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

• DOI: 10.1371/journal.pone.0244109
• Publication Date: 2021-01-14T18:55:36Z
• Authors: Helen M. Nabwera; Dingmei Wang; Olukemi O. Tongo; Pauline E. A. And...; Isa Abdulkadir; Chinyere V. Ezeaka; Beatrice N. Ezenwa; Iretiola B. Fajolu; Zainab O. Imam; Martha K. Mwangome; Dominic D. Umoru; Abimbola E. Akind...; Walter Otieno; Grace M. Nalwa; Alison W. Talbert; Ismaela Abubakar; Nicholas D. Embleton; Stephen J. Allen
• Keywords: Interquartile range; Perinatal asphyxia

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