Prospective observational study of the challenges in diagnosing common neonatal conditions in Nigeria and Kenya

Staunton, Aimee, Nabwera, Helen, Allen, Stephen ORCID: https://orcid.org/0000-0001-6675-249X, Tongo, Olukemi O, Akindolire, Abimbola E, Abdulkadir, Isa, Ezeaka, Chinyere V, Ezenwa, Beatrice N, Fajolu, Iretiola B, Imam, Zainab O, Umoru, Dominic D, Otieno, Walter, Nalwa, Grace M, Olwala, Macrine, Talbert, Alison W, Andang'o, Pauline E A, Mwangome, Martha K, Abubakar, Ismaela and Embleton, Nicholas D (2022) 'Prospective observational study of the challenges in diagnosing common neonatal conditions in Nigeria and Kenya'. BMJ Open, Vol 12, Issue 12, e064575.

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Abstract

Objectives: Accurate and timely diagnosis of common neonatal conditions is crucial for reducing neonatal deaths. In low/middle-income countries with limited resources, there is sparse information on how neonatal diagnoses are made. The aim of this study was to describe the diagnostic criteria used for common conditions in neonatal units (NNUs) in Nigeria and Kenya.
Design: Prospective observational study. Standard case report forms for suspected sepsis, respiratory disorders, birth asphyxia and abdominal conditions were co-developed by the Neonatal Nutrition Network (https://www.lstmed.ac.uk/nnu) collaborators. Clinicians completed forms for all admissions to their NNUs. Key data were displayed using heatmaps.
Setting: Five NNUs in Nigeria and two in Kenya comprising the Neonatal Nutrition Network.
Participants: 2851 neonates, which included all neonates admitted to the seven NNUs over a 6-month period.
Results: 1230 (43.1%) neonates had suspected sepsis, 874 (30.6%) respiratory conditions, 587 (20.6%) birth asphyxia and 71 (2.5%) abdominal conditions. For all conditions and across all NNUs, clinical criteria were used consistently with sparse use of laboratory and radiological criteria.
Conclusion: Our findings highlight the reliance on clinical criteria and extremely limited use of diagnostic technologies for common conditions in NNUs in sub-Saharan Africa. This has implications for the management of neonatal conditions which often have overlapping clinical features. Strategies for implementation of diagnostic pathways and investment in affordable and sustainable diagnostics are needed to improve care for these vulnerable infants.

Item Type:	Article
Corporate Authors:	Neonatal Nutrition Network Members
Subjects:	WS Pediatrics > WS 20 Research (General) WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjopen-2022-064575
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	04 Jan 2023 09:57
Last Modified:	04 Jan 2023 09:57
URI:	https://archive.lstmed.ac.uk/id/eprint/21631

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