BackgroundBirth asphyxia is a leading cause of infant morbidity and mortality in developing nations, such as Ethiopia. Though Ethiopia has made considerable achievement in the reduction of under-five mortality rate, the neonatal mortality burden has not experienced the same reduction, which may be attributed to birth asphyxia. Thus, this study attempts to assess the prevalence and associated factors of birth asphyxia among newborns in public hospitals in the northeastern Amhara region, Ethiopia.MethodsAn institution-based cross-sectional study was conducted on 357 births from 1st April to 2nd May 2018. The sample size was proportionally allocated to randomly selected three public hospitals namely, Dessie referral hospital, Debre Berhan referral hospital, and Woldia general hospital. The allocation was made by taking the average number of deliveries given in each hospital six months before the data collection period. Using the delivery registration of hospitals a systematic random sampling technique was used to get all study participants. The diagnosis of birth asphyxia was confirmed based on the physician’s diagnosis of an APGAR score < 7 in the 1st and 5th minutes of birth. A pretested and structured questionnaire was used to collect data. Variables with p-values < 0.25 in the bivariable analysis were entered into a multivariable logistic regression analysis. A statistical significant level was declared at a p-value of <0.05.ResultsThe prevalence of birth asphyxia was found to occur 22.6% of the time [95% CI 19.2% - 26.4%] in the first minute of birth. In the multivariable logistic regression being primipara [AOR = 3.77: 95% CI 1.86, 7.65], presented with complicated labor [AOR = 3.45: 95% CI 1.58, 7.49], premature rupture of membrane [AOR = 3.85: 95% CI 1.76, 8.44) and having blood-stained amniotic fluid at birth [AOR = 5.02: 95% CI 1.69, 14.87] were the independent predictors of birth asphyxia.ConclusionThe study revealed that birth asphyxia is a common newborn complication in the Amhara region. Integrated mitigation measure to reduce neonatal mortality in the Amahar region should give due attention to primipara women and for these high-risk pregnancies in order for the region to achieve national and global commitment to have sustainable change in women and neonatal health.

Objectives: The aim was to assess the incidence of sink contamination by multidrug-resistant (MDR) Pseudomonas aeruginosa and Enterobacteriaceae, risk factors for sink contamination and splashing, and their association with clinical infections in the intensive care setting. Methods: A prospective French multicentre study (1 January to 30 May 2020) including in each intensive care unit (ICU) a point-prevalence study of sink contamination, a questionnaire of risk factors for sink contamination (sink use, disinfection procedure) and splashing (visible plashes, distance and barrier between sink and bed), and a 3-month prospective infection survey. Results: Seventy-three ICUs participated in the study. In total, 50.9% (606/1191) of the sinks were contaminated by MDR bacteria: 41.0% (110/268) of the sinks used only for handwashing, 55.3% (510/923) of those used for waste disposal, 23.0% (62/269) of sinks daily bleached, 59.1% (126/213) of those daily exposed to quaternary ammonium compounds (QACs) and 62.0% (285/460) of those untreated; 459 sinks (38.5%) showed visible splashes and 30.5% (363/1191) were close to the bed (<2 m) with no barrier around the sink. MDR-associated bloodstream infection incidence rates 0.70/1000 patient days were associated with ICUs meeting three or four of these conditions, i.e. a sink contamination rate 51%, prevalence of sinks with visible splashes 14%, prevalence of sinks close to the patient's bed 21% and no daily bleach disinfection (6/30 (20.0%) of the ICUs with none, one or two factors vs. 14/28 (50.0%) of the ICUs with three or four factors; p 0.016). Discussion: Our data showed frequent and multifactorial infectious risks associated with contaminated sinks in ICUs.

Background: Neonatal mortality is public health issue in developing countries, such as Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged. Subsequently, Afar in Ethiopia contributes the largest burden of under-five mortality when compared to other regions in the country. Regrettably, there is no current information to the rates and predictors of neonatal mortality for the region. Thus, this study aims to assess neonatal mortality and associated factors in pastoral communities residing in Afar, Ethiopia. Methods: A health facility based retrospective cross sectional study was conducted on 403 neonates admitted to the neonatal intensive care unit (NICU) from May 1 st 2015 - May 2nd 2019. Medical records were reviewed and audited for both mothers and neonates to collect data using standardized data extraction checklist. The medical records were selected using a systematic random sampling technique. Binary logistic regression with odds ratio and 95% Confidence interval was calculated to assess the association between neonatal mortality and associated factors. Finally, the statistical significance level was declared at a p-value <0.05. Results: 391 medical records of newborns were included with data complete rate of 97.02%. The prevalence of neonatal mortality was 14.6% (95% CI 11.0%-18.4%). Lack of antenatal care (ANC) follow up (AOR = 4.69: 95%CI 1.77, 12.47), giving birth through cesarean section (AOR 3.59, 95%CI 1.22, 10.55), having a temperature less than 36.5 o C within the first hour of admission (AOR 10.75, 95%CI 3.75, 30.80), perinatal asphyxia (AOR 7.16, 95%CI 2.22, 23.10) and/or having a length of stay greater than five days in the hospital (AOR 0.23, 95%CI 0.08, 0.66) were significantly associated with neonatal mortality. Conclusion: This study revealed that the rate of neonatal mortality is still too high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature with in the first hour of admission and perinatal asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention for improving antenatal cares, intra-partum cares and standardized cares for admitted neonates. Additional prospective studies are recommended.