Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya.
<h4>Objective</h4>To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria.<h4>Study design</h4>In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya,...
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Public Library of Science (PLoS)
2021-01-01
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| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0244109&type=printable |
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| author | Helen M Nabwera Dingmei Wang Olukemi O Tongo Pauline E A Andang'o Isa Abdulkadir Chinyere V Ezeaka Beatrice N Ezenwa Iretiola B Fajolu Zainab O Imam Martha K Mwangome Dominic D Umoru Abimbola E Akindolire Walter Otieno Grace M Nalwa Alison W Talbert Ismaela Abubakar Nicholas D Embleton Stephen J Allen Neonatal Nutrition Network (NeoNuNet) |
| author_facet | Helen M Nabwera Dingmei Wang Olukemi O Tongo Pauline E A Andang'o Isa Abdulkadir Chinyere V Ezeaka Beatrice N Ezenwa Iretiola B Fajolu Zainab O Imam Martha K Mwangome Dominic D Umoru Abimbola E Akindolire Walter Otieno Grace M Nalwa Alison W Talbert Ismaela Abubakar Nicholas D Embleton Stephen J Allen Neonatal Nutrition Network (NeoNuNet) |
| author_sort | Helen M Nabwera |
| collection | DOAJ |
| description | <h4>Objective</h4>To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria.<h4>Study design</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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. |
| format | Article |
| id | doaj-art-552a380dc83340b48a045cee5747a04a |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-552a380dc83340b48a045cee5747a04a2025-08-20T03:44:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01161e024410910.1371/journal.pone.0244109Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya.Helen M NabweraDingmei WangOlukemi O TongoPauline E A Andang'oIsa AbdulkadirChinyere V EzeakaBeatrice N EzenwaIretiola B FajoluZainab O ImamMartha K MwangomeDominic D UmoruAbimbola E AkindolireWalter OtienoGrace M NalwaAlison W TalbertIsmaela AbubakarNicholas D EmbletonStephen J AllenNeonatal Nutrition Network (NeoNuNet)<h4>Objective</h4>To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria.<h4>Study design</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0244109&type=printable |
| spellingShingle | Helen M Nabwera Dingmei Wang Olukemi O Tongo Pauline E A Andang'o Isa Abdulkadir Chinyere V Ezeaka Beatrice N Ezenwa Iretiola B Fajolu Zainab O Imam Martha K Mwangome Dominic D Umoru Abimbola E Akindolire Walter Otieno Grace M Nalwa Alison W Talbert Ismaela Abubakar Nicholas D Embleton Stephen J Allen Neonatal Nutrition Network (NeoNuNet) Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya. PLoS ONE |
| title | Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya. |
| title_full | Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya. |
| title_fullStr | Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya. |
| title_full_unstemmed | Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya. |
| title_short | Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya. |
| title_sort | burden of disease and risk factors for mortality amongst hospitalized newborns in nigeria and kenya |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0244109&type=printable |
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