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IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
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\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
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\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
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The definition of live birth is a sign of life such as breathing, heartbeat, or voluntary muscular movements of the newborn after separation from the mother, regardless of the gestational age [2]. The majority of these deaths occur by preventable or treatable diseases, especially in low- and middle-income countries (LMICs). The most common causes of death under 5 years old are acute respiratory infections, diarrhea, malaria, and birth complications [3]. Underlying problems are also critical in U5MR. Malnutrition is the leading cause of about 45% of all childhood deaths [4].
The World Bank divides the world’s economies into four groups according to their income status: low-income, lower-middle-income, upper-middle-income, and high-income countries. The classification is made annually based on the gross national income (GNI) per capita in US dollars (USD) of the preceding year. According to the current data for 2021, countries with a GNI per capita of less than 1046 USD are classified as low-income countries, and those with less than 12,695 USD are classified as middle-income countries [5].
Child mortality under the age of 5 consists of several subgroups. These are neonatal mortality (birth—the first month of life), infant mortality (birth—the first year of life), and child mortality (1–5 years). Looking at the U5MR in each subgroup, it is observed that the neonatal group has the highest risk. Among this population, the youngest has the highest mortality rate. A review showed that approximately one-third of all neonatal deaths occur within the first day after birth, and nearly three-fourths occur within the first week of life [6].
Data from the last three decades show that the fastest decline in U5MR occurred between 2000 and 2009. Globally, the annual rate of reduction (ARR) was 1.9 percent in 1990–1999, 4.0 percent in 2000–2009, and 3.4 percent in 2010–2019. While 1 out of every 11 children could not see their 5th birthday in the 1990s, this number dropped to 1 in 27 in 2019. In 34 LMICs, U5MR was reduced by more than two-thirds between 1990 and 2019 [7].
Although there was a similar decrease in neonatal mortality rates (NMR), it was slower than the decline in child mortality rates between 1 and 59 months. Between 1990 and 2019, the average ARR for child mortality in the first 1–59 months was 3.6 percent, compared to only 2.5 percent in the neonatal period. As a result of these rates, deaths in children under 5 years of age began to concentrate in the neonatal period. While the ratio of newborn deaths to all childhood deaths under 5 was 40 percent in 1990, this rate increased to 47 percent in 2019 (Figure 1) [7].
Distribution of global under-five deaths by age, 1990–2019 [
The U5MR is a good indicator of the healthcare system and general social-economic development. The reasons are as follows:
First, these data precede results, not inputs. For example, the number of doctors and nurses per child is an input, it is related to child health, but positive/negative inputs do not necessarily mean that outcomes will be positive/negative. The U5MR clearly shows the extent to which these inputs achieve their goal.
The U5MR is closely related to some negative socio-economic factors (malnutrition, low immunization rates, poor maternal health, and education). Therefore, it is a strong indicator of inequality and systemic health problems.
At the same time, as many of these deaths are preventable, the rate reflects better than any other measure the lack of access to critical and essential quality health care, including family planning, antenatal and postnatal services, and disease prevention and case management.
For these and similar reasons, many global initiatives, mainly the United Nations Global Strategy for Women’s Children’s and Adolescents’ Health (2016–2030) [8] and the Sustainable Development Goals (SDG) [9], have set child survival goals to improve the U5MR.
In this chapter, we aim to examine the causes of death under the age of 5 and the methods of prevention.
In LMICs, maternal and neonatal diseases, respiratory infections and tuberculosis, enteric and other infections, and malaria are the leading causes of under-five mortality. While in high-income countries, complex neonatal conditions such as prematurity top the list of causes of under-five mortality, in LMICs, infectious diseases still rank high among causes of death.
Since the decline in NMR has not been achieved to a similar extent as in U5MR, the rate of deaths due to maternal and neonatal diseases among under-five mortality has increased recently, especially in high-income countries. In one study, the two most common causes of death in the neonatal period in LMICs were perinatal asphyxia and severe infections such as sepsis, meningitis, and pneumonia [10]. Approximately 23% of the 2.5 million annual infant deaths in the neonatal period are related to infections [7]. Deaths are due to complications associated with prematurity account for about one-fifth of neonatal deaths in these countries. These three causes account for 90% of total neonatal deaths in LMICs [11].
