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


PLoS One

OBJECTIVE: To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria. STUDY DESIGN: 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. RESULTS: 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. CONCLUSION: 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. Nabwera, H. M., Wang, D., Tongo, O. O., Andang’o, P. E. A., Abdulkadir, I., Ezeaka, C. V., Ezenwa, B. N., Fajolu, I. B., Imam, Z. O., Mwangome, M. K., Umoru, D. D., Akindolire, A. E., Otieno, W., Nalwa, G. M., Talbert, A. W., Abubakar, I., Embleton, N. D., Allen, S. J., Neonatal Nutrition, Network

Pages:e0244109, Volume:16, Edition:1/15/2021, Date,

Link: https://www.ncbi.nlm.nih.gov/pubmed/33444346

Notes:Nabwera, Helen M|Wang, Dingmei|Tongo, Olukemi O|Andang’o, Pauline E A|Abdulkadir, Isa|Ezeaka, Chinyere V|Ezenwa, Beatrice N|Fajolu, Iretiola B|Imam, Zainab O|Mwangome, Martha K|Umoru, Dominic D|Akindolire, Abimbola E|Otieno, Walter|Nalwa, Grace M|Talbert, Alison W|Abubakar, Ismaela|Embleton, Nicholas D|Allen, Stephen J|(NeoNuNet)|eng|Wellcome Trust/United Kingdom|MC_PC_MR/R019789/1/MRC_/Medical Research Council/United Kingdom|Research Support, Non-U.S. Gov’t|2021/01/15 06:00|PLoS One. 2021 Jan 14;16(1):e0244109. doi: 10.1371/journal.pone.0244109. eCollection 2021.

ISBN: 1932-6203 (Electronic)|1932-6203 (Linking) Permanent ID: PMC7808658 Accession Number: 33444346

Author Address: Liverpool School of Tropical Medicine, Liverpool, United Kingdom.|Alder Hey Children’s Hospital NHS Trust, Liverpool, United Kingdom.|Children’s Hospital of Fudan University, Minhang District, Shanghai, China.|University College Hospital, Ibadan, Nigeria.|Maseno University, Maseno, Kenya.|Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria.|Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.|Massey Street Children’s Hospital, Lagos, Nigeria.|KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.|Maitama District Hospital, Maitama, Abuja, Nigeria.|Jaramogi Oginga Odinga Teaching and Referral Hospital, Jomo Kenyatta Highway Kaloleni Kisumu KE, Central, Kenya.|Newcastle University, Newcastle upon Tyne, United Kingdom.|The Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle upon Tyne, United Kingdom.