Pediatrics and Child Health

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Browsing Pediatrics and Child Health by Subject "East and West Gojjam, case control, neonate, sepsis,"

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    Predictors of neonatal sepsis in public referral hospitals of east and west Gojjam zones of Amhara regional state, north west Ethiopia: a case control study
    (Addis Ababa University, 2018-06) Yirga, Tadesse; Gebremichael, Bereket (BSc, MSc)
    Introduction: Globally, neonatal sepsis is one of the most leading reasons for inflated death and illness of neonates. It is also one of 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. Despite few studies related to neonatal sepsis there are inconsistencies among findings. Identification of risk factors and early initiation of therapy can significantly reduce the burden of neonatal death and illness. Objective: The main aim of this study was to assess predictors of neonatal sepsis in public referral hospitals of East and West Gojjam Zones in Amhara Region, North Ethiopia from March-April 2018. Methods: Institutional based unmatched case-control study was conducted among a total sample size of 231 (77 cases and 154 controls) in Debre Markos referral hospital and Felege Hiwot referral hospital from March 2018- April 2018. Neonates diagnosed as sepsis were considered as cases and neonates diagnosed with other problem except sepsis were controls. Study participants were selected from NICUs in the two referral hospitals. For each case two consecutive controls were selected by lottery method. Data was collected using structured pretested questionnaire through face to face interview with index mothers and by neonatal record review using checklists. It was entered into Epi data version 3.1 and exported to STATA/ SE software version 14. Finally, it was analyzed by logistic regression model. Variables with (p< 0.25) in bivariate analysis, were entered to multivariable logistic regression. Statistical significance was declared at P<0.05. Result: In this study, 77 cases and 154 controls with their mothers were included with the overall response rate of 100%. After multivariable logistic regression analysis, significantly associated variables with sepsis were; Number of maternal ANC service <3 (AOR=4.35, 95%CI=1.66-11.45), Duration of rupture of membrane > 18hours (AOR=10.37, 95%CI= 2.31-46.52), meconium stained amniotic fluid ( AOR =3.87, 95%CI=1.53-9.77), urinary tract infection during pregnancy (AOR=10.8, 95% CI=3.44-33.97), intranatal fever (AOR=3.19, 95% CI=1.07-9.47), first minute APGAR score <7 (AOR=3.17, 95% CI=1.30-7.71), resuscitation at birth (AOR= 5.35, 95% CI= 1.86-15.45), nasogastric tube (NGT) insertion (AOR=3.73, 95% CI=1.37-10.16). Conclusion: In this study, neonatal invasive procedures, neonatal and maternal variables were found to be significantly associated with the risk of neonatal sepsis. Therefore, Professionals should adapt risk based early recognition systems and implement standardized emergency treatments. Potential researchers on sepsis should include neonates in the community which may increase external a validity of the study.