Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study
- Autores
- Althabe, Fernando; Espinoza, Marisa Mabel; Pasquale, Julia; Hernández Muñoz, Rosalinda; Carvajal, Javier; Escobar, María Fernanda; Cecatti, José Guilherme; Ribeiro Do Valle, Carolina C.; Mereci, Wilson; Vélez, Paola; Pérez, Aquilino M.; Vitureira, Gerardo; Leroy, Charlotte; Roelens, Kristien; Vandenberghe, Griet; Aguemon, Christiane Tshabu; Cisse, Kadari; Ouedraogo, Henri Gautier; Kannitha, Cheang; Rathavy, Tung; Tebeu, Pierre Marie; Bustillo, Carolina; Bredy, Lara; Herrera Maldonado, Nazarea; Abdosh, Abdulfetah Abdulkadir; Teklu, Alula M.; Kassa, Dawit Worku; Kumar, Vijay; Suri, Vanita; Trikha, Sonia
- Año de publicación
- 2020
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Background: Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. Methods: We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups. Findings: Between Nov 28, 2017, and Dec 4, 2017, of 2965 women assessed for eligibility, 2850 pregnant or recently pregnant women with suspected or confirmed infection were included. 70·4 (95% CI 67·7–73·1) hospitalised women per 1000 livebirths had a maternal infection, and 10·9 (9·8–12·0) women per 1000 livebirths presented with infection-related (underlying or contributing cause) severe maternal outcomes. Highest ratios were observed in LMICs and the lowest in HICs. The proportion of intrahospital fatalities was 6·8% among women with severe maternal outcomes, with the highest proportion in low-income countries. Infection-related maternal deaths represented more than half of the intrahospital deaths. Around two-thirds (63·9%, n=1821) of the women had a complete set of vital signs recorded, or received antimicrobials the day of suspicion or diagnosis of the infection (70·2%, n=1875), without marked differences across severity groups. Interpretation: The frequency of maternal infections requiring management in health facilities is high. Our results suggest that contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths is greater than previously thought. Improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices.
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Espinoza, Marisa Mabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Pasquale, Julia. No especifíca;
Fil: Hernández Muñoz, Rosalinda. No especifíca;
Fil: Carvajal, Javier. No especifíca;
Fil: Escobar, María Fernanda. No especifíca;
Fil: Cecatti, José Guilherme. No especifíca;
Fil: Ribeiro Do Valle, Carolina C.. No especifíca;
Fil: Mereci, Wilson. No especifíca;
Fil: Vélez, Paola. No especifíca;
Fil: Pérez, Aquilino M.. No especifíca;
Fil: Vitureira, Gerardo. No especifíca;
Fil: Leroy, Charlotte. No especifíca;
Fil: Roelens, Kristien. No especifíca;
Fil: Vandenberghe, Griet. No especifíca;
Fil: Aguemon, Christiane Tshabu. No especifíca;
Fil: Cisse, Kadari. No especifíca;
Fil: Ouedraogo, Henri Gautier. No especifíca;
Fil: Kannitha, Cheang. No especifíca;
Fil: Rathavy, Tung. No especifíca;
Fil: Tebeu, Pierre Marie. No especifíca;
Fil: Bustillo, Carolina. No especifíca;
Fil: Bredy, Lara. No especifíca;
Fil: Herrera Maldonado, Nazarea. No especifíca;
Fil: Abdosh, Abdulfetah Abdulkadir. No especifíca;
Fil: Teklu, Alula M.. No especifíca;
Fil: Kassa, Dawit Worku. No especifíca;
Fil: Kumar, Vijay. No especifíca;
Fil: Suri, Vanita. No especifíca;
Fil: Trikha, Sonia. No especifíca; - Materia
-
Maternal infection
Maternal mortality
Maternal morbidity - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/142687
Ver los metadatos del registro completo
