scholarly journals Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Zebenay Workneh Bitew ◽  
Ayinalem Alemu ◽  
Ermias Getaneh Ayele ◽  
Desalegn Abebaw Jember ◽  
Michael Tamene Haile ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Sub Saharan Africa ◽  
Incidence Density ◽  
Neonatal Intensive Care Units ◽  
Sub Saharan ◽  
Incidence Density Rate ◽  
Density Rate

Background. Neonatal mortality in Sub-Saharan countries is remarkably high. Though there are inconsistent studies about the incidence density rate of neonatal mortalities (IDR) and predictors in Sub-Saharan Africa, they are inconclusive to policymakers and program planners. In this study, the IDR of neonatal mortalities and predictors was determined. Methods. Electronic databases (Web of Science, PubMed, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), World Cat, Google Scholar, and Google) were explored. 20 out of 818 studies were included in this study. The IDRs and predictors of neonatal mortality were computed from studies conducted in survival analysis. Fixed and random effect models were used to compute pooled estimates. Subgroup and sensitivity analyses were performed. Results. Neonates were followed for a total of 1,095,611 neonate-days; 67142 neonate-days for neonates treated in neonatal intensive care units and 1,028,469 neonate-days for community-based studies. The IDRs of neonatal mortalities in neonatal intensive care units and in the community were 24.53 and 1.21 per 1000 person-days, respectively. The IDRs of early and late neonatal mortalities neonatal intensive care units were 22.51 and 5.09 per 1000 neonate-days, respectively. Likewise, the IDRs of early and late neonatal mortalities in the community were 0.85 and 0.31, respectively. Not initiating breastfeeding within one hour, multiple births, rural residence, maternal illness, low Apgar score, being preterm, sepsis, asphyxia, and respiratory distress syndrome were independent predictors of time to neonatal mortality in neonatal intensive care units and male gender, perceived small size, multiple births, and ANC were predictors of neonatal mortality in the community. Conclusion. The incidence density rate of neonatal mortality in Sub-Saharan Africa is significantly high. Multiple factors (neonatal and maternal) were found to be independent predictors. Strategies must be designed to address these predictors, and prospective studies could reveal other possible factors of neonatal mortalities.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates Admitted to the Neonatal Intensive Care Units of Public Hospitals in Eastern Ethiopia: Facilities Based Prospective Follow-up Study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing neonatal mortality and it continues to be a significant public health issue. The facilities-based causes and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the causes and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Methods Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data were collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis respectively. Multivariable logistic regression was used to find out the predictors of facilities-based neonatal mortality. Results The proportion of facilities-based neonatal mortality was 20%(95% CI: 16.7-23.8%) The causes of death were complications of preterm birth 28.58%, birth asphyxia 22.45%, infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14% and congenital malformation 4.08%. Low birth weight, preterm births, length of stay in NICU, low 5 minute Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion The proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving timing and quality of ANC is essential for early detection, anticipating high-risk newborns and timely interventions. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

Neonatal Mortality Statistics

PEDIATRICS ◽  
1984 ◽  
Vol 74 (1) ◽  
pp. 168-168
Author(s):  
SAM SHAPIRO ◽  
MARIE C. MCCORMICK ◽  
BARBARA STARFIELD
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Mortality Statistics ◽  
Total Reduction ◽  
Social Environmental

In Reply.— Sepkowitz uses data in our paper to question the influence of neonatal intensive care units (NICUs) during the 1970s in reducing neonatal mortality. Part of the argument is based on the calculation that about 43% of the total reduction in such deaths between 1976 and 1978 to 1979 occurred among infants weighing more than 2,500 g at birth, a group for which "neonatal intensive care ... would seldom be necessary ..." Certainly there are many factors—social, environmental, and medical, including improved care in the antenatal and intrapartum periods—that have affected the reduction in neonatal mortality.

scholarly journals Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia: A facility-based prospective follow-up study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa, including Ethiopia. This region shows the least progress in reducing neonatal mortality and continues to be a significant public health issue. In this study setting, the causes and predictors of neonatal death in the neonatal intensive care units are not well documented. Hence, this study aimed to determine the causes and predictors of neonatal mortality among infants admitted to neonatal intensive care units in eastern Ethiopia. Methods: A facility-based prospective follow-up study was conducted among neonates admitted to neonatal intensive care units in public hospitals in eastern Ethiopia from November 1 to December 30, 2018. Data were collected using a pre-tested structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis, respectively. Multivariable logistic regression was used to identify the predictors of facility-based neonatal mortality.Results: The proportion of facility-based neonatal mortality was 20%(95% CI:16.7-23.8%). The causes of death were complications of preterm birth (28.58%), birth asphyxia (22.45%), neonatal infection (18.36%), meconium aspiration syndrome (9.18%), respiratory distress syndrome (7.14%), and congenital malformation (4.08%). Low birth weight, preterm births, length of stay in the neonatal intensive care unit, low 5 minutes APGAR score, hyperthermia, and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals in eastern Ethiopia.Conclusions: The proportion of facility-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving the timing and quality of antenatal care is essential for early detection, anticipating high-risk newborns, and timely interventions. Furthermore, early initiation of feeding and better referral linkage to tertiary health facilities could lead to a reduction in neonatal death in this setting.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia ◽  
Follow Up Study

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality.Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5thminutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia.ConclusionIn summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting.

scholarly journals Incidence Trends in Pathogen-Specific Central Line–Associated Bloodstream Infections in US Intensive Care Units, 1990–2010

