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Ayele A, Abera S, Edin A, Jara D, Amaje E. Does neonatal resuscitation associated with neonatal death in low-resource settings? A follow-up study. J Matern Fetal Neonatal Med 2024; 37:2285234. [PMID: 38105523 DOI: 10.1080/14767058.2023.2285234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The newborn period is the most vulnerable phase for a child's survival, with around half of all under-five deaths worldwide occurring during this time. Despite existing policies and measures, Ethiopia ranks among the top 10 African countries in terms of newborn mortality. In spite of many studies being carried out in the country, the incidence and predictors of neonatal mortality in the Pastoralist and agro-pastoralist parts of the country's southern still remain unidentified. Therefore, this study aimed to identify the predictors of neonatal mortality in selected public Hospitals in southern Ethiopia. MATERIALS AND METHODS An institution-based retrospective cohort study was conducted among 568 neonates admitted to the neonatal intensive care unit at Bule Hora University teaching Hospital and Yabelo General Hospital, Southern Ethiopia from 1 January 2020-31 December 2021. A simple random sampling technique was used to select records of neonates. Data entry was performed using Epidata version 3.1 and the analysis was performed using STATA version 14.1 Kaplan Meir curve and Log-rank test were used to estimate the survival time and compare survival curves between variables. Hazard Ratios with 95% CI were computed and all the predictors associated with the outcome variable at p-value 0.05 in the multivariable cox proportional hazards analysis were declared as a significant predictor of neonatal death. RESULTS Out of 565 neonates enrolled, 54(9.56%) neonates died at the end of the follow-up period. The overall incidence rate of death was 17.29 (95% CI: 13.24, 22.57) per 1000 neonatal days with a restricted mean follow-up period of 20 days. Of all deaths, 64.15% of neonates died within the first week of life. In the multivariable cox-proportional hazard model, neonatal age < 7 days (AHR: 9.17, 95% CI: (4.17, 20.13), place of delivery (AHR: 2.48, 95% CI: (1.38, 4.47), Initiation of breastfeeding after 1 h of birth (AHR: 6.46, 95% CI: (2.24, 18.59), neonates' body temperature <36.5 °C (AHR: 2.14, 95% CI: (1.19, 3.83), and resuscitated neonates (AHR: 2.15, 95% CI: (1.20, 3.82) were independent predictors of neonatal death. CONCLUSION In the research setting, the incidence of neonatal death was high, especially during the first week of life. The study found that neonatal age < 7 days, place of delivery, Initiation of breastfeeding after 1 h of birth, neonates' body temperature <36.5 °C, and resuscitated neonates were predictors of neonatal death. To improve newborn survival, significant neonatal problems, improved resuscitation, and other relevant factors should be addressed.
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Affiliation(s)
- Angefa Ayele
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Sewunet Abera
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Alo Edin
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Dube Jara
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
- Department of Public Health, College of Health sciences, Salale University, Fiche, Ethiopia
| | - Elias Amaje
- Department of Epidemiology, School of public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
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Huka AE, Oljira L, Weldesenbet AB, Bushra AA, Ahmed IA, Tura AK, Tuluka AA. Predictors of time to death among preterm neonates admitted to neonatal intensive care units at public hospitals in southern Ethiopia: A cohort study. PLoS One 2023; 18:e0283143. [PMID: 37824535 PMCID: PMC10569587 DOI: 10.1371/journal.pone.0283143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/02/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Although the survival of preterm neonates has improved, thanks to advanced and specialized neonatal intensive care, it remains the main reason for neonatal admission, death, and risk of lifelong complication. In this study, we assessed time to death and its predictors among preterm neonates admitted to neonatal intensive care units (NICU) at public hospitals in southern Ethiopia. METHODS A hospital based retrospective cohort was conducted among preterm neonates admitted to NICU at public hospitals in west Guji and Borena zones, Oromia National Regional State, southern Ethiopia. Simple random sampling technique was used to select records of preterm neonates admitted to both major hospitals in the study area. Data on neonatal condition, obstetric information, and status at discharge were collected from admission to discharge by trained research assistant through review of their medical records. Kaplan Meir curve and Log rank test were used to estimate the survival time and compare survival curves between variables. Cox-Proportional Hazards model was used to identify significant predictors of time to death at p<0.05. RESULT Of 510 neonates enrolled, 130(25.5%; 95% CI: 22-29) neonates died at discharge or 28days. The median survival time was 18 days with an interquartile range of (IQR = 6, 24). The overall incidence of neonatal mortality was 47.7 (95% CI: 40.2-56.7) per 1000 neonatal days. In the multivariable cox-proportional hazard analysis, lack of antenatal care (AHR: 7.1; 95%CI: 4-12.65), primipara (AHR: 2.3; 95% CI: 1.16-4.43), pregnancy complications (AHR: 3.4; 95% CI: 1.94-6.0), resuscitation at birth (AHR: 2.1, 95% CI: 0.28-0.77) and not receiving Kangaroo mother care (AHR: 9.3, 95% CI: 4.36-19.9) were predictors of preterm neonatal death. CONCLUSION Despite admission to NICU for advanced care and follow up, mortality of preterm neonates was found to be high in the study settings. Addressing major intrapartum complications is required to improve survival of neonates admitted to NICU.