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Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort studyAlthabe, FernandoEspinoza, Marisa MabelPasquale, JuliaHernández Muñoz, RosalindaCarvajal, JavierEscobar, María FernandaCecatti, José GuilhermeRibeiro Do Valle, Carolina C.Mereci, WilsonVélez, PaolaPérez, Aquilino M.Vitureira, GerardoLeroy, CharlotteRoelens, KristienVandenberghe, GrietAguemon, Christiane TshabuCisse, KadariOuedraogo, Henri GautierKannitha, CheangRathavy, TungTebeu, Pierre MarieBustillo, CarolinaBredy, LaraHerrera Maldonado, NazareaAbdosh, Abdulfetah AbdulkadirTeklu, Alula M.Kassa, Dawit WorkuKumar, VijaySuri, VanitaTrikha, SoniaMaternal infectionMaternal mortalityMaternal morbidityhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. Methods: We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups. Findings: Between Nov 28, 2017, and Dec 4, 2017, of 2965 women assessed for eligibility, 2850 pregnant or recently pregnant women with suspected or confirmed infection were included. 70·4 (95% CI 67·7–73·1) hospitalised women per 1000 livebirths had a maternal infection, and 10·9 (9·8–12·0) women per 1000 livebirths presented with infection-related (underlying or contributing cause) severe maternal outcomes. Highest ratios were observed in LMICs and the lowest in HICs. The proportion of intrahospital fatalities was 6·8% among women with severe maternal outcomes, with the highest proportion in low-income countries. Infection-related maternal deaths represented more than half of the intrahospital deaths. Around two-thirds (63·9%, n=1821) of the women had a complete set of vital signs recorded, or received antimicrobials the day of suspicion or diagnosis of the infection (70·2%, n=1875), without marked differences across severity groups. Interpretation: The frequency of maternal infections requiring management in health facilities is high. Our results suggest that contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths is greater than previously thought. Improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices.Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Espinoza, Marisa Mabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Pasquale, Julia. No especifíca;Fil: Hernández Muñoz, Rosalinda. No especifíca;Fil: Carvajal, Javier. No especifíca;Fil: Escobar, María Fernanda. No especifíca;Fil: Cecatti, José Guilherme. No especifíca;Fil: Ribeiro Do Valle, Carolina C.. No especifíca;Fil: Mereci, Wilson. No especifíca;Fil: Vélez, Paola. No especifíca;Fil: Pérez, Aquilino M.. No especifíca;Fil: Vitureira, Gerardo. No especifíca;Fil: Leroy, Charlotte. No especifíca;Fil: Roelens, Kristien. No especifíca;Fil: Vandenberghe, Griet. No especifíca;Fil: Aguemon, Christiane Tshabu. No especifíca;Fil: Cisse, Kadari. No especifíca;Fil: Ouedraogo, Henri Gautier. No especifíca;Fil: Kannitha, Cheang. No especifíca;Fil: Rathavy, Tung. No especifíca;Fil: Tebeu, Pierre Marie. No especifíca;Fil: Bustillo, Carolina. No especifíca;Fil: Bredy, Lara. No especifíca;Fil: Herrera Maldonado, Nazarea. No especifíca;Fil: Abdosh, Abdulfetah Abdulkadir. No especifíca;Fil: Teklu, Alula M.. No especifíca;Fil: Kassa, Dawit Worku. No especifíca;Fil: Kumar, Vijay. No especifíca;Fil: Suri, Vanita. No especifíca;Fil: Trikha, Sonia. No especifíca;Elsevier2020-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/142687Althabe, Fernando; Espinoza, Marisa Mabel; Pasquale, Julia; Hernández Muñoz, Rosalinda; Carvajal, Javier; et al.; Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study; Elsevier; The Lancet Global Health; 8; 5; 5-2020; e661-e6712214-109XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30109-1/fulltextinfo:eu-repo/semantics/altIdentifier/doi/10.1016/S2214-109X(20)30109-1info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:51:57Zoai:ri.conicet.gov.ar:11336/142687instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:51:58.225CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study |
title |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study |
spellingShingle |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study Althabe, Fernando Maternal infection Maternal mortality Maternal morbidity |
title_short |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study |
title_full |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study |
