Neonatal sepsis and its associated factors in East Africa: a systematic review and meta-analysis, 2019

Abstract

Background: Neonatal sepsis is one of the most leading causes of inflated death and illness of neonates. Different primary studies in Eastern Africa showed the burden of neonatal sepsis. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of neonatal sepsis from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result: A total of 26 studies with 11239 participants were used for analysis. The pooled prevalence of neonatal sepsis in East Africa was 29.65% (95% CI; 23.36–35.94).Home delivery(AOR =2.67; 95% CI: 1.15-4.00; I2= 0.0%; P=0.996), maternal history of UTI (AOR=2.083; 95% CI :0.24-3.93; I2= 69.1%; P=0.001),gestational age (preterm) (AOR=1.56; 95% CI: 1.04-2.08; I2= 27.8%;P=0.000) ,prolonged labor (AOR=3.23 ;95% CI: -0.04-6.51; I2= 62.7%; P=0.020) and PROM (AOR= 1.95; 95% CI: 0.53-3.37; I2= 43.2%; P=0.062) were identified factors of neonatal sepsis. Conclusions: The prevalence of neonatal sepsis in Eastern Africa remains high. This review may help policy-makers and program officers to design neonatal sepsis preventive interventions. Keywords: Neonatal sepsis, Eastern Africa

Prevalence and Predictors of Neonatal Sepsis among Neonates Admitted at the Newborn Unit of Kenyatta National Hospital, Nairobi, Kenya

“…The primary objective of this study was to determine the prevalence and predic- The high prevalence of neonatal sepsis found in this study is expected due to the fact that the study area is a national referral hospital, which receives neonates with severe complications as well as complicated pregnancies. Similar to our findings, a systematic review and meta-analysis conducted in East Africa found a prevalence of neonatal sepsis of 29.7% [25]. The prevalence of neonatal sepsis in the current study is lower than findings from Ethiopia at 45% [5], Tanzanian at [8], Cameroon at 37.9% [6] and Nigeria at 37.6% [7].…”

Knowledge, attitude and practice of home management of diarrhea among under-five children in East Africa: A systematic review and meta-analysis

“…Table 1 summarizes the characteristics of the 19 included studies in this systematic review and meta-analysis. Twelve studies were from Ethiopia, [32][33][34][35][36][37][38][39][40][41] three from Kenya, one from Rwanda, one from South Sudan, and two from Uganda (Table 1).…”

“…The third and fourth (AW and FG) authors checked the correctness of the data independently. Any disagreements between reviewers were resolved through discussions with third and fourth reviewers when required [37,38]. The mistyping of data was resolved through crosschecking with the included papers.…”

Trends and spatial distribution of neonatal sepsis, Uganda, 2016–2020

“…Generally, an increasing number of districts showed incidence rates in the highest category (≥ 47.0/1,000 LB) from 2016 to 2020. The highest number of districts [8] with incidences > 47.0 cases/1,000 LB occurred in 2020, and included three districts (Gulu, Agago, Arua) from Northern Region, three from Western Region (Mbarara, Hoima, Kitagwenda), one from Central Region (Mityana), and one from Eastern Region (Kapchorwa) (Fig. 3).…”

“…In resource-rich settings with lower neonatal death rates, approximately 9-15% of neonatal deaths are due to sepsis, whereas in resourcelimited settings like Africa with high neonatal death rates, sepsis accounts for 23-27% of neonatal deaths [7]. Risk factors for neonatal sepsis include prematurity, low birth weight (< 2.5 kg), premature rupture of membranes, prolonged labour, caesarean section delivery, maternal infection, and lack of antenatal care [5,[8][9][10]. Home births and lack of skilled birth attendants are also associated with increased risk of neonatal sepsis [11].…”