Prevalence of Sepsis and Possible Severe Bacterial Infection among Neonates in Nepal

Paudel

J Nepal Health Res Council

et al. 2018

Self Cite

Background: Nepal has made a significant progress in reducing child mortality. However, the annual rate of reduction in neonatal mortality is not satisfactory. As safeguarded by constitution of Nepal and to address neonatal mortality due to poverty and inequity, government has introduced free newborn care (FNC) package. This study aims to assess the status of FNC services in all the public hospitals.Methods: Child Health Division organized 5 workshops region-wise with the theme of newborn care services in March/April 2018 to cover all the public hospitals in the country. A template was designed comprising of duration of FNC implementation, number of newborns admitted since implementation, morbidities pattern, and number of babies served. It was circulated and all hospitals were advised to fill it and present in the review. Later, the data were compiled and analyzed.Results: Only 58 presentations out of 93 participated hospitals were included in this study. The total admitted cases were 8564 newborns. The common causes of admission were neonatal sepsis (44.5%) followed by asphyxia (14.29%) and hyperbilirubinemia (11.4%). A total of 1573 neonates received services of FNC package C, 3722 package B, 3081 received package A. The main challenges faced in implementation reported were lack of infrastructure and human resources to provide services and the reimbursement is not enough.Conclusions: Free newborn care is a new initiative taken to reduce neonatal mortality. This package is very helpful to serve sick newborns. However, the package should be revised taking into consideration the appropriate reimbursement and extra staffs to provide this service.

Section: Discussionmentioning

confidence: 99%

Free Newborn Care Services: A New Initiative in Nepal

Paudel

J Nepal Health Res Council

et al. 2018

Self Cite

“…Between 2001 to 2016, the neonatal mortality rate in Nepal declined from 39 to 21 deaths per thousand [10]. However, Neonatal infection is one of the leading causes of hospital admissions and neonatal deaths in Nepal [11][12][13]. The prevalence of neonatal infections ranges between 2 and 4% in Nepal [12], with 37.1% of infections occurring in neonatal intensive care units of tertiary referral hospital [11].…”

Section: Introductionmentioning

confidence: 99%

“…However, Neonatal infection is one of the leading causes of hospital admissions and neonatal deaths in Nepal [11][12][13]. The prevalence of neonatal infections ranges between 2 and 4% in Nepal [12], with 37.1% of infections occurring in neonatal intensive care units of tertiary referral hospital [11]. Previous study on exploring trends and determinants of neonatal mortality in Nepal identified several risk factors of neonatal mortality in Nepal [10].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of neonatal infections in hospitals of Nepal: evidence from a large- scale study

et al. 2020

Background: Every year, neonatal infections account for approximately 750,000 neonatal deaths globally. It is the third major cause of neonatal death, globally and in Nepal. There is a paucity of data on clinical aetiology and outcomes of neonatal infection in Nepal. This paper aims to assess the incidence and risk factors of neonatal infection in babies born in public hospitals of Nepal. Methods: This is a prospective cohort study conducted for a period of 14 months, nested within a large-scale cluster randomized control trial which evaluated the Helping Babies Breathe Quality Improvement package in 12 public hospitals in Nepal. All the mothers who consented to participate within the study and delivered in these hospitals were included in the analysis. All neonates admitted into the sick newborn care unit weighing > 1500 g or/and 32 weeks or more gestation with clinical signs of infection or positive septic screening were taken as cases and those that did not have an infection were the comparison group. Bivariate and multi-variate analysis of sociodemographic, maternal, obstetric and neonatal characteristics of case and comparison group were conducted to assess risk factors associated with neonatal infection. Results: The overall incidence of neonatal infection was 7.3 per 1000 live births. Babies who were born to first time mothers were at 64% higher risk of having infection (aOR-1.64, 95% CI, 1.30-2.06, p-value< 0.001). Babies born to mothers who had no antenatal checkup had more than threefold risk of infection (aOR-3.45, 95% CI, 1.82-6.56, p-value< 0.001). Babies born through caesarean section had more than twofold risk (aOR-2.06, 95% CI, 1.48-2.87, p-value< 0.001) and babies with birth asphyxia had more than threefold risk for infection (aOR-3.51, 95% CI, 1.71-7.20, p-value = 0.001). Conclusion: Antepartum factors, such as antenatal care attendance, and intrapartum factors such as mode of delivery and birth asphyxia, were risk factors for neonatal infections. These findings highlight the importance of ANC visits and the need for proper care during resuscitation in babies with birth asphyxia.

“…Between 2001 to 2016, the neonatal mortality rate in Nepal declined from 39 to 21 deaths per thousand [10]. However, Neonatal infection is one of the leading causes of hospital admissions and neonatal deaths in Nepal [11][12][13]. The prevalence of neonatal infections ranges between 2-4% in Nepal [12], with 37.1% of infections occurring in neonatal intensive care units of tertiary referral hospital [11].…”

Section: Neonatal Infection Is Manifested By Systemic Signs Of Infectmentioning

confidence: 99%

“…However, Neonatal infection is one of the leading causes of hospital admissions and neonatal deaths in Nepal [11][12][13]. The prevalence of neonatal infections ranges between 2-4% in Nepal [12], with 37.1% of infections occurring in neonatal intensive care units of tertiary referral hospital [11]. Previous study on exploring trends and determinants of neonatal mortality in Nepal identified several risk factors of neonatal mortality in Nepal [10].…”

Section: Neonatal Infection Is Manifested By Systemic Signs Of Infectmentioning

confidence: 99%

Epidemiology of neonatal infections in hospitals of Nepal: Evidence from a large- scale study

Budhathoki

Sunny²,

Paudel³

et al. 2019

Preprint

Introduction Every year, neonatal infections account for approximately 750,000 neonatal deaths globally. It is the third major cause of neonatal death, globally and in Nepal. There is a paucity of data on clinical aetiology and outcomes of neonatal infection in Nepal. This paper aims to assess the incidence and risk factors of neonatal infection in babies born in public hospitals of Nepal.Methods This is a prospective cohort study conducted for a period of 14 months, nested within a large-scale cluster randomized control trial which evaluated the Helping Babies Breathe Quality Improvement package in 12 public hospitals in Nepal. All the mothers who consented to participate within the study and delivered in these hospitals were included in the analysis. All neonates admitted into the sick newborn care unit weighing >1500 gram or/and 32 weeks or more gestation with clinical signs of infection or positive septic screening were taken as cases and those that did not have an infection were the comparison group. Bivariate and multi-variate analysis of socio-demographic, maternal, obstetric and neonatal characteristics of case and comparison group were conducted to assess risk factors associated with neonatal infection.Results The overall incidence of neonatal infection was 7.3 per 1000 live births. Babies who were born to first time mothers were at 59% higher risk of having infection (aOR-1.64, 95% CI, 1.30-2.06, p-value<0.001). Babies born to mothers who had no antenatal check-up had more than three-fold risk of infection (aOR-3.45, 95% CI, 1.82-6.56, p-value<0.001). Babies born through caesarean section had more than two-fold risk (aOR-2.06, 95% CI, 1.48-2.87, p-value<0.00) and babies with birth asphyxia had more than three-fold risk for infection (aOR-3.51, 95% CI, 1.71-7.20, p-value=0.001).Conclusion Antepartum factors, such as antenatal care attendance, and intrapartum factors such as mode of delivery and birth asphyxia, were risk factors for neonatal infections. These findings highlight the importance of ANC visits and the need for proper care during resuscitation in babies with birth asphyxia.