Predictors of mortality among neonates hospitalized with neonatal sepsis: a case control study from southern Ethiopia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tadele Bekele ◽  
Hailu Merga ◽  
Tamiru Tesfaye ◽  
Henok Asefa
Keyword(s):  
Logistic Regression ◽  
Respiratory Distress ◽  
General Hospital ◽  
Neonatal Mortality ◽  
Neonatal Sepsis ◽  
Case Control Study ◽  
Case Control ◽  
Southern Ethiopia ◽  
Predictors Of Mortality ◽  
Control Study

Abstract Background Neonatal sepsis, which resulted from bacterial, viral, and fungal invasions of the bloodstream, is the major cause of neonatal mortality and neurodevelopmental impairment among neonates. It is responsible for more than one-third of neonatal deaths in Ethiopia. Frequently neonates referred to health facilities are at high risk of death. Hence, assessing and preventing the predictors of mortality in neonatal sepsis helps to reduce the burden of neonatal mortality. Objectives To determine predictors of mortality among neonates admitted with sepsis at Durame general hospital, southern Ethiopia, 2020. Methods Institution-based unmatched case-control study was carried out from March 8 to 30, 2020, among 219 neonates in Durame general hospital in southern Ethiopia. Neonates admitted with sepsis and died were considered as cases and neonates admitted with sepsis and survived (discharged alive) as controls. Cases were selected by taking the deaths of neonates consecutively among those neonates admitted with the diagnosis of neonatal sepsis. The next immediate three corresponding controls were selected by lottery method from the Neonatal Intensive Care Unit (NICU) case registration book. Data was collected by using structured pretested checklists from neonates’ records and then entered into Epi data version 3.1 and exported to SPSS version 20. Logistic regression was used to identify the predictors of mortality. Statistical significance was declared at P < 0.05. Results A total of 55 cases and 164 controls were included in this study. More than three quarters (81.8%) of cases had early onset sepsis. The multivariable logistic regression analysis showed that predictors of mortality in this study were; poor feeding [AOR = 4.15; 95% CI (1.64, 10.49)], respiratory distress [AOR = 2.72; 95% CI (1.31, 5.61)], estimated gestational age less than 37 weeks [AOR = 4.64; 95% CI (2.17, 9.91)], and convulsion [AOR = 3.13; 95% CI (1.12, 8.76)]. Conclusion This study showed that prematurity, convulsion, poor feeding, and respiratory distress were the predictors of sepsis-related neonatal mortality. It is important to pay attention to septicemic babies with any of the identified predictors to reduce sepsis-related mortality.

scholarly journals Clinical and Laboratory Predictors of Mortality in Patients With SARS-CoV-2 Infection in A Tertiary Care Center of Central Kerala, India - A Case control Study

2021 ◽  
Vol 6 (4) ◽  
pp. 111-120
Author(s):  
Priyanka Rajmohan ◽  
◽  
Anil Kumar Chellappan pillai Chellappan pillai Rajamma ◽  
Mimtha Ayiravelil Mohanan ◽  
Ponnu Jose ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Serum Creatinine ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Case Control ◽  
Hospital Death ◽  
Predictors Of Mortality ◽  
Multivariable Logistic Regression ◽  
Control Study

Background: Since various studies indicate differences in the case fatality rate of SARS-CoV-2 in different settings, it is vital to elucidate the clinical and laboratory parameters. This would be helpful in identifying individuals who are susceptible to adverse outcomes, thereby targeting essential health interventions to resource poor settings. This study aimed to determine the clinical and laboratory predictors of mortality due to COVID-19. Materials & Methods: In this case control study, we included 162 adult inpatients who died due to COVID-19 from May 2020 to February 2021, as cases (n=81) and those discharged as controls (n=81). Demographic, clinical, treatment, and laboratory data was extracted from medical records and electronic database and compared between survivors and non-survivors. Univariate analysis and multivariable logistic regression methods were used to identify the risk factors associated with in-hospital death. Results: Comorbidities were present among 82 (50.6%) participants. Hypertension was the most common comorbidity 99(61.1%) followed by diabetes mellitus 92 (56.8%) and coronary artery disease 55(34%). Multivariable logistic regression model showed that cardiovascular disease (OR=5.80, 95%CI: 1.09–47.55, P=0.011), decreased oxygen saturation (OR=33.68, 95%CI: 2.81–403.80, P=0.006), elevated CRP (OR=1.16, 95%CI: 1.01–1.32, P=0.026), and serum creatinine (OR=3.26, 95%CI: 1.02–11.55, P=0.047) were the significant predictors of mortality. Conclusion: This study found that comorbidities such as CAD, elevated serum creatinine, elevated inflammatory markers, and decreased O2 saturation were independent predictors of mortality among COVID-19 patients.

scholarly journals Determinants of Perinatal Mortality in Tercha General Hospital, Southern Ethiopia; Facility Based Case Control Study.

