Determinants of Neonatal Sepsis among Neonates Admitted to Public Hospitals in Central Ethiopia: Unmatched Case-control Study

Abstract

Background. Neonatal sepsis is the cause of substantial morbidity and mortality, mostly affecting the developing countries including Ethiopia. Previously conducted studies also highlighted the high prevalence of neonatal sepsis in Ethiopia. Therefore, this study was aimed at assessing the determinants of neonatal sepsis in the central Ethiopia. Method. Institution based un-matched case control study was conducted among 192 cases (neonates with sepsis) and 384 controls (without sepsis) in public hospitals in Central Ethiopia. The data were collected through face-to-face interview using structured questionnaire and extraction from maternal and neonatal charts. Binary logistic regression (bi-variable and multi-variable) model was fitted. Adjusted odds ratio with respect to 95% confidence interval was employed for the strength and directions of the association. Results. Younger maternal-age; 30 to 34 years (AOR = 0.41, 95%CI: 0.19-0.85) and 25 to 29 years (AOR = 0.38, 95%CI: 0.17-0.84), not having antenatal care (ANC) follow-ups (AOR = 1.89, 95%CI: 1.02-3.49), place of delivery; home (AOR = 12.6, 95%CI: 5.32-29.82) and health center (AOR = 2.74, 95%CI: 1.7, 4.41), prolonged duration of labor (AOR = 1.90, 95%CI: 1.22, 2.96), prolonged rupture of membrane 12 to 17 hours (AOR = 3.26, 95%CI: 1.46, 7.26) and ≥18 hours (AOR = 5.18, 95%CI: 1.98, 13.55) were maternal related determinants of neonatal sepsis. Whereas, prematurity (AOR = 2.74, 95%CI: 1.73, 4.36), being resuscitated (AOR = 1.93, 95%CI: 1.22, 3.06) and not having meconium aspiration syndrome (AOR = 2.55, 95%CI: 1.34, 4.83) were identified as neonatal related determinants of neonatal sepsis. Conclusion. Younger maternal age, not having antenatal care follow-up, home, and health center delivery, prolonged duration of labor, prolonged duration of rupture of membrane, prematurity, had resuscitation, and neonates without meconium aspiration syndrome were found to be determinants of neonatal sepsis. Therefore, the concerned stakeholders should consider those identified determinants during an intervention for improvement of neonatal health.

Admission Outcome and Antimicrobial Resistance Pattern of Bacterial Isolates among Neonates with Suspected Sepsis in Neonatal Intensive Care Unit at Dessie Comprehensive Specialized Hospital, Dessie, Northeastern Ethiopia

“…In agreement with this result, systematic review and meta-analysis in Ethiopia reported that maternal UTI during antenatal care demonstrated remarkable association with the development of neonatal sepsis [49]. Other similar studies in Ethiopia and Bangladesh also exhibited the UTI during pregnancy, prolonged rupture of membrane, place where delivery has done as potential predictor for the occurrence of neonatal septicemia [48,50,51].…”

“…In addition to the above-mentioned variables, maternal age below 35 years old, having history of UTI, assisted vaginal delivery and prolonged rupture of membrane greater than or equals to 18 hours are determinants for the bacterial infection among the neonates. Comparably, another study which was conducted in public hospitals in central Ethiopia showed younger maternal age had reduced likelihood of neonatal sepsis [48]. In the current study neonates born to mothers who had antenatal UTI showed 19 times higher odds of acquiring bacterial sepsis in comparison with their counterparts.…”

Factors associated with early onset neonatal sepsis among neonates in public hospitals of Sidama region, Southern Ethiopia, 2021: Unmatched case control study

“…The prevalence of neonatal sepsis in Ethiopia ranges from 17% to 78% [ 11 ]. The pooled prevalence of neonatal sepsis in Ethiopia was 45%, with early-onset neonatal sepsis accounting for 75.4% of cases [ 4 ].…”

“…Early-onset neonatal sepsis is still common in Ethiopia, and the major contributor to neonatal mortality and morbidity [ 4 , 11 ]. In developing countries like Ethiopia, neonatal sepsis is one of the main reasons for neonatal hospitalization and mortality [ [21] , [22] , [23] ].…”

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.…”