacterial infection in young infants with high sensitivity (87%, 95% CI 82%–91%) and lower specificity (62%, 95% CI 48%–75%) (six studies, <i>n</i> = 14,254). Frontline health workers diagnosed pBI in young infants with an average sensitivity of 82% (95% CI 76%–88%) and specificity of 69% (95% CI 54%–83%) (eight studies, <i>n</i> = 11,857) compared to physicians. For question 2, first-line injectable agents (ampicillin, gentamicin, and penicillin) had low variable availability in first-level health facilities in Africa and South Asia. Oral amoxicillin and cotrimoxazole were widely available at low cost in most regions. For question 3, no studies on young infants were identified, however 25% of pediatric antibiotic purchases in LMICs were obtained without a prescription (11 studies, 95% CI 18%–34%), with lower rates among infants <1 year. Study limitations included potential selection bias and lack of neonatal-specific data.</p><p>Conclusions</p><p>Trained frontline health workers may screen for pBI in young infants with relatively high sensitivity and lower specificity. Availability of first-line injectable antibiotics appears low in many health facilities in Africa and Asia. Improved data and advocacy are needed to increase the availability and appropriate utilization of antibiotics for young infant infections in LMICs.</p><p>Review Registration</p><p>PROSPERO International prospective register of systematic reviews (<a href=\"http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013004586#.VCBdC2PyQR8\" target=\"_blank\">CRD42013004586</a>).</p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204554, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001741.s001", "https://dx.doi.org/10.1371/journal.pmed.1001741.s002", "https://dx.doi.org/10.1371/journal.pmed.1001741.s003", "https://dx.doi.org/10.1371/journal.pmed.1001741.s004", "https://dx.doi.org/10.1371/journal.pmed.1001741.s005", "https://dx.doi.org/10.1371/journal.pmed.1001741.s006", "https://dx.doi.org/10.1371/journal.pmed.1001741.s007"], "stats"=>{"downloads"=>6, "page_views"=>18, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Treatment_of_Infections_in_Young_Infants_in_Low_and_Middle_Income_Countries_A_Systematic_Review_and_Meta_analysis_of_Frontline_Health_Worker_Diagnosis_and_Antibiotic_Access_/1204554", "title"=>"Treatment of Infections in Young Infants in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis of Frontline Health Worker Diagnosis and Antibiotic Access", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717483"], "description"=>"<p>Receiver operating curve of studies of diagnostic accuracy of clinical sign algorithms versus physician-laboratory diagnosis of severe disease/pBI in young infants.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204535, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.g004", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Receiver_operating_curve_of_studies_of_diagnostic_accuracy_of_clinical_sign_algorithms_versus_physician_laboratory_diagnosis_of_severe_disease_pBI_in_young_infants_/1204535", "title"=>"Receiver operating curve of studies of diagnostic accuracy of clinical sign algorithms versus physician-laboratory diagnosis of severe disease/pBI in young infants.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717484"], "description"=>"<p>Forest plot of studies of diagnostic accuracy of frontline health worker diagnosis of pBI compared to physician diagnosis.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204536, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.g005", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Forest_plot_of_studies_of_diagnostic_accuracy_of_frontline_health_worker_diagnosis_of_pBI_compared_to_physician_diagnosis_/1204536", "title"=>"Forest plot of studies of diagnostic accuracy of frontline health worker diagnosis of pBI compared to physician diagnosis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717501"], "description"=>"<p>Total cost is estimated for the course of treating a 3 kg neonatal child for 10 days. For capsular formulation, the assumption was reconstitution in sterile water. For oral suspension 10% wastage was assumed.</p><p>For vials, a shelf life of 24 hours was assumed for ceftriaxone. The data were from 2001 to 2013, and were not adjusted for inflation.</p>a<p>Data based on national surveys from: AFR (<i>n</i> = 4), AMR (<i>n</i> = 1).</p>b<p>Data based on national surveys from: AFR (<i>n</i> = 8), AMR (<i>n</i> = 2), EMR (<i>n</i> = 9), SEAR (<i>n</i> = 4), WPR (<i>n</i> = 5).</p>c<p>Data based on national surveys from: AFR (<i>n</i> = 15), AMR (<i>n</i> = 9), EMR (<i>n</i> = 13), SEAR (<i>n</i> = 4), WPR (<i>n</i> = 5).</p>d<p>Data based on national surveys from: AFR (<i>n</i> = 15), AMR (<i>n</i> = 9), EMR (<i>n</i> = 13), SEAR (<i>n</i> = 3), WPR (<i>n</i> = 4).</p>e<p>Data based on national surveys from: AFR (<i>n</i> = 0), AMR (<i>n</i> = 1), EMR (<i>n</i> = 0), SEAR (<i>n</i> = 0), WPR (<i>n</i> = 0).</p><p>AFR, Africa; AMR, Americas; EMR, Eastern Mediterranean; SEAR, Southeast Asia; WPR, Western Pacific.</p><p>WHO/HAI antibiotic pricing data for treatment of neonatal sepsis by WHO region.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204549, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.t006", "stats"=>{"downloads"=>6, "page_views"=>25, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_WHO_HAI_antibiotic_pricing_data_for_treatment_of_neonatal_sepsis_by_WHO_region_/1204549", "title"=>"WHO/HAI antibiotic pricing data for treatment of neonatal sepsis by WHO region.