Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya

Nabwera, Helen, Wang, Dingmei, Tongo, Olukemi O., Andang’o, Pauline E. A., Abdulkadir, Isa, Ezeaka, Chinyere V., Ezenwa, Beatrice N., Fajolu, Iretiola B., Imam, Zainab O., Mwangome, Martha K., Umoru, Dominic D., Akindolire, Abimbola E., Otieno, Walter, Nalwa, Grace M., Talbert, Alison W., Abubakar, Ismaela, Embleton, Nicholas D. and Allen, Stephen ORCID: https://orcid.org/0000-0001-6675-249X (2021) 'Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya'. PLoS ONE, Vol 16, Issue 1, e0244109.

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Abstract

Objective
To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria.
Study design
In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period.
Results
2280 newborns were admitted. Mean birthweight was 2.3 kg (SD 0.9); 57.0% (1214/2128)
infants were low birthweight (LBW; <2.5kg) and 22.6% (480/2128) were very LBW (VLBW; <1.5 kg). Median gestation was 36 weeks (interquartile range 32, 39) and 21.6% (483/2236) infants were very preterm (gestation <32 weeks). The most common morbidities were jaundice (987/2262, 43.6%), suspected sepsis (955/2280, 41.9%), respiratory conditions (817/ 2280, 35.8%) and birth asphyxia (547/2280, 24.0%). 18.7% (423/2262) newborns died; mortality
was very high amongst VLBW (222/472, 47%) and very preterm infants (197/483, 40.8%). Factors independently associated with mortality were gestation <28 weeks (adjusted odds ratio 11.58; 95% confidence interval 4.73–28.39), VLBW (6.92; 4.06–11.79),
congenital anomaly (4.93; 2.42–10.05), abdominal condition (2.86; 1.40–5.83), birth asphyxia (2.44; 1.52–3.92), respiratory condition (1.46; 1.08–2.28) and maternal antibiotics within 24 hours before or after birth (1.91; 1.28–2.85). Mortality was reduced if mothers
received a partial (0.51; 0.28–0.93) or full treatment course (0.44; 0.21–0.92) of dexamethasone before preterm delivery.
Conclusion
Greater efforts are needed to address the very high burden of illnesses and mortality in hospitalized newborns in sub-Saharan Africa. Interventions need to address priority issues during
pregnancy and delivery as well as in the newborn.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pone.0244109
Depositing User:	Rachel Dominguez
Date Deposited:	20 Jan 2021 14:29
Last Modified:	20 Jan 2021 14:29
URI:	https://archive.lstmed.ac.uk/id/eprint/16708

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