2019 ◽  
Author(s):  
Firehiwot Tebeje ◽  
Animut Addis ◽  
Muktar Basher ◽  
Chernet Hialu
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
General Hospital ◽  
Perinatal Mortality ◽  
Case Control Study ◽  
Perinatal Death ◽  
Case Control ◽  
Southern Ethiopia ◽  
Prolonged Labour ◽  
Control Study

Abstract Background: Ethiopia meets the target millennium development goal 4 on child survival three years ahead of time. However, there were high perinatal deaths in the country and the reduction was not impressive. Identifying determinants and implement evidence based interventions is crucial to reduce perinatal death. However, there were no clear evidences on determinants of perinatal mortality in Tercha General Hospital.Objective: To assess determinants of perinatal mortality in Tercha general hospital, Southern Ethiopia, January 1, 2014 and December 30, 2017.Method: An unmatched case control study using secondary data as a source of information was conducted in Tercha general hospital. Cases were stillbirths and early neonatal deaths. Controls were those newborns live till 7th days. Randomly selected 366 (183 cases and 183 controls) study subjects were constituted for this study. The data were collected from March 1-20/2018. Epi-Data version 3.1 and SPSS Version 23 were used for data entry and analysis, respectively. Descriptive statistics were used to describe the study population in relation to study variables. Logistic regressions were employed to identify determinants of perinatal death.Results: In multivariable logistic analysis, rural in residence of the mother [AOR=1.82; 95%CI:(1.04-3.19)], ANC booking [AOR=0.47; 95%CI:(0.27,0.83)], prolonged labour [AOR=2.75; 95%CI: (1.58-4.78)], low birth weight [AOR=1.78; 95%CI (1.06-2.97)], presence of obstetrics complication [AOR=2.15; 95%CI: (1.28-3.62)], using partograph [AOR=0.5; 95%CI: 0.25-0.9]. Using safe child birth checklist [AOR=0.52; 95%CI: 0.30-0.91], and coming with referral [(AOR=2.69; 95% CI: (1.51-4.8)] were significantly associated with perinatal mortality. Conclusion and Recommendation: Being rural in residence, coming with referral, low birth weight, prolonged labour and presence of obstetric complication were associated with elevated the risk of perinatal mortality, and antenatal care booking, using partograph and using safe childbirthchecklist were associated with reduced risk of perinatal mortality. We therefore, recommend strengthening maternal health and newborn care servicesby taking into account these factors to reduce perinatal death.

scholarly journals Determinants of postnatal care non-utilization among women in Demba Gofa rural district, southern Ethiopia: a community-based unmatched case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Markos Manote ◽  
Tsegaye Gebremedhin
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Postnatal Care ◽  
Case Control Study ◽  
Care Service ◽  
Case Control ◽  
Rural District ◽  
Southern Ethiopia ◽  
Community Based ◽  
Control Study

Abstract Background Maternal and neonatal mortality remain a significant problem across much of the developing world, especially in sub-Saharan Africa countries. In Ethiopia, most maternal and neonatal deaths occur during the postpartum period; this is a critical time for monitoring the health of women and newborns, but the most neglected period for care. In rural communities of Ethiopia, the utilization of postnatal care service is very low and evidence on which factors contribute to the non-utilization of postnatal care (PNC) is insufficient. Consequently, this study was designed to identify the determinants of postnatal service non-utilization among women who gave birth in Demba Gofa rural district, Southern Ethiopia. Methods A community-based unmatched case-control study was conducted among 186 cases (postnatal care non-utilizers) and 186 controls (postnatal care utilizers) in Demba Gofa rural district from March 1 to April 10, 2019. A previously tested interviewer-administered structured questionnaire was used for data collection. Binary logistic regression analysis was performed. In the final multivariable logistic regression analysis model, a p-value of less than 0.05 and an Adjusted Odd Ratio (AOR) with a 95% confidence interval (CI) was used to determine variables for postnatal care non-utilization. Results In this study, women who delivered recently were incorporated within 186 cases and 186 controls. Not knowing the availability of PNC services (AOR: 4.33, 95% CI: 1.71–10.99), having a home delivery (AOR: 7.06, 95% CI: 3.71–13.44), ANC non-attendance (AOR: 6.14, 95% CI: 3.01–12.50), unable to make an independent decision (AOR: 9.31, 95% CI: 3.29–26.35), and not participating in the Women’s Development Army (WDA) (AOR: 5.09, 95% CI: 2.73–9.53) comprised the determinants which were assessed for non-utilization of postnatal care services. Conclusions Encouraging institutional delivery along with integrated health education about postnatal care and postnatal danger signs, empowering women to execute independent decisions, accessing PNC services and strengthening participation in the Model Families will likely improve postnatal care service utilization in the district of Ethiopia.