Despite improvements in living conditions and increases in vaccination rates, respiratory infections are the leading cause of under-five death after neonatal diseases in LMICs. It is estimated that approximately 100 million pneumonia episodes occur annually under 5 [12]. With the increase in Pneumococcal conjugate and Haemophilus influenza type b vaccination, changes in the etiology of pneumonia have occurred recently. Among bacterial pathogens, non-type b Haemophilus influenza and Staphylococcus aureus are more common, whereas RSV stands out among viral pathogens. Although less common, CMV pneumonia can be fatal in HIV-infected and immunosuppressed patients [12].
Within this group of diseases, tuberculosis occupies a special place in LMICs. About a quarter of the world’s population is infected with Mycobacterium tuberculosis, which is not always easy to treat with its extrapulmonary involvement and resistant strains [13]. About half of all people with tuberculosis live in eight countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines, and South Africa [14]. In 2019, there were a total of 50,000 deaths due to tuberculosis in children under 5 years of age [15].
Enteral infections are the leading cause of death in children under 5 years among all infections, causing 1.5–2 million deaths per year [16, 17]. In LMICs, there are six episodes of diarrhea per year in infants and three episodes per year in children [18]. Rotavirus, Cryptosporidium, Shigella, and enterotoxigenic Escherichia coli (ETEC) are the most common pathogens observed in the moderate and severe diarrheal disease under 5 years of age in LMICs [19]. In the past, severe dehydration and fluid loss were the main causes of death from diarrhea. Other causes, such as septic bacterial infections, are now increasingly responsible for all diarrheal deaths [20].
Infection with Plasmodium falciparum potentially is fatal and most commonly manifests as a nonspecific febrile illness often without localizing signs. About 635,000 deaths from malaria occurred in LMICs in 2019, of which more than 50% were children under 5 years of age [14]. Moreover, malaria in pregnancy leads to fetal growth retardation, low birth weight, and later malaria infection in the infant, which increases neonatal mortality [21, 22]. In sub-Saharan Africa, a region at high risk of malaria, peripheral malaria is detected in the blood of about half of pregnant women during antenatal care [23].
In addition to these main causes, some factors increase the frequency and treatability or mortality of these diseases. The Covid-19 pandemic, which has been ongoing for about two years, has placed a heavy burden on the health care system. A survey by UNICEF conducted in 77 countries shows that almost 68 percent of countries reported slight reductions in health checks and immunizations for children. In addition, 63 percent of countries reported interruptions in antenatal checkups and 59 percent in postnatal care [24]. In regions with a high burden of HIV, malaria, and tuberculosis, the Covid-19 pandemic may increase HIV-related deaths by 10%, tuberculosis-related deaths by 20%, and malaria-related deaths by up to 36% over 5 years [7].
Some other exacerbating underlying factors include food insecurity, inadequate feeding practices, household air pollution, lack of hygiene, and access to safe water or adequate sanitation.
While the U5MR was about 85 per 1000 live births worldwide in 1990, it dropped to 38 per 1000 live births by 2019, a decline of over 50%. According to 2019 data, the global NMR was 17 per 1000 live births. While this rate was 11 per 1000 for children aged 1 month to 1 year, it was 10 per 1000 for children aged 1–5 years. The gap between the highest and lowest regional U5MR narrowed from 171 deaths per 1000 live births in 1990 to 73 in 2019. In 1990, the number of countries with a mortality rate above 100 per 1000 live births was over 50, while this number has dropped to 5 in 2019. Variation in NMR and U5MR in LMICs by year is shown in Figures 2–5.
Number of under-5 deaths between 1990 and 2019. Data were obtained from the healthdata.org website.
U5MR between 1990 and 2019. Data were obtained from the
Number of neonatal deaths between 1990 and 2019. Data were obtained from the
NMR between 1990 and 2019. Data were obtained from the
Despite these developments, U5MR in low-income countries remains high. These countries are all located in sub-Saharan Africa. In sub-Saharan Africa, the region with the highest U5MR, one in 13 children does not reach the age of five. This rate is 15–20 times higher than in developed countries. Of the 37 countries in this region, 31 have a high mortality rate (U5MR above 50 per 1000 live births). Although sub-Saharan Africa and Central and South Asia account for about 50% of children under 5, 80% of all under 5 deaths in 2019. On a country basis, nearly half of under-five deaths in 2019 occurred in five countries: Nigeria, India, Pakistan, the Democratic Republic of the Congo and, Ethiopia. Nigeria and India alone account for nearly a third. The alteration of mortality rates by regions over time is shown in Figure 6.
