Determinants of Neonatal Sepsis Admitted In Neonatal Intensive Care Unit At Public Hospitals Of Kaffa Zone, South West Ethiopia

Abstract

Background : Neonatal sepsis is a systemic inflammatory response syndrome in the presence of infection during the first 28 days of life. Globally every year about 4 million children die in the first 4 weeks of life, of which 99% of the deaths occur in low and middle income countries and the most common causes of neonatal death in Ethiopia. Identification of the determinants for neonatal sepsis and treatment of newborns with sepsis is not adequate in low income countries like Ethiopia especially in southern part of the country. Objective : To identify determinants of neonatal sepsis admitted in neonatal intensive care unit at public hospitals of Kaffa zone, south west Ethiopia 2021. Methods : Institutional based unmatched case control study was conducted on a total sample of 248 (62 cases and 186 controls) in public Hospitals of kaffa zone from March to April 2021.The collected data were entered, coded and cleaned by Epidata version 3.1 and it was exported to SPSS version 25. Bi-variable and multivariable logistic regression was conducted. Variables with (p< 0.25) in bi-variable logistic regression analysis, were entered to multivariable logistic regression and then determinants which is statistical significant will be declared at P<0.05. Result: A total of 248 (62 cases and 186 controls) were included in the study. variables like prolonged rupture of membrane >=18 hours [AOR =5.13, 95%CI=1.38-19.05], meconium stained amniotic fluid[AOR =6.03, 95%CI=2.16-16.90], intra-partum fever [AOR =8.26, 95%CI=3.12-21.97], urinary tract infections [AOR=14,55, 95%CI=4.91-43.10], breast feeding after a hour [AOR =3.9, 95%CI=1.27-12.02], resuscitation [AOR =13.25, 95%CI=3.44-51.01], no chlorohexidine application [AOR =4.27, 95%CI=1.65-11.08] were significantly associated with neonatal sepsis. Conclusion and Recommendation: Among the variables prolonged rupture of membranes, meconium stained amniotic fluid, intra-partum fever, UTI/STI, and not breast feeding with in a hour were maternal variables and resuscitation at birth and not application of chlorohexidine ointment on the umbilicus were neonatal variables that were found to be neonatal-related risk factors of neonatal sepsis. Infection prevention strategies and clinical management need to be strengthening and/or implementing by providing especial attention for the specified determinants.

Determinants of Neonatal Sepsis Among Neonates Admitted to Neonatal Intensive Care Units in Ethiopian Hospitals: A Systematic Review and Meta-Analysis

“…Eight of them are case-control by design [9,11,[25][26][27][28][29][30] where the rest are cross-sectional [10,12,14,15,[31][32][33]. Five of the included studies are from Amhara region [9,10,14,25,33] four from Oromia [12,28,29,31], four from southern nation nationalities and peoples of the region (SNNPR) [26,27,30,32], one from Harari [15] , and one Tigray [11]. The total sample size of original studies included in this meta-analysis is 4,895.…”

“…The association between neonatal sepsis and prolonged PROM was examined based on the result of seven studies [9][10][11]27,28,31,32]. This meta-analysis indicated that a neonate born from pregnant mothers having prolonged PROM had 4.03 (OR: 4.03, 95: CI: 1.88-8.60) times higher odds of neonatal sepsis than their counterparts.…”

“…The association between delayed breastfeeding and neonatal sepsis was examined based on the results from two studies [27,30]. The pooled odds ratio (OR: 3.41,95 CI: 2.18-5.35) revealed that delayed breastfeeding is associated with the onset of neonatal sepsis.…”