scholarly journals Risk Factors for Neonatal Sepsis: A Retrospective Case-Control Study among Neonates Who Were Delivered by Caesarean Section at the Trauma and Specialist Hospital, Winneba, Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Peter Adatara ◽  
Agani Afaya ◽  
Solomon Mohammed Salia ◽  
Richard Adongo Afaya ◽  
Anthony K. Kuug ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Caesarean Section ◽  
Neonatal Sepsis ◽  
Case Control Study ◽  
Case Control ◽  
Multivariate Logistic Regression ◽  
Retrospective Case ◽  
Chi Square Analysis ◽  
Control Study

The third Sustainable Development Goal (SDG) for child health, which targets ending preventable deaths of neonates and children under five years of age by 2030, may not be met without substantial reduction of neonatal sepsis-specific mortality in developing countries. This study aimed at assessing the prevalence and risk factors for neonatal sepsis among neonates who were delivered via caesarean section. A retrospective case-control study was conducted among neonates who were delivered via caesarean section at the Trauma and Specialist Hospital, Winneba, Ghana. Data collection lasted for 4 weeks. The extracted data were double-entered using Epidata software version 3.1 to address discrepancies of data entry. Descriptive statistics such as frequencies and percentages of neonatal characteristics were generated from the data. Both univariate and multivariate logistic regression were used to determine associations between neonatal sepsis and neonatal characteristics with odds ratios, 95% confidence intervals, and p values calculated using variables that showed significant association (p<0.05) in the chi-square analysis for the multivariate logistic regression. A total of 383 neonates were recruited; 67 (17.5%) had sepsis (cases). The neonatal risk factors associated with sepsis were birth weight (χ2=6.64, p=0.036), neonatal age (χ2=38.31, p<0.001), meconium passed (χ2=12.95, p<0.001), reason for CS (χ2=24.27, p<0.001), and the duration of stay on admission (χ2=36.69, p<0.001). Neonatal sepsis poses a serious threat to the survival of the newborn as the current study uncovered 6.0% deaths among sepsis cases. The findings of this study highlight the need for routine assessment of neonates in order to identify risk factors for neonatal sepsis and to curb the disease burden on neonatal mortality.

scholarly journals Risk factors for neonatal sepsis in Lubumbashi, Democratic Republic of Congo: A retrospective case-control study

2021 ◽  
Vol 3 (1) ◽  
pp. 63-70
Author(s):  
Adonis Muganza Nyenga ◽  
◽  
Olivier Mukuku ◽  
Janet Ziazia Sunguza ◽  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Neonatal Sepsis ◽  
Democratic Republic ◽  
Case Control Study ◽  
Democratic Republic Of Congo ◽  
Case Control ◽  
Republic Of Congo ◽  
Tract Infections ◽  
Control Study

Purpose: Neonatal sepsis (NS) is a major cause of neonatal morbidity and mortality, particularly in developing countries. Delays in the identification and treatment of NS are the main contributors to the high mortality. This study aims to identify risk factors for NS in newborns in the two university hospitals in Lubumbashi, in the Democratic Republic of Congo. Methods: This hospital-based case-control study was carried out on 486 mother-newborn pairs using the systematic sampling method during November 2019 to October 2020. Data were analyzed using STATA software (version 15). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results: A total of 162 cases and 324 controls were included in this study. Multiple logistic regression analysis showed that the possible risk factors for NS in this study were low level of education (AOR = 9.16 [2.23-37.67]), maternal genitourinary tract infections (AOR = 42.59 [17.90-101.37]), premature rupture of membranes (AOR = 19.95 [7.27-54.76]), peripartum fever (AOR = 26.25 [2.31-297.83]), prolonged labor (AOR = 14.16 [3.88-51.71]), cesarean section (AOR = 3.57 [1.48-8.61]), obstructed vaginal delivery (AOR = 13.40 [1.32-136.19]), birth weight <1500 grams (AOR = 70.38 [8.64-572.95]), and between 1500-2500 grams (AOR = 7.90 [3.04-20.52]). Conclusion: The study found that maternal and neonatal factors were strongly associated with the risk of developing NS. The present study suggests the possibility of routine assessment of sepsis in newborns born with the above characteristics.