U5MR (deaths per 1000 live births) by regions, 1990, 2000, and 2019 [
When evaluating neonatal mortality, sub-Saharan Africa has the highest rate in 2019 (27 per 1000), followed by Central and South Asia (24 per 1000). Nearly 80% of neonatal deaths in 2019 occurred in these two regions. From 1990 to 2019, sub-Saharan Africa was the only SDG region without a decline in neonatal mortality due to the relatively low decrease in NMR and increase in the birth rate. In this period, newborn deaths did not decline in 21 of 48 countries in sub-Saharan Africa, and the total number of newborn deaths remained stable at about 1 million per year.
The difference between the sexes has tended to narrow over time in under-five mortality. In general, the risk of death is higher for boys under the age of 5 than for girls. However, due to regional risks, the mortality rate of girls is much higher than expected in some countries. These countries are located in the South and West Asia. After 1990, there were similar developments in this area, and the number of countries with higher than expected girl mortality dropped from 25 to 7.
The SDG aims to finish under-five mortality from preventable causes by reducing the NMR to 12 and below per 1000 live births and the U5MR to 25 and below per 1000 live births by 2030. If the current trend in under-five mortality continues, 27 percent of the 195 countries evaluated in the latest UNICEF report will not meet the SDG target. Achieving the 2030 target requires high-level efforts and a focus on child mortality in the remaining 53 countries. All these countries are in the status of LMICs. In light of current data, it is estimated that 48 million children under the age of 5 will die between 2020 and 2030. Nearly 80% of these deaths are expected to occur in sub-Saharan Africa and Central and South Asia, where almost all of the countries they host are LMICs. Moreover, if current trends continue, it does not seem possible for nearly 90% of sub-Saharan African countries to reach the neonatal mortality target of the SDG [7].
Access to life-saving interventions is at the forefront of consistently reducing mortality in LMICs. Examining the main causes of under-five deaths in these countries, it is observed that care during and after birth, vaccinations, and preventive and therapeutic services in early childhood play a crucial role [25]. An analysis conducted in 118 LMICs found that disrupting access to basic life-saving interventions could cause millions of under-five deaths in as little as six months [26]. We can consider protective interventions under several headings:
Due to the increase in the birth rate and the dependence of mother-infant life on basic life-saving interventions, prenatal, natal and postnatal care is a priority issue in LMICs. At this point, comprehensive prenatal care, skilled and rapid care during childbirth, regular postnatal care for mother and child, and high-quality and adequate care for premature and sick newborns should be the goal. For reasons other than congenital anomalies causing one in 10 neonatal deaths [27], the following precautions should be taken:
Home visits during pregnancy can play an active role in reducing NMR. A large-scale study in India has shown that antenatal care provided by Accredited Social Health Activists significantly reduces infant mortality rates under 1-year-old [28]. All pregnant women should be visited by experienced teams at least four times during pregnancy, including one visit in the first trimester. At these visits, preeclampsia and eclampsia can be diagnosed and treatment initiated in appropriate cases. In addition, these visits provide an opportunity to start folic acid and iron supplements that improve fetal health and to test for HIV, which is at risk of transmission from mother to fetus. Home visits can also help ensure that adequate precautions are taken in areas where malaria is common. Tetanus vaccinations recommended during pregnancy can be given during these visits. Finally, these visits can encourage pregnant women to deliver in the hospital and provide information about birth complications and nutrition.
Facility-based delivery should be provided to all pregnant women and, expectant mothers should be encouraged in this regard. Basic hygiene rules such as hand washing, sterile cord-cutting, and cord care should be followed in these facilities. To achieve this, using clean delivery kits (CDK) should be expanded for both home and facility deliveries. The use of CDK containing soap, gloves, cord ties, and other sterile equipment has been shown to reduce neonatal mortality and neonatal tetanus in studies in LMIC countries [29, 30, 31]. Drugs (oxytocin, etc.) and materials (partograph, etc.) used in the active management of labor should also be available. In communities where access to facilities is not possible, the number of staff with basic emergency obstetric and newborn care (BEmONC) training should be increased. However, a fast and safe referral and transport system should be ready in case of complications where the capabilities and knowledge of these staff may be inadequate. The purpose of this transportation is to transport the patient to facilities where comprehensive emergency obstetric and newborn care (CEmONC) can be provided.