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Affiliation(s)
- Alo Edin Huka
- Department of Epidemiology, School of Public Health, Institute of Health, Bule Hora University Bule Hora, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdulmalik Abdela Bushra
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ibsa Abdusemed Ahmed
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, Collage of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Angefa Ayele Tuluka
- Department of Epidemiology, School of Public Health, Institute of Health, Bule Hora University Bule Hora, Ethiopia
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Chekole B, Terefe TF, Tenaw SG, Zewudie BT, GebreEyesus FA, Kassaw A, Gelaw Walle B, Aynalem Mewahegn A, Tadesse B, Mesfin Y, Argaw M, Abebe H, Tesfa S, Tamene Zeleke F. Survival Status, Length of Stay, and Predictors of Mortality Among Neonates Admitted in the Neonatal Intensive Care Unit of Gurage Zone Public Hospitals. SAGE Open Nurs 2023; 9:23779608231187480. [PMID: 37476331 PMCID: PMC10354824 DOI: 10.1177/23779608231187480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/22/2023] Open
Abstract
Background Many countries need to accelerate their progress to achieve the sustainable development goal target of neonatal death. It is still high in Ethiopia. Thus, this study aimed to assess the mortality predictors and length of hospital stay among Neonates admitted to the Neonatal Intensive Care Unit of Gurage zone public Hospitals. Method In this study, a facility-based retrospective follow-up study was applied among 375 neonates admitted to the NICU of selected public hospitals in the Gurage zone from June 1, 2019 to June 30, 2021. The researchers used Epi-Data entry 3.1 for the data entry and then exported it to STATA version 14 for analysis. The Kaplan-Meier survival curve and log-rank test were used to estimate and compare the survival time of categorical variables, respectively. Result The researchers observed about 85 (22.7% with 95%CI: 18.7, 27.2) deaths from the 2305 person-days follow-up. The median survival time was 14 days. The overall incidence density rate was 36.9 per 1000 person-days observed (95%CI: 29.8, 45.6). Perinatal asphyxia (AHR: 2.9[CI: 1.8; 4.8]), cesarean section as a mode of delivery (AHR: 1.1[CI; 1.01; 1.15]), maternal age of greater or equal to 35 years (AHR: 1.1[95% CI: 1.01, 1.15]), and twin pregnancy (AHR: 2.3[95% CI: 1.2, 4.3]) were predictors of neonatal mortality. Conclusion The survival rate of neonates was higher compared to other studies. So, to reduce the burden of neonatal mortality, health care providers should give special attention to twin pregnancies, neonates delivered via cesarean section, and neonates with a problem of perinatal asphyxia.
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Affiliation(s)
- Bogale Chekole
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Tamene Fetene Terefe
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Shegaw Geze Tenaw
- Department of Midwifery, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Bitew Tefera Zewudie
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Fisha Alebel GebreEyesus
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Amare Kassaw
- Department of Pediatric Nursing, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Northwest Ethiopia
| | - Belete Gelaw Walle
- Department of Pediatric Nursing, College of Medicine and Health Science, Wolaita Sodo University, Wolaita sodo, Southwest Ethiopia
| | - Agerie Aynalem Mewahegn
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Betelihem Tadesse
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Yibeltal Mesfin
- Department of Midwifery, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Muche Argaw
- Department of Midwifery, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Haimanot Abebe
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Shegaw Tesfa
- Department of Nursing, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
| | - Fentahun Tamene Zeleke
- Department of Midwifery, College of Medicine and Health Science, Wolkite University Southwest, Wolkite, Ethiopia
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Nurses’ and Midwives’ Knowledge regarding Neonatal Resuscitation in Public Hospitals of South Wollo Zone of Amhara Region, Northern Ethiopia. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2023. [DOI: 10.1016/j.ijans.2023.100527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Predictors of Neonatal Mortality in Ethiopia: A Comprehensive Review of Follow-Up Studies. Int J Pediatr 2022; 2022:1491912. [PMID: 35189632 PMCID: PMC8856832 DOI: 10.1155/2022/1491912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/20/2022] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Neonatal mortality remains a prominent public health problem in developing countries. Particularly, Ethiopia has a higher neonatal mortality rate than the average sub-Saharan African countries. Hereafter, this review article was aimed at synthesizing existing predictors of neonatal mortality in Ethiopia. Methods A systematic search and review of peer-reviewed articles were conducted on the predictors of neonatal mortality in Ethiopia. A search of key terms across different databases including Web of Science, SCOPUS, Cochrane Library, PubMed, EMBASE, Hinari, and Google Scholar was conducted, supplemented by reference screening. The SANRA tool was used to critically appraise studies included in the review. Results After removing duplicates and applying the eligibility criteria, 14 of the 64 initially identified articles were included in the final review. These were original articles published between 2011 and 2021. The identified predictors were narrated and presented under different domains. Accordingly, sociodemographic predictors such as residence, distance from the health facility, and maternal age; service delivery-related predictors such as no ANC follow-up, not taking iron-folic acid supplementation during pregnancy, and no PNC visit; neonate-related predictors such as low birth weight, extreme prematurity/preterm, and low APGAR score; pregnancy and childbirth-related predictors such as birth interval < 18 months, twin pregnancy, and time of rupture of membrane > 12 hours; and maternal-related predictors such as maternal HIV infection, maternal childbirth-related complications, and maternal near-miss were stated to increase a likelihood of newborn death in Ethiopia. Conclusion Public health interventions directed at decreasing neonatal mortality should address the rural residents, mothers not having ANC follow-up, low birth weight, twin pregnancy, and maternal HIV infection. The wealth of data gathered during primary research should not only lead to identification of predictors, but should also provide guidance for health system intervention strategies in a country aiming to reduce neonatal mortality.
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