ABSTRACT
Teriflunomide is a pyrimidine synthesis inhibitor used in the treatment of multiple sclerosis that has in rare instances been associated with liver toxicity, though there are few documented cases. Here, we report a case of probable teriflunomide-induced liver injury as assessed for causality using the updated RUCAM. The liver injury occurred approximately nine months after teriflunomide initiation and improved with discontinuation of the drug and treatment with cholestyramine.
Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Fever/diagnosis , Neutropenia/diagnosis , Pneumonia, Viral/diagnosis , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/complications , Diagnosis, Differential , Fever/blood , Fever/etiology , Humans , Male , Middle Aged , Neutropenia/blood , Neutropenia/etiology , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/complications , SARS-CoV-2ABSTRACT
BACKGROUND: Nearly three million neonates die each year, largely from preventable illnesses in developing countries. Sub-Saharan Africa has disproportionately high neonatal mortality. Community health worker (CHW) programs are a promising intervention to reduce mortality rates. This research evaluates a CHW newborn home visitation program in rural Kenya by assessing the frequency of health service utilization and overnight hospitalization. METHODS: This quasi-experimental study encompassed two consecutive years and compared the rate of medical service utilization for neonatal illness in an intervention group with that of a control group using a household survey. Severity of neonatal illness was assessed by need for overnight hospitalization. Household, maternal, and child characteristics were collected. RESULTS: A total of 489 surveys were completed and showed that 35% of not-visited families reported taking their infant to a healthcare facility, compared with 21% of CHW-visited families (P < 0.01). Rates of overnight hospitalization were 6% for not-visited infants and 1% for visited infants (P < 0.01). Few significant differences were found in household, maternal, and child characteristics. DISCUSSION: This study found that a CHW newborn home visitation program in rural Kenya significantly decreased rates of health service utilization and overnight hospitalization, but did not have the power to detect an effect on neonatal mortality.