In the postnatal period, attention should be paid to hypothermia and allow the mother to feed her baby within the first hour of life. It should be ensured that the mother and newborn stay in the facility for the first 24 hours, and an early postnatal visit should be scheduled to recognize the danger signs. In cases of suspected or proven infection, neonates should be treated with antibiotics, and newborns at risk should be followed up in neonatal intensive care units with adequate personnel and equipment.
Vaccination is an essential component of primary health care and an indisputable human right. Also, it is the single most effective prevention method for reducing mortality in children under 5. The following vaccines are at the forefront of preventing early childhood deaths: measles, polio, diphtheria, tetanus and pertussis, Haemophilus influenza type B, pneumococcal, and rotavirus vaccines. Reaching large populations with effective community health programs is crucial for vaccination success. Despite significant advances in immunization, too many children worldwide—including around 20 million infants each year—do not have adequate access to vaccines [32].
Since it is more difficult to diagnose tuberculosis (TB) in childhood, prevention may be more feasible than cure. At this point, neonatal use of the BCG vaccine, which is still the only vaccine against tuberculosis, could be the solution. Neonatal administration of BCG has been associated with a lower prevalence of TB disease [33].
Access to antibiotics and antimalarial to treat diarrhea, malaria, and lower respiratory tract infections also contribute to reducing child mortality. In diarrhea, oral rehydration solution and zinc supplementation help reduce mortality.
Community health workers play a vital role in providing health care to underprivileged communities. Public health workers organize public education programs, especially in the field of preventive health services. The performance of these workers is critical to increasing vaccination and breastfeeding rates, disseminating malaria prophylaxis devices such as insecticide-treated bed nets, and improving hygiene behaviors.
Studies in rural areas of three LMICs found that proximity to health facilities was a significant risk factor for infant, child, and general under-five mortality [34, 35, 36]. Similarly, a meta-analysis found that a distance of over 5 km from the health facility can increase mortality by up to 60% in newborns and children under five years of age [37]. In these and similar situations, governments should eliminate inequality of opportunity among communities and ensure access to health services for all. For example, maternity waiting homes, initiated under the leadership of the World Health Organization (WHO), can be expanded for pregnant women with limited access to facilities.
The integrated management of childhood diseases, in collaboration with national and international organizations, will help to address regional and cross-national disparities and share experience and knowledge. Finally, it is essential to build a people-centered and high-quality health system to implement all these preventive measures. At the same time, families’ desire for medical care and behavior to seek medical help when their children are ill should be encouraged.
Encouraging breastfeeding is a practical and cost-effective method of preventing early childhood deaths. However, about two out of three infants do not have access to exclusive breastfeeding for 6 months. Breast milk provides all the energy and nutrients a baby needs in the first months of life, and continues to meet at least one-third of the baby’s nutritional needs during the second half of the first year [38]. Breastfeeding not only improves the child’s nutrition but also protects the child from the dirty water used in food preparation and cleaning kitchen utensils. Vitamin A supplementation should be encouraged as it has been proven to reduce the risk of illness and death from measles and diarrhea. Access to clean water and ensuring hygiene will be particularly effective in reducing the incidence of diarrheal diseases. Screening for acute malnutrition allows early detection of cases with a risk for mortality.
The U5MR has been significantly reduced over the last 30 years through concerted action and resource allocation. The next goal of countries achieving the SDG targets should be to ensure the protection of children by eliminating inequalities that arise for reasons such as household income, race and ethnicity, and subnational division. While there are some developments in child health globally, 75% of countries failing to meet the SDG targets are found in sub-Saharan Africa clearly showing the inequality that children face in terms of their chances of survival due to birthplace. These inequalities are exacerbated in times of crisis, such as the Covid-19 pandemic, and have an even more negative impact on vulnerable children [39]. Attention should be given to sub-Saharan Africa, where mortality rates are highest in all age groups and the population continues to grow, considering that 11 million children could be saved by 2030 if all countries achieve the SDG targets.
