A Survey of Technology and Temperature Control on a Neonatal Unit in Kathmandu, Nepal

Johanson, R. B.; Malla, DS; Tuladhar, C.; Amatya, Mohan Prasad; Spencer, SA; Rolfe, P.

doi:10.1093/tropej/39.1.4

Cited by 18 publications

(13 citation statements)

References 18 publications

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“…Many studies revealed increased incidence (11-85%) of hypothermia among hospital and home-born newborn in South Asia, including Bangladesh, India, Pakistan, Bhutan and Nepal, as well as in developing countries with tropical climate 12 . For example, in Nepal, 85% of newborns in a maternity hospital had a temperature <36 0 C within 2 h of birth 13 . In Ethiopia, Zambia and Zimbabwe, one-half to two-thirds of newborns evaluated were hypothermic 12 .…”

Section: Discussionmentioning

confidence: 99%

Admission Hypothermia Among Neonates Presented to Neonatal Intensive Care Unit

Akter¹,

Parvin

Yasmeen

2013

J. Nepal Paedtr. Soc.

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Introduction:In developing countries, thermal protection of the newborn is not properly addressed. Neonates presented to Neonatal intensive care unit (NICU) for admission with various problems are frequently found to be hypothermic. The objective of this study was to determine the incidence and associated risk factors for neonatal hypothermia on admission to NICU. Materials and Methods: This was a prospective observational study carried over a period of three years at Enam Medical College and Hospital (EMCH) among the newborns admitted to NICU. Hypothermia has been defined as axillary temperature <36.5 0 C (<97.7 0 F). Temperature was measured at admission. Data were collected regarding perinatal and socio economic factors. Bivariate and multivariate analysis has been done to see the association of risk factors. Result: A total of 2310 babies between 0 and 680 h of age (mean 43± 12 hours) were studied. Thirty four percent (785) of the neonates had hypothermia. Mean gestation was 34±3 weeks and 42.5% were inborn.

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Section: Discussionmentioning

confidence: 99%

Admission Hypothermia Among Neonates Presented to Neonatal Intensive Care Unit

Akter¹,

Parvin

Yasmeen

2013

J. Nepal Paedtr. Soc.

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“…3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Uniform adoption and application of the standard WHO definition is fundamental to coordinated advancements in detection and management, but hypothermia continues to be variably defined, leading to under-recognition and under-reporting, and inadvertent denial of care to those who are misclassified but in need of care.…”

Section: Definitionmentioning

confidence: 99%

“…For example, in Nepal, 85% of newborns in a maternity hospital had a temperature <36 1C within 2 h of birth. 16 In Ethiopia, 56 Zambia 57 and Zimbabwe, 17 one-half to two-thirds of newborns evaluated were hypothermic. The incidence of primary hypothermiaFan independent morbidity that presents as a result of cold stressFis high immediately following birth in hospital settings.…”

Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

“…[11][12][13][14]16,20,[58][59][60] Few studies have addressed aspects surrounding the birth and postpartum care that can put the newborn at risk for hypothermia. 9,16,57,61 In one village-based study in India, 11% of 189 neonates were found to be hypothermic (<35.6 1C) based on a single temperature reading taken within the first 24 h after birth. Only 58% of newborns were wiped soon after delivery, the head was covered in 59% in winter and 11% in summer, no baby was kept skin-to-skin, and the room temperature was <24 1C in 41% of households.…”

Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

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Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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“…In our review, case fatality rates (CFR) for newborn hypothermia globally range from 8.5% to 52% [21,26,34,59,60]. A study from India that included only hypothermic babies specifically investigated morbidities and mortalities and found CFRs that ranged from 39.3% for mild hypothermia to 80% for severe hypothermia.…”

Section: Associations Of Hypothermia With Newborn Morbidity and Mortamentioning

confidence: 99%