scholarly journals A cross sectional study to ascertain various causes of neonatal mortality using verbal autopsy in Etawah district

Author(s):  
Nawazish Ali ◽  
Pankaj Kumar Jain ◽  
Sushil Kumar Shukla ◽  
Dhiraj Kumar Srivastava ◽  
Shailendra Kumar Chaurasiya ◽  
...  

Background: Neonatal death is defined as no. of deaths during the first 28 completed days of life per 1000 live births in a given year or period.  Around 2.6 million deaths or roughly 46% of all under five deaths had occurred during this period in 2016 which means that 7000 newborn deaths occur each day. Most of the neonatal deaths occur on the first day and week accounting to about 1 million dying on the 1st day. Objective of this study was to ascertain various causes of neonatal mortality using verbal autopsy in Etawah district.Methods: The present study was a retrospective cross-sectional study carried out for a period of 1 year (July 17 to June 2018) using WHO verbal autopsy questionnaire by finding out the study subjects from medical information system of UPUMS, Saifai and district hospital, Etawah. A total of 89 neonatal deaths were found out of which 87 were interviewed by going to their residences to get the relevant information regarding the causes of deaths.Results: Most common cause of neonatal mortality came out to be low birth weight with prematurity 44 of 87 (50.6%), followed by birth asphyxia 23 of 87 (26.4%) and sepsis 8 of 87 (9.2%).Conclusions: Effective interventions should be incorporated into policy decisions to reduce neonatal mortality due to these causes.

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Afizu Alhassan ◽  
Abdul-Ganiyu Fuseini ◽  
Wahab Osman ◽  
Alhassan Basour Adam

Background. Efforts to reduce under-five mortality across the globe are being hindered by a disproportionately high rate of neonatal deaths. About a quarter of these neonatal deaths are caused by birth asphyxia. Available evidence shows that effective neonatal resuscitation delivered by providers skilled in and knowledgeable about neonatal resuscitation can significantly reduce neonatal mortality rates. Objectives. This cross-sectional study was conducted to determine knowledge and experience in neonatal resuscitation among midwives in Tamale, and the factors associated with their knowledge on neonatal resuscitation. Methods. This was a cross-sectional study involving all midwives practicing in three large hospitals in Tamale. We developed a questionnaire to collect data on demographic characteristics of participants, and their knowledge and experience in neonatal resuscitation. We used the Statistical Package for Social Sciences (SPSS), version 21, to analyse the data. Demographic characteristics of participants were summarized using descriptive statistics. Pearson’s correlation was used to determine associations between knowledge and some selected demographic features, while the one-way ANOVA was conducted to determine differences in level of knowledge based on the demographic features. Results. 98.1% of the participants in this study had insufficient knowledge on neonatal resuscitation. Midwives at the Tamale Central Hospital demonstrated a statistically significantly higher level of knowledge (24.67 ± 2.79, p = .014), compared to those at the Tamale Teaching Hospital (22.92 ± 4.56, p = .028) and Tamale West Hospital (21.50 ± 6.24, p = .021). Those who had a first-degree qualification in midwifery and those with a Post-NAC/NAP midwifery certificate had a statistically significantly higher knowledge than those with a diploma in midwifery. Training in neonatal resuscitation was associated with more knowledge in neonatal resuscitation (r(158) = .195, p = .013). In terms of experience, 55% of the participants in this study were not experienced in performing neonatal resuscitation. There were no differences in their level of experience based on their academic qualification, work place, and years of practice as a midwife. Conclusion. Considering the generally low level of knowledge and experience of midwives in neonatal resuscitation as discovered in this study, there is an urgent need for government to provide more opportunities for all practicing midwives to be trained in this important lifesaving skill.


2021 ◽  
Vol 11 (Number 2) ◽  
pp. 26-34
Author(s):  
Nahian Ahmed Chowdhury ◽  
Dipak Kumar Mitra ◽  
Afrin Ahmed Clara ◽  
Md. Suhail Alam ◽  
MD. Zahed Hossain

Background: The moment most common cause of in-hospital infection is pneumonia. Pneumonia is prevalent within the ICU (Intensive Care Unit) setting and can be deadly. The Incidence of pneumonia is approximately 17% in the therapeutic ICU2 but can be 6 to 20 times increased in mechanically ventilated patients. The duration of hospital stay and expenditure are both expanded in patients who develop ventilator-associated pneumonia. This study aims to identify the causative microorganism responsible for CAP (Community-Acquired Pneumonia) and VAP (Ventilator-Associated Pneumonia) and their antibiotic sensitivity pattern. Methods: This was a comparative cross-sectional study that was carried out at two ICU in Sylhet city. The data was collected from the patient's medical information, the patient's file, and the hospital information system. Culture and sensitivity (C/S) were collected from the electronic medical information system (MIS). All data from January 2019 to December 2020, including patient's information, course of the disease (in terms of death or recovery-if available), clinical features, and investigation reports, was transferred to an electronic data collection sheet (Microsoft Excel). After completion of all data collection, analysis was conducted through a spreadsheet. Comparison between two disease groups was made by independent t-test. Within the group, the analysis was done by the Chi-Square test. Results: In this thesis study, it was found that the most common organism responsible for CAP was Streptococcus spp. (34.70%) and is sensitive to Meropenem (92.21%), Imipenem (88.16%), Amikacin (70.67%), Piperacillin (70.91%), Moxifloxacin (70.96%), Levofloxacin (67.95%), Amoxiclav (67.92%), and Ceftriaxone(63.95%). The most common causative organism responsible for VAP was Staphylococcus spp. (36.51%) and it was sensitive to Imipenem (100%), Moxifloxacin (100%), Meropenem (94.73%), Amikacin (85.71%), Ceftriaxone (60%), Amoxiclav (66.66%), Levofloxacin (57.14%), and