On the other hand, newborns, whose mortality rate is declining more slowly than other age groups and therefore continues to increase their share in the under-five mortality rate, also deserve special attention. Moreover, it is more difficult to reduce the number of deaths during this period due to the establishment of more advanced health care facilities and the need for quality health care services over a longer time, beginning with the antenatal period. In addition to these, it is necessary to provide adequate health services during childbirth and in the early postnatal period. These services, along with NMR, will also reduce maternal mortality rates, the risk of stillbirths, and disability.
When we look at under-five deaths as a whole, it is essential that evidence-based life-saving interventions are accessible and accepted in the community. In addition, the impact of contextual factors such as female empowerment, nutrition, and health system resources should not be ignored in achieving success.
Another issue that should not be ignored in child mortality is the reliability of the data. In resource-poor areas, deaths may not be reported, or the cause of death may not be identified. This information may not be made available to national authorities and international health organizations promptly. Therefore, there is a need for a high-level integrated database at local, national, regional, and global levels, especially for under-five mortality data.
In summary, ending preventable child deaths is only possible by improving access to well-equipped health care professionals during pregnancy and childbirth, life-saving interventions such as vaccinations, breastfeeding, and the provision of low-cost medicines, and access to water and sanitation, which are now lacking in low-income countries.
We believe financial barriers should not prevent researchers from publishing their findings. With the need to make scientific research more publicly available and support the benefits of Open Access, more and more institutions and funders are dedicating resources to assist faculty members and researchers cover Open Access Publishing Fees (OAPFs). In addition, IntechOpen provides several further options presented below, all of which are available to researchers, and could secure the financing of your Open Access publication.
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\\n\\nThe application process is open after your submitted manuscript has been accepted for publication. To apply, please fill out a Waiver Request Form and send it to your Author Service Manager. If you have an official letter from your university or institution showing that funds for your OA publication are unavailable, please attach that as well. The Waiver Request will normally be addressed within one week from the application date. All chapters that receive waivers or partial waivers will be designated as such online.
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\n\nThe first step in obtaining funds for your Open Access publication begins with your institution or library. IntechOpen’s publishing standards align with most institutional funding programs. Our advice is to petition your institution for help in financing your Open Access publication.
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\n\nPlease consult our Open Access Funding page to explore some of these funding opportunities and learn more about how you could finance your IntechOpen publication. Keep in mind that this list is not definitive, and while we are constantly updating and informing our Authors of new funding opportunities, we recommend that you always check with your institution first.
\n\nFor Authors who are unable to obtain funding from their institution or research funding bodies and still need help in covering publication costs, IntechOpen offers the possibility of applying for a Waiver.
\n\nOur mission is to support Authors in publishing their research and making an impact within the scientific community. Currently, 14% of Authors receive full waivers and 6% receive partial waivers.
\n\nWhile providing support and advice to all our international Authors, waiver priority will be given to those Authors who reside in countries that are classified by the World Bank as low-income economies. In this way, we can help ensure that the scientific work being carried out can make an impact within the worldwide scientific community, no matter where an Author might live.
\n\nThe application process is open after your submitted manuscript has been accepted for publication. To apply, please fill out a Waiver Request Form and send it to your Author Service Manager. If you have an official letter from your university or institution showing that funds for your OA publication are unavailable, please attach that as well. The Waiver Request will normally be addressed within one week from the application date. All chapters that receive waivers or partial waivers will be designated as such online.
\n\nDownload Waiver Request Form
\n\nFeel free to contact us at funders@intechopen.com if you have any questions about Funding options or our Waiver program. If you have already begun the process and require further assistance, please contact your Author Service Manager, who is there to assist you!
\n\nNote: All data represented above was collected by IntechOpen from 2013 to 2017.
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He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}}]}},subseries:{item:{id:"86",type:"subseries",title:"Business and Management",keywords:"Demographic Shifts, Innovation, Technology, Next-gen Leaders, Worldwide Environmental Issues and Clean Technology, Uncertainty and Political Risks, Radical Adjacency, Emergence of New Business Ecosystem Type, Emergence of Different Leader and Leader Values Types, Universal Connector, Elastic Enterprise, Business Platform, Supply Chain Complexity",scope:"