2013 ◽  
Vol 34 (9) ◽  
pp. 893-899 ◽  
Author(s):  
Ryan P. Fagan ◽  
Jonathan R. Edwards ◽  
Benjamin J. Park ◽  
Scott K. Fridkin ◽  
Shelley S. Magill
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Patient Characteristics ◽  
Central Line ◽  
Incidence Density ◽  
Gram Negative ◽  
Incidence Trends ◽  
Incidence Density Rate ◽  
Density Rate

Objective.To quantify historical trends in rates of central line-associated bloodstream infections (CLABSIs) in US intensive care units (ICUs) caused by major pathogen groups, includingCandidaspp.,Enterococcusspp., specified gram-negative rods, andStaphylococcus aureus.Design.Active surveillance in a cohort of participating ICUs through the Centers for Disease Control and Prevention, the National Nosocomial Infections Surveillance system during 1990–2004, and the National Healthcare Safety Network during 2006–2010.Setting.ICUS.Participants.Patients who were admitted to participating ICUs.Results.The CLABSI incidence density rate forS. aureusdecreased annually starting in 2002 and remained lower than for other pathogen groups. Since 2006, the annual decrease forS. aureusCLABSIs in nonpediatric ICU types was −18.3% (95% confidence interval [CI], −20.8% to −15.8%), whereas the incidence density rate forS. aureusamong pediatric ICUs did not change. The annual decrease for all ICUs combined since 2006 was −17.8% (95% CI, −19.4% to −16.1%) forEnterococcusspp., −16.4% (95% CI, −18.2% to −14.7%) for gram-negative rods, and −13.5% (95% CI, −15.4% to −11.5%) forCandidaspp.Conclusions.Patterns of ICU CLABSI incidence density rates among major pathogen groups have changed considerably during recent decades. CLABSI incidence declined steeply since 2006, except for CLABSI due toS. aureusin pediatric ICUs. There is a need to better understand CLABSIs that still do occur, on the basis of microbiological and patient characteristics. New prevention approaches may be needed in addition to central line insertion and maintenance practices.

scholarly journals ANTENATAL CARE AND NEONATAL MORTALITY AND MORBIDITY IN THREE HOSPITALS OF PUNJAB, PAKISTAN

2021 ◽  
Vol 71 (2) ◽  
pp. 562-66
Author(s):  
Rizwana Akbar ◽  
Naila Azam ◽  
Fatima Ali Raza Mughal ◽  
Mahmood Ur Rahman ◽  
Ahmed Tariq ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Morbidity ◽  
Neonatal Intensive Care Units ◽  
Neonatal Health ◽  
Military Hospitals ◽  
Antenatal Visits

Objective: To find out the association between neonatal morbidity & mortality and the number of ante-natal visits of the mother of the newborn. Study Design: Comparative cross-sectional study. Place and Duration of Study: Neonatal Intensive Care Units (NICUs) of three military hospitals of the Punjab province, from Jan to Mar 2019.Methodology: Data of all newborns (total of 3065 neonates) delivered in selected Military Hospitals, and all newborns admitted to Neonatal Intensive care units, of Military Hospitals born in same hospital (in born) and born outside the Military Hospital (out born) during this period along with their mothers was collected. Neonatal morbidity and mortality in the selected hospitals was recorded. Mothers were classified as booked and unbooked according to the number of antenatal care visits. Data was analyzed by Statistical Packages for Social Science (SPSS) version 20. Results: Neonatal morbidity including prematurity, low birth weight, birth asphyxia, neonatal sepsis, pneumonia, diarrhoea, congenital malformation, and fits was significantly less (p-value <0.001) in children whose mothers had at least 4 or more antenatal visits (booked) than those newborns whose mothers had less than 4 antenatal visits (unbooked). The neonatal mortality in booked mothers was less than half of that in unbooked mothers. Conclusion: Booked mothers had better outcomes in terms of neonatal health and survival, and the neonatal health and survival was strongly correlated with the number of antenatal visits of the mother.

scholarly journals Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study

2019 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia ◽  
Follow Up Study

Abstract Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality. Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5 th minutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia. Conclusion In summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting. Keywords: Facilities based study, Neonatal mortality, predictors, NICU, Ethiopia

scholarly journals Cause and predictors of neonatal mortality among neonates admitted to the Neonatal Intensive Care Units of public Hospitals in eastern Ethiopia: Facilities based prospective follow-up study

2020 ◽  
Author(s):  
Assefa Desalew ◽  
Yitagesu Sintayehu ◽  
Nardos Teferi ◽  
Firehiwot Amare ◽  
Bifitu Geda ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Mortality ◽  
Intensive Care Units ◽  
Neonatal Death ◽  
Neonatal Intensive Care ◽  
Causes Of Death ◽  
Public Hospitals ◽  
Neonatal Intensive Care Units ◽  
Eastern Ethiopia

Abstract Background: The first month is the most crucial period for child survival and neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing this high mortality rate and it continues to be a significant public health issue. The facilities-based cause and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the cause and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data was collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and cause of death was set by pediatricians and residents. Epi-Data 3.1 and SPSS 25 Version software were used for data entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality. Result: The proportion of facilities-based neonatal mortality was 20%. The top five causes of death were a complication of prematurity (49%), birth asphyxia (37.8%), infection (32.6%), meconium aspiration syndrome (17.3%) and congenital malformation (6.1%). Low birth weight, preterm births, length of stay in NICU , low 5 minute Apgar score , hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion In summary, the proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving ANC and this would lead to early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

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