Determinants of neonatal sepsis among neonates admitted to the neonatal intensive care unit of public hospitals in Hawassa City Administration, Sidama Region, Ethiopia, 2020: an unmatched, case–control study

Abstract

ObjectiveThis study was conducted to assess the determinants of neonatal sepsis in the neonatal intensive care units of public hospitals in Hawassa City Administration, Sidama Region, Ethiopia, in 2020.DesignInstitutional-based, unmatched, case–control study.SettingThe study was conducted in three public hospitals (Hawassa University Teaching Hospital, Adare General Hospital and Hawela Tula Primary Hospital) of Hawassa City, Ethiopia.ParticipantsA total of 331 (110 cases and 221 controls) neonates with their index mothers were included in the study from 1 August to 30 September 2020.Outcome measuresA pretested, interviewer-administered questionnaire and data extraction checklist were used to collect data. Data were coded and entered into EpiData V.3.1 before being exported to SPSS V.20 for analysis. The factors associated with neonatal sepsis were assessed using bivariable and multivariable logistic regression analyses. P value of less than 0.05 was used to establish statistically significant association of variables.ResultsCaesarean section delivery (adjusted OR (AOR)=2.56, 95 % CI 1.3 to 5.00), maternal anaemia (AOR=2.58, 95 % CI 1.45 to 4.6) and lack of vaccination with tetanus toxoid (AOR=3.5, 95% CI 2.07 to 6.19) were all identified as factors significantly associated with neonatal sepsis.ConclusionsCaesarean section delivery, maternal history of anaemia and lack of vaccination with tetanus toxoid were found to be risk factors for neonatal sepsis. Establishing preconception care practice, strengthening the quality of antenatal care and standardising infection prevention practice are needed to improve neonatal health.

Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

“…The maternal factors were history of urinary tract infection in the mother (13 studies) ( 31 , 45 , 53 , 55 , 56 , 61 , 62 , 65 , 66 , 68–71 ), parity (10 studies) ( 31 , 45 , 48 , 53 , 56 , 61 , 62 , 65 , 67 , 68 ), prolonged labor (5 studies) ( 31 , 53 , 62 , 69 , 73 ), intrapartum fever (13 studies) ( 31 , 45 , 48 , 52 , 55 , 56 , 61 , 64 , 66 , 68 , 70 , 72 , 73 ), multiple vaginal examinations (7 studies) ( 45 , 53 , 61 , 64 , 66–68 ), performance of ANC (13 studies) (45, 48, 50, 55, 61, 64, 65, 67–71), prolonged rupture of membranes (18 studies) ( 31 , 33 , 45 , 46 , 52 , 53 , 56 , 61 , 62 , 65–73 ), and mode of delivery (14 studies) ( 31 , 32 , 35 , 44 , 46 , 48 , 52 , 61 , 62 , 64 , 66–68 …”

“…A total of 39 studies were included in our review: 32 studies of neonatal sepsis and 7 studies of maternal sepsis. There were 24 crosssectional studies (22, 30-34, 44-60), 13 case-control studies (28,35,(61)(62)(63)(64)(65)(66)(67)(68)(69), and 2 cohorts (29, 70).…”

Determinants of neonatal sepsis among neonates admitted to neonatal intensive care units in ethiopian hospitals: A systematic review and meta-analysis

“…T his systematic review and meta-analysis include a total of nineteen studies, out of which ten follow a case-control design [ 9 , 11 , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] ], while the remaining studies are cross-sectional [ 10 , 12 , 14 , 15 , [33] , [34] , [35] , [36] , [37] ]. Six studies were conducted in the Amhara region [ 9 , 10 , 14 , 25 , 35 , 36 ], four in Oromia [ 12 , 28 , 29 , 33 ], four in the southern nation nationalities and peoples of the region (SNNPR) [ 26 , 27 , 30 , 34 ], two in Sidama [ 31 , 32 ], and one each in Somali [ 37 ], one from Harari [ 15 ], and one Tigray [ 11 ]. The total sample size across the original studies included in this meta-analysis is 6190.…”

“…Five studies were used to determine the association between mode of delivery and neonatal sepsis [ 10 , 12 , 14 , 15 , 32 ]. The pooled odds ratio (OR: 1.51, 95 CI: 0.79–2.87) showed cesarean section delivery is not associated with neonatal sepsis.…”

Bone and joint infection complicated with sepsis in neonates and infants under three months of age

“…Previous studies have indicated risk factors of sepsis in neonates, including prematurity, low birth weight and cesarean delivery. 7 , 25 , 26 Due to the immature skin barrier, underdeveloped immune regulatory systems, delayed start of breastfeeding, the risk of nosocomial transmission in prolonged hospitalization, less skin-to-skin contact, and frequent need for invasive procedures, infants with these risk factors are susceptible to infection at an increased rate. 27 , 28 The risk could be exacerbated further due to the underlying disease of the mother during pregnancy.…”