scholarly journals Risk factors and etiology of neonatal sepsis after hospital delivery: A case-control study in a tertiary care hospital of Rajshahi, Bangladesh

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242275
Author(s):  
Md. Abdur Rafi ◽  
M. Morsed Zaman Miah ◽  
Md. Abdul Wadood ◽  
Md. Golam Hossain
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Neonatal Sepsis ◽  
Case Control Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Control ◽  
Care Hospital ◽  
Multiple Logistic Regression ◽  
Control Study

Background Sepsis is one of the major causes of neonatal death worldwide as well as in Bangladesh. The objective of the present study was to identify the risk factors and causative organisms of neonatal sepsis after delivery in a tertiary care hospital, Bangladesh. Methods This was a case-control study conducted in the neonatal ward of Rajshahi Medical College Hospital (RMCH), a 1000-bed tertiary hospital situated in Rajshahi, Bangladesh. Neonates diagnosed as neonatal sepsis by clinical and laboratory parameters were included as cases in this study. Admitted neonates unsuspected or undiagnosed for sepsis were considered as controls. Maternal and neonatal information and their laboratory reports were collected and analyzed. Both bivariate and multiple logistic regression models were used to identify the risk factors of neonatal sepsis. Results A total of 91 cases and 193 controls were included in the study. Maternal history of urinary tract infection (UTI) during the third trimester of pregnancy (aOR 2.75, 95% CI: 1.04–7.23, p <0.05), premature birth (aOR 2.77, 95% CI: 1.08–7.13, p <0.05) and APGAR score <7 at five minutes (aOR 2.58, 95% CI: 1.04–6.39, p <0.05) were associated with onset of neonatal sepsis in multiple logistic regression model. All these factors were also associated with developing early-onset neonatal sepsis, while maternal UTI and male sex of neonates were associated with developing late-onset neonatal sepsis. Escherichia coli (40.7%), Staphylococcus aureus (27.5%), and Klebsiella pneumoniae (18.7%) were the commonly isolated organisms causing neonatal sepsis. All these organisms were highly resistant to common antibiotics like amoxicillin, cephalosporins, aminoglycosides and quinolones. Carbapenemase group of drugs along with amikacin, nitrofurantoin and linezolid were the most sensitive drugs. Conclusions Strengthening the existing facility for antenatal screening for early diagnosis and treatment of maternal infection during pregnancy as well as identifying high-risk pregnancy for adequate perinatal management is necessary to prevent neonatal sepsis-related morbidity and mortality. Rational use of antibiotics according to local epidemiology and culture and sensitivity reports may minimize the increasing hazards of antibiotic resistance.

scholarly journals Risk Factors for Neonatal Sepsis in Lubumbashi, Democratic Republic of Congo: A Retrospective Case-Control Study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nyenga AM ◽  
◽  
Mukuku O ◽  
Sunguza JZ ◽  
Assumani AN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Neonatal Sepsis ◽  
Democratic Republic ◽  
Case Control Study ◽  
Democratic Republic Of Congo ◽  
Case Control ◽  
Republic Of Congo ◽  
Tract Infections ◽  
Control Study

Background: Neonatal Sepsis (NS) is a major cause of neonatal morbidity and mortality, particularly in developing countries. Delays in the identification and treatment of NS are the main contributors to the high mortality. This study aims to identify risk factors for NS in newborns in the two university hospitals in Lubumbashi, in the Democratic Republic of Congo. Methods: This hospital-based case-control study was carried out on 486 mother-newborn pairs using the systematic sampling method during November 2019 to October 2020. Data were analyzed using STATA software (version 15). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results: A total of 162 cases and 324 controls were included in this study. Multiple logistic regression analysis showed that the possible risk factors for NS in this study were low level of education (AOR=9.16 [2.23-37.67]), maternal genitourinary tract infections (AOR=42.59 [17.90-101.37]), premature rupture of membranes (AOR=19.95 [7.27-54.76]), peripartum fever (AOR=26.25 [2.31-297.83]), prolonged labor (AOR=14.16 [3.88-51.71]), cesarean section (AOR=3.57 [1.48-8.61]), obstructed vaginal delivery (AOR=13.40 [1.32- 136.19]), birth weight <1500 grams (AOR=70.38 [8.64-572.95]), and between 1500-2500 grams (AOR=7.90 [3.04-20.52]). Conclusion: The study found that maternal and neonatal factors were strongly associated with the risk of developing NS. The present study suggests the possibility of routine assessment of sepsis in newborns born with the above characteristics.

