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      Treatment Outcome and Associated Factors of Neonatal Sepsis at Mizan Tepi University Teaching Hospital, South West Ethiopia: A Prospective Observational Study

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          Abstract

          Introduction

          Neonatal sepsis is the gravest problem in neonates, ending in significant morbidity and mortality. World wide 6.9 million neonates were spotted with potentially severe bacterial infections needing treatment and 2.6 million of them occurred in sub-Saharan Africa (SSA). Sepsis is the leading cause of neonatal mortality and is perhaps answerable for about 30–50% of the total neonatal deaths per year in emerging countries.

          Objective

          This study aims to assess the treatment outcome and associated factors of neonatal sepsis at Mizan Tepi University Teaching Hospital, South West Ethiopia.

          Methods

          A hospital-based prospective observational study was done at Mizan Tepi University Teaching Hospital (MTUTH) from May to November 2019 among neonates admitted with sepsis. Data were entered to Epi-data 4.2 and analyzed by SPSS version 21. Bivariate and multivariate Cox regression was used to identify the relationship between dependent and independent variables. All neonates ≤28 days who were admitted to MTUTH at the neonatal intensive care unit (NICU) and neonates diagnosed with sepsis by the attending physician either clinically or laboratory-confirmed included in the study.

          Results

          Of the 211 neonatal sepsis patients, 110 (52.1%) were females, 161 (76.3%) were admitted with late-onset sepsis, 16 (7.6%) were very low birth weight, and 156 (73.9%) were term. About 143 (67.8%) had a good outcome and 68 (32.2%) had a poor outcome. Very low birth weight [P = 0.006, AHR = 1.692, 95% CI: (1.245, 4.36)], age of neonate being less than 4 days at admission [P = 0.001, AHR = 9.67, 95% CI: (2.24, 41.70)], maternal infection [P = 0.032, AHR = 3.186, 95% CI: (1.32, 30.68)], and prolonged length of hospital stay [(P = 0.017, AHR = 12.29, 95% CI: (1.55, 96.31), were significantly associated to mortality.

          Conclusion

          The mortality rate of neonatal sepsis was found to be high. Age of neonate <4 days, birth weight of the neonate <1500 gm, and prolonged length of hospital stay were identified as independently associated factors of increased risk of mortality.

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          Most cited references30

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          Defining neonatal sepsis.

          James Wynn (2016)
          Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm neonates. Despite multiple attempts to address this unmet need, there have been minimal advances in clinical management, outcomes, and accuracy of diagnostic testing options over the last 3 decades. One strong contributor to a lack of medical progress is a variable case definition of disease. The inability to agree on a precise definition greatly reduces the likelihood of aligning findings from epidemiologists, clinicians, and researchers, which, in turn, severely hinders progress toward improving outcomes.
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            Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study

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              The burden of invasive early-onset neonatal sepsis in the United States, 2005-2008.

              Sepsis in the first 3 days of life is a leading cause of morbidity and mortality among infants. Group B Streptococcus (GBS), historically the primary cause of early-onset sepsis (EOS), has declined through widespread use of intrapartum chemoprophylaxis. We estimated the national burden of invasive EOS cases and deaths in the era of GBS prevention. Population-based surveillance for invasive EOS was conducted in 4 of the Centers for Disease Control and Prevention's Active Bacterial Core surveillance sites from 2005 to 2008. We calculated incidence using state and national live birth files. Estimates of the national number of cases and deaths were calculated, standardizing by race and gestational age. Active Bacterial Core surveillance identified 658 cases of EOS; 72 (10.9%) were fatal. Overall incidence remained stable during the 3 years (2005: 0.77 cases/1000 live births; 2008: 0.76 cases/1000 live births). GBS (∼ 38%) was the most commonly reported pathogen followed by Escherichia coli (∼ 24%). Black preterm infants had the highest incidence (5.14 cases/1000 live births) and case fatality (24.4%). Nonblack term infants had the lowest incidence (0.40 cases/1000 live births) and case fatality (1.6%). The estimated national annual burden of EOS was approximately 3320 cases (95% confidence interval [CI]: 3060-3580), including 390 deaths (95% CI: 300-490). Among preterm infants, 1570 cases (95% CI: 1400-1770; 47.3% of the overall) and 360 deaths (95% CI: 280-460; 92.3% of the overall) occurred annually. The burden of invasive EOS remains substantial in the era of GBS prevention and disproportionately affects preterm and black infants. Identification of strategies to prevent preterm births is needed to reduce the neonatal sepsis burden.
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                Author and article information

                Journal
                Pediatric Health Med Ther
                Pediatric Health Med Ther
                phmt
                pedhlth
                Pediatric Health, Medicine and Therapeutics
                Dove
                1179-9927
                11 September 2021
                2021
                : 12
                : 467-479
                Affiliations
                [1 ]Clinical Midwifery, Department of Midwifery, College of Medicine and Health Science, MizanTepi University , Mizan, Ethiopia
                [2 ]Clinical Pharmacy, School of Pharmacy, Institute of Health, Addis Ababa University , Addis Ababa, Ethiopia
                [3 ]Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, MizanTepi University , Mizan, Ethiopia
                Author notes
                Correspondence: Alemnew Wale; Yohannes Wobie Email walealemnew@gmail.com; yohanneswobie@gmail.com
                Author information
                http://orcid.org/0000-0002-5705-4371
                http://orcid.org/0000-0002-0323-5011
                http://orcid.org/0000-0002-5194-4330
                Article
                322069
                10.2147/PHMT.S322069
                8443800
                34539194
                47a36fa4-d7a1-4166-bd5f-56fffc29eb83
                © 2021 Wale et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 22 June 2021
                : 20 August 2021
                Page count
                Figures: 6, Tables: 8, References: 31, Pages: 13
                Funding
                Funded by: no funding;
                There was no funding for this study.
                Categories
                Original Research

                neonate,sepsis,treatment outcome,mizan,ethiopia 2021
                neonate, sepsis, treatment outcome, mizan, ethiopia 2021

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