Survival Status of Infants with Congenital Anomalies in the Selected Hospitals, Addis Ababa, Ethiopia: A Retrospective Cohort Study
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Date
2021-05
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Addis Abeba University
Abstract
Background: Congenital malformations are a major health problem and highly contributed to
neonatal and child mortality in all Sub-Saharan Africa. However, there are limited and
inconsistent pieces of evidence on the survival status of congenital anomalies and their
determinants in Ethiopia.
Objective: to assess the probability of survivorship and its predictors in the first year of life
among babies with congenital anomalies.
Methods: A retrospective cohort study design was used among infants with congenital
anomalies in Black Lion Specialized Hospital and Zewditu Memorial Hospital in Addis Ababa,
registered from 2014 to 2017 which are referred from Addis Ababa region health facilities. Data
were collected by reviewing the registration book and interviewing parents by visiting their
homes using an electronic data collection tool. Data were analyzed using STATA version 14.
The actuarial life table and Kaplan Meier survival curve were analyzed to estimate time to death
with a log-rank test to compare survival time between groups. To identify independent predictors
Cox-proportional model was carried out and crude and adjusted hazard ratios with 95%
Confidence Interval (CI) were used to determine statistical significance.
Results: The overall survival probability of infants with congenital anomalies to 7 days, 28 days,
and 1-year was 70.3%, 50.0%, and 46.5%. Infant 1-year survival probability with nervous
system congenital anomalies had (40.9%), digestive system (42.5%), circulatory system
anomalies (43.3%), chromosomal system anomalies (60.0%), musculoskeletal system anomalies
(50.0%), respiratory system anomalies (75.0%), and urogenital system (93.3%). The median
survival time for those cases that died was 6 days. Survival of male infants and low birth weight
infants was significantly poorer survival and those infants who had surgical intervention were
significantly better survival.
Conclusion: Survival of infants with congenital anomalies to one year is low. Effective
interventions are required to focus on nutritional counseling, birth weight, and early surgical
intervention to improve the survival probability of infants with congenital anomalies.
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Keywords
Congenital anomalies, Survival Status, Infant, Addis Ababa