scholarly journals Determinants of neonatal mortality among newborns admitted in neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern, Ethiopia: unmatched case control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Atnafu Adem ◽  
Azmach Dache ◽  
Aregahegn Dona
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Mortality ◽  
Neonatal Intensive Care ◽  
Case Control Study ◽  
Case Control ◽  
Referral Hospital ◽  
Southern Ethiopia ◽  
Control Study

Abstract Background Around two and half million neonatal mortality occurred in 2017, especially in developing countries. This study was conducted to determine the determinants of neonatal mortality among newborns admitted in the neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern Ethiopia. Methods An unmatched case-control study was conducted from February, 24 to March 6, 2020 at Dilla University Referral Hospital in Gedeo Zone Southern Ethiopia. A total of 304 neonates (76 cases and 228 controls) were involved. Neonates registered as died were considered as cases and neonates registered as improved were considered as controls. Data were extracted by pretested checklists from medical records of neonates admitted during the last one year period. Data was entered into EpiData3.1, and analyzed by statistical package for social science software Version 22.Bivariate and multivariate logistic regressions were used to identify determinants associated with neonatal mortality. Finally, AORs at 95 % CI and P-values < 0.05 were used to declare statistical significance. Results In this study, a total of 304 cases were assessed with 100 % reviewed rate. It was found that referrals from other health facilities, [AORs = 2.43, 95 % CI (1.14, 5.22)], gestational age < 37 weeks,[AORs = 2.50, 95 % CI (1.12, 5.58)], the weight of newborn < 2500 g, [AORs = 2.44, 95 % CI (1.13, 5.28)], neonates positive for sepsis, [AORs = 2.45, 95 % CI (1.11, 5.41)]and neonates who not breastfed within first hour after delivery,[AORs = 5.24, 95 % CI (2.42, 11.37)] were statistically significant determinants to neonatal mortality. Conclusions This study suggests that referral, gestational age, weight of newborn, sepsis and breastfeeding were significant determinants to neonatal mortality. This study shows that neonatal intensive care unit service should be strengthened in Dilla University Referral Hospital; targeting neonate aged below 28 days. Most of these determinants may be prevented and minimized by strengthening referral linkage, improving intrapartum and postpartum care.

Risk factors associated with subacromial pain in young athletes: A case control study

2021 ◽  
pp. 1-9
Author(s):  
Zoran Z. Sarcevic ◽  
Andreja P. Tepavcevic
Keyword(s):  
Logistic Regression ◽  
Case Control Study ◽  
Case Control ◽  
Sternoclavicular Joint ◽  
Pectoralis Major ◽  
Young Athletes ◽  
Serratus Anterior ◽  
Significant Difference ◽  
Lower Trapezius ◽  
Control Study

BACKGROUND: Subacromial pain (SAP) is a common complaint of young athletes, independently of the sport engaged. The prevalence of SAP in some sports is up to 50%. OBJECTIVE: The study was aimed to investigate some new factors possibly associated to subacromial pain in young athletes. The factors considered were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. METHODS: This case-control study included 82 young athletes 9–15 years, 41 with the symptoms of SAP and 41 controls. All participants self-reported whether they had subacromial pain. In addition, Hawkins–Kennedy Test was performed to all the participants to evaluate the subacromial pressure. Main outcome measures were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. The grade of tightness of the clavicular portion of the pectoralis major and the dysfunction of the sternoclavicular joint were measured with an inclinometer. Serratus anterior and lower trapezius strength were measured by a handheld dynamometer with external belt-fixation. The data were analyzed using t-test for independent samples, Mann-Whitney U test, contingency coefficients and a stepwise binary logistic regression. RESULTS: Significant statistical difference was observed in the grade of tightness of the clavicular portion of the pectoralis major and in the variable representing the physiological functioning of the sternoclavicular joint, between the cases and the controls. There was no significant difference in serratus anterior and lower trapezius strength between the cases and the controls. Logistic regression analysis showed that the variable representing the physiological functioning of the sternoclavicular joint and the grade of shortening of the clavicular portion of the pectoralis major were good predictors for presence of SAP. CONCLUSIONS: A strong association was determined between subacromial pain in young athletes, clavicular portion of pectoralis major tightness and the dysfunction of the sternoclavicular joint.

Sign in / Sign up

Export Citation Format

Share Document