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717482"], "description"=>"<p>Forest plot of studies of diagnostic accuracy of clinical sign (IMCI) algorithms to detect severe disease/pBI in young infants compared to physician-laboratory diagnosis.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204534, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.g003", "stats"=>{"downloads"=>4, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Forest_plot_of_studies_of_diagnostic_accuracy_of_clinical_sign_IMCI_algorithms_to_detect_severe_disease_pBI_in_young_infants_compared_to_physician_laboratory_diagnosis_/1204534", "title"=>"Forest plot of studies of diagnostic accuracy of clinical sign (IMCI) algorithms to detect severe disease/pBI in young infants compared to physician-laboratory diagnosis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717500"], "description"=>"a<p>Facilities that provide normal delivery services during childbirth.</p>b<p>Facilities that provide “curative care for sick children.”</p>c<p>Defined as oral amoxicillin, augmentin, ampicillin, or cotrimoxazole.</p><p>AFRO, African Region; EMRO, Eastern Mediterranean Region; SEARO, Southeast Asian Region.</p><p>Service provision assessments: antibiotic availability in delivery and pediatric ambulatory facilities.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204548, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.t005", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Service_provision_assessments_antibiotic_availability_in_delivery_and_pediatric_ambulatory_facilities_/1204548", "title"=>"Service provision assessments: antibiotic availability in delivery and pediatric ambulatory facilities.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717497"], "description"=>"<p>For VSD (very severe disease), we are including red zone IMCI and pSBI (possible severe bacterial infection).</p><p>For PVSD (possible very severe disease), we are including both red AND yellow zone in IMCI, and pSBI as well as possible local bacterial infection.</p><p>Diagnostic accuracy of clinical algorithms and frontline health workers to detect severe disease/possible bacterial infection in young infants.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204545, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.t002", "stats"=>{"downloads"=>0, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Diagnostic_accuracy_of_clinical_algorithms_and_frontline_health_workers_to_detect_severe_disease_possible_bacterial_infection_in_young_infants_/1204545", "title"=>"Diagnostic accuracy of clinical algorithms and frontline health workers to detect severe disease/possible bacterial infection in young infants.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717478"], "description"=>"<p>Conceptual model of access to antibiotics for newborns with infection.</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204530, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.g001", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Conceptual_model_of_access_to_antibiotics_for_newborns_with_infection_/1204530", "title"=>"Conceptual model of access to antibiotics for newborns with infection.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-10-14 03:54:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1717491"], "description"=>"<p>Effect size is the Logit (prevalence of antibiotic purchases that were obtained over the counter without a prescription).</p>", "links"=>[], "tags"=>["service provision assessments", "hai", "antibiotic", "sensitivity", "crd", "LMICs.Review RegistrationPROSPERO International", "May 2014. Data", "Frontline Health Worker Diagnosis", "specificity", "ci", "spa", "frontline health workers", "Antibiotic Access BackgroundInadequate illness recognition", "health facilities", "Multiple Indicator Cluster Surveys", "infant infections", "pbi"], "article_id"=>1204543, "categories"=>["Biological Sciences"], "users"=>["Anne CC Lee", "Aruna Chandran", "Hadley K. Herbert", "Naoko Kozuki", "Perry Markell", "Rashed Shah", "Harry Campbell", "Igor Rudan", "Abdullah H. Baqui"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001741.g007", "stats"=>{"downloads"=>0, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_logit_of_the_prevalence_of_non_prescription_over_the_counter_antibiotic_use_by_young_infants_and_children_in_low_and_middle_income_countries_/1204543", "title"=>"Meta-analysis of the logit of the prevalence of non-prescription over-the-counter antibiotic use by young infants and children in low- and middle-income countries.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-10-14 03:54:03"}

PMC Usage Stats | Further Information

  • {"unique-ip"=>"45", "full-text"=>"43", "pdf"=>"24", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"42", "full-text"=>"40", "pdf"=>"15", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"11", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"32", "full-text"=>"24", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"12", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