title_fullStr |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study |
title_full_unstemmed |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study |
title_sort |
Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study |
dc.creator.none.fl_str_mv |
Althabe, Fernando Espinoza, Marisa Mabel Pasquale, Julia Hernández Muñoz, Rosalinda Carvajal, Javier Escobar, María Fernanda Cecatti, José Guilherme Ribeiro Do Valle, Carolina C. Mereci, Wilson Vélez, Paola Pérez, Aquilino M. Vitureira, Gerardo Leroy, Charlotte Roelens, Kristien Vandenberghe, Griet Aguemon, Christiane Tshabu Cisse, Kadari Ouedraogo, Henri Gautier Kannitha, Cheang Rathavy, Tung Tebeu, Pierre Marie Bustillo, Carolina Bredy, Lara Herrera Maldonado, Nazarea Abdosh, Abdulfetah Abdulkadir Teklu, Alula M. Kassa, Dawit Worku Kumar, Vijay Suri, Vanita Trikha, Sonia |
author |
Althabe, Fernando |
author_facet |
Althabe, Fernando Espinoza, Marisa Mabel Pasquale, Julia Hernández Muñoz, Rosalinda Carvajal, Javier Escobar, María Fernanda Cecatti, José Guilherme Ribeiro Do Valle, Carolina C. Mereci, Wilson Vélez, Paola Pérez, Aquilino M. Vitureira, Gerardo Leroy, Charlotte Roelens, Kristien Vandenberghe, Griet Aguemon, Christiane Tshabu Cisse, Kadari Ouedraogo, Henri Gautier Kannitha, Cheang Rathavy, Tung Tebeu, Pierre Marie Bustillo, Carolina Bredy, Lara Herrera Maldonado, Nazarea Abdosh, Abdulfetah Abdulkadir Teklu, Alula M. Kassa, Dawit Worku Kumar, Vijay Suri, Vanita Trikha, Sonia |
author_role |
author |
author2 |
Espinoza, Marisa Mabel Pasquale, Julia Hernández Muñoz, Rosalinda Carvajal, Javier Escobar, María Fernanda Cecatti, José Guilherme Ribeiro Do Valle, Carolina C. Mereci, Wilson Vélez, Paola Pérez, Aquilino M. Vitureira, Gerardo Leroy, Charlotte Roelens, Kristien Vandenberghe, Griet Aguemon, Christiane Tshabu Cisse, Kadari Ouedraogo, Henri Gautier Kannitha, Cheang Rathavy, Tung Tebeu, Pierre Marie Bustillo, Carolina Bredy, Lara Herrera Maldonado, Nazarea Abdosh, Abdulfetah Abdulkadir Teklu, Alula M. Kassa, Dawit Worku Kumar, Vijay Suri, Vanita Trikha, Sonia |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.subject.none.fl_str_mv |
Maternal infection Maternal mortality Maternal morbidity |
topic |
Maternal infection Maternal mortality Maternal morbidity |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.3 https://purl.org/becyt/ford/3 |
dc.description.none.fl_txt_mv |
Background: Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. Methods: We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups. Findings: Between Nov 28, 2017, and Dec 4, 2017, of 2965 women assessed for eligibility, 2850 pregnant or recently pregnant women with suspected or confirmed infection were included. 70·4 (95% CI 67·7–73·1) hospitalised women per 1000 livebirths had a maternal infection, and 10·9 (9·8–12·0) women per 1000 livebirths presented with infection-related (underlying or contributing cause) severe maternal outcomes. Highest ratios were observed in LMICs and the lowest in HICs. The proportion of intrahospital fatalities was 6·8% among women with severe maternal outcomes, with the highest proportion in low-income countries. Infection-related maternal deaths represented more than half of the intrahospital deaths. Around two-thirds (63·9%, n=1821) of the women had a complete set of vital signs recorded, or received antimicrobials the day of suspicion or diagnosis of the infection (70·2%, n=1875), without marked differences across severity groups. Interpretation: The frequency of maternal infections requiring management in health facilities is high. Our results suggest that contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths is greater than previously thought. Improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices. Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Espinoza, Marisa Mabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Pasquale, Julia. No especifíca; Fil: Hernández Muñoz, Rosalinda. No especifíca; Fil: Carvajal, Javier. No especifíca; Fil: Escobar, María Fernanda. No especifíca; Fil: Cecatti, José Guilherme. No especifíca; Fil: Ribeiro Do Valle, Carolina C.. No especifíca; Fil: Mereci, Wilson. No especifíca; Fil: Vélez, Paola. No especifíca; Fil: Pérez, Aquilino M.. No especifíca; Fil: Vitureira, Gerardo. No especifíca; Fil: Leroy, Charlotte. No especifíca; Fil: Roelens, Kristien. No especifíca; Fil: Vandenberghe, Griet. No especifíca; Fil: Aguemon, Christiane Tshabu. No especifíca; Fil: Cisse, Kadari. No especifíca; Fil: Ouedraogo, Henri Gautier. No especifíca; Fil: Kannitha, Cheang. No especifíca; Fil: Rathavy, Tung. No especifíca; Fil: Tebeu, Pierre Marie. No especifíca; Fil: Bustillo, Carolina. No especifíca; Fil: Bredy, Lara. No especifíca; Fil: Herrera Maldonado, Nazarea. No especifíca; Fil: Abdosh, Abdulfetah Abdulkadir. No especifíca; Fil: Teklu, Alula M.. No especifíca; Fil: Kassa, Dawit Worku. No especifíca; Fil: Kumar, Vijay. No especifíca; Fil: Suri, Vanita. No especifíca; Fil: Trikha, Sonia. No especifíca; |
description |
Background: Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. Methods: We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups. Findings: Between Nov 28, 2017, and Dec 4, 2017, of 2965 women assessed for eligibility, 2850 pregnant or recently pregnant women with suspected or confirmed infection were included. 70·4 (95% CI 67·7–73·1) hospitalised women per 1000 livebirths had a maternal infection, and 10·9 (9·8–12·0) women per 1000 livebirths presented with infection-related (underlying or contributing cause) severe maternal outcomes. Highest ratios were observed in LMICs and the lowest in HICs. The proportion of intrahospital fatalities was 6·8% among women with severe maternal outcomes, with the highest proportion in low-income countries. Infection-related maternal deaths represented more than half of the intrahospital deaths. Around two-thirds (63·9%, n=1821) of the women had a complete set of vital signs recorded, or received antimicrobials the day of suspicion or diagnosis of the infection (70·2%, n=1875), without marked differences across severity groups. Interpretation: The frequency of maternal infections requiring management in health facilities is high. Our results suggest that contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths is greater than previously thought. Improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-05 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/142687 Althabe, Fernando; Espinoza, Marisa Mabel; Pasquale, Julia; Hernández Muñoz, Rosalinda; Carvajal, Javier; et al.; Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study; Elsevier; The Lancet Global Health; 8; 5; 5-2020; e661-e671 2214-109X CONICET Digital CONICET |
url |
http://hdl.handle.net/11336/142687 |
identifier_str_mv |
Althabe, Fernando; Espinoza, Marisa Mabel; Pasquale, Julia; Hernández Muñoz, Rosalinda; Carvajal, Javier; et al.; Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study; Elsevier; The Lancet Global Health; 8; 5; 5-2020; e661-e671 2214-109X CONICET Digital CONICET |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/url/https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30109-1/fulltext info:eu-repo/semantics/altIdentifier/doi/10.1016/S2214-109X(20)30109-1 |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/2.5/ar/ |
eu_rights_str_mv |
openAccess |
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https://creativecommons.org/licenses/by/2.5/ar/ |
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application/pdf application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
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reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) |
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Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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1842269126586793984 |
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13.13397 |