Time to death and its predictors among neonates who were admitted to the neonatal intensive care unit at tertiary hospital, Addis Ababa, Ethiopia: Retrospective follow up study (original) (raw)

Abstract

Background: In spite of recent advances in health care, neonatal sepsis is still one of the major causes of morbidity and mortality in neonates and is an ongoing major global public health challenge. Its incidence of mortality varies from health institution to health institution and within the same health institution at varied times and depends on predisposing factors. So the aim of this study was to determine the time to death and its predictors among neonates admitted with neonatal sepsis. Methods: An institutional based retrospective cohort study was conducted among 500 randomly selected neonatal charts. The data was entered using Epi data version 3.1, and exported to and analyzed at STATA version 14. Bivariable and multivariable cox regression analysis were conducted to identify predictors of mortality. Association was summarized using adjusted hazard ratio (AHR) and statistical signi cances were declared at 95% CI and P-value <0.05. Proportionality assumption was tested by global test based on Schoenfeld residuals analysis. Results: During the follow up time, 58 (11.6%) neonates were died with neonatal sepsis while the rest were censored. In this study the overall death incidence rate was 20.5 per 1000 neonate days.

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References (27)

  1. Dessu S, Habte A, Melis T, Gebremedhin M. Survival Status and Predictors of Mortality among Newborns Admitted with Neonatal Sepsis at Public Hospitals in Ethiopia. International Journal of Pediatrics. 2020;2020:8327028.
  2. Gebremedhin D, Berhe H, Gebrekirstos K. Risk Factors for Neonatal Sepsis in Public Hospitals of Mekelle City, North Ethiopia, 2015: Unmatched Case Control Study. PLOS ONE. 2016;11(5):e0154798.
  3. Goldstein B, Giroir B, Randolph A, Sepsis MotICCoP. International pediatric sepsis consensus conference: De nitions for sepsis and organ dysfunction in pediatrics*. Pediatric Critical Care Medicine. 2005;6(1):2-8.
  4. Huynh B-T, Kermorvant-Duchemin E, Herindrainy P, Padget M, Rakotoarimanana FMJ, Feno H, et al. Bacterial infections in neonates, Madagascar, 2012-2014. Emerging infectious diseases. 2018;24(4):710.
  5. Ansari S, Nepal HP, Gautam R, Shrestha S, Neopane P, Chapagain ML. Neonatal septicemia in Nepal: early-onset versus late-onset. International journal of pediatrics. 2015;2015.
  6. Chiabi A, Djoupomb M, Mah E, Nguefack S, Mbuagbaw L, Zafack J, et al. The clinical and bacteriogical spectrum of neonatal sepsis in a tertiary hospital in Yaounde, Cameroon. Iranian Journal of Pediatrics. 2011;21(4):441.
  7. Organization WH. Every newborn: an action plan to end preventable deaths. 2014. . Ambey R, Gupta R. Committing to Child Survival: A Promise Renewed-Progress Report 2013. Australasian Medical Journal (Online). 2014;7(2):136.
  8. Demographic CE. Health Survey-2011. Central Statistical Agency Addis Ababa. Ethiopia ICF International Calverton, Maryland, USA. 2012. 2016.
  9. Shaha CK, Dey SK, Shabuj KH, Chisti J, Mannan M, Jashimuddin M, et al. Neonatal sepsis a review. Bangladesh Journal of Child Health. 2012;36(2):82-9.
  10. Tiru B, DiNino EK, Orenstein A, Mailloux PT, Pesaturo A, Gupta A, et al. The Economic and Humanistic Burden of Severe Sepsis. PharmacoEconomics. 2015;33(9):925-37.
  11. Ranjeva SL, Warf BC, Schiff SJ. Economic burden of neonatal sepsis in sub-Saharan Africa. BMJ global health. 2018;3(1).
  12. Freitas F, Araujo A, Melo M, Romero G. Late-onset sepsis and mortality among neonates in a Brazilian Intensive Care Unit: a cohort study and survival analysis. Epidemiology & Infection. 2019;147.
  13. Kayange N, Kamugisha E, Mwizamholya DL, Jeremiah S, Mshana SE. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania. BMC pediatrics. 2010;10(1):39.
  14. Mugalu J, Nakakeeto M, Kiguli S, Kaddu-Mulindwa DH. Aetiology, risk factors and immediate outcome of bacteriologically con rmed neonatal septicaemia in Mulago hospital, Uganda. African health sciences. 2006;6(2):120-6.
  15. Shobowale E, Ogunsola F, Oduyebo O, Ezeaka V. A study on the outcome of neonates with sepsis at the Lagos University Teaching Hospital. International Journal of Medicine and Biomedical Research. 2015;4(1):41-9.
  16. Motara F, Ballot DE, Perovic O. Epidemiology of Neonatal Sepsis at Johannesburg Hospital. Southern African Journal of Epidemiology and Infection. 2005;20(3):90-3.
  17. Bitew ZW, Alemu A, Ayele EG, Jember DA, Haile MT, Worku T. Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. International journal of pediatrics. 2020;2020.
  18. Alam MM, Saleem AF, Shaikh AS, Munir O, Qadir M. Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan. The Journal of Infection in Developing Countries. 2014;8(01):067-73.
  19. Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatric Clinics of North America. 2013;60(2):367.
  20. Setiawan C. Background Paper 6.23 Neonatal Conditions. Priority Medicines for Europe and the World A Public Health Approach to Innovation. 2013:1-50.
  21. Meshram RM, Gajimwar VS, Bhongade SD. Predictors of mortality in outborns with neonatal sepsis: A prospective observational study. Nigerian Postgraduate Medical Journal. 2019;26(4):216.
  22. Kardana IM. Incidence and factors associated with mortality of neonatal sepsis. Paediatrica Indonesiana. 2011;51(3):144-8.
  23. Jumah DS. Predictors of mortality outcome in neonatal sepsis. The Medical Journal of Basrah University. 2007;25(1):11-8.
  24. Bharad RV, Singh CS, Singh LR. Risk factors and immediate outcome of early onset neonatal sepsis. J Med Sci Res. 2017;5:21050-6.
  25. Gebrehiwot A, Lakew W, Moges F, Moges B, Anagaw B, Unakal C, et al. Predictors of positive blood culture and death among neonates with suspected neonatal sepsis in Gondar University Hospital, Northwest Ethiopia. European Journal of Experimental Biology. 2012;2(6):2212-8.
  26. Bandyopadhyay T, Kumar A, Saili A, Randhawa V. Distribution, antimicrobial resistance and predictors of mortality in neonatal sepsis. Journal of neonatal-perinatal medicine. 2018;11(2):145- 53.
  27. Liang L, Kotadia N, English L, Kissoon N, Ansermino JM, Kabakyenga J, et al. Predictors of Mortality in Neonates and Infants Hospitalized With Sepsis or Serious Infections in Developing Countries: A Systematic Review. Frontiers in Pediatrics. 2018;6(277).