  • {"unique-ip"=>"36", "full-text"=>"40", "pdf"=>"20", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"28", "full-text"=>"23", "pdf"=>"19", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"35", "full-text"=>"36", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"29", "full-text"=>"26", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
  • {"unique-ip"=>"28", "full-text"=>"32", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"25", "full-text"=>"26", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"35", "full-text"=>"37", "pdf"=>"22", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"40", "full-text"=>"36", "pdf"=>"19", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"55", "full-text"=>"52", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"46", "full-text"=>"48", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"56", "full-text"=>"53", "pdf"=>"15", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"45", "full-text"=>"42", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"33", "full-text"=>"32", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"31", "full-text"=>"31", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"42", "full-text"=>"40", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"20", "full-text"=>"24", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"27", "full-text"=>"30", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"35", "full-text"=>"35", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"45", "full-text"=>"52", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"7", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"36", "full-text"=>"34", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"44", "full-text"=>"42", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"42", "full-text"=>"45", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"26", "full-text"=>"29", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"12", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"23", "full-text"=>"25", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"64", "full-text"=>"65", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"56", "full-text"=>"54", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"43", "full-text"=>"43", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"33", "full-text"=>"38", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"36", "full-text"=>"34", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"35", "full-text"=>"39", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"38", "full-text"=>"40", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"24", "full-text"=>"24", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"35", "full-text"=>"36", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"31", "full-text"=>"30", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"30", "full-text"=>"34", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"31", "full-text"=>"34", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"17", "full-text"=>"18", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"48", "full-text"=>"71", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"21", "full-text"=>"22", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"29", "full-text"=>"33", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"21", "full-text"=>"20", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"19", "full-text"=>"24", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"25", "full-text"=>"21", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"25", "full-text"=>"23", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"14", "full-text"=>"13", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"19", "full-text"=>"17", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"32", "full-text"=>"37", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"4", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"22", "full-text"=>"25", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"16", "full-text"=>"13", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"17", "full-text"=>"16", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"7", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"23", "full-text"=>"23", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"26", "full-text"=>"39", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"31", "full-text"=>"26", "pdf"=>"14", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
  • {"unique-ip"=>"30", "full-text"=>"38", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"10"}
  • {"unique-ip"=>"37", "full-text"=>"34", "pdf"=>"12", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"12"}
  • {"unique-ip"=>"25", "full-text"=>"31", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"2"}
  • {"unique-ip"=>"30", "full-text"=>"35", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"3"}
  • {"unique-ip"=>"24", "full-text"=>"25", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"4"}
  • {"unique-ip"=>"14", "full-text"=>"12", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"5"}
  • {"unique-ip"=>"28", "full-text"=>"30", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2020", "month"=>"6"}

Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Developmental biology", "average_usage"=>[285]}, {"subject_area"=>"/Medicine and health sciences/Pathology and laboratory medicine", "average_usage"=>[287]}, {"subject_area"=>"/Medicine and health sciences/Pediatrics", "average_usage"=>[304, 478]}]}
Loading … Spinner
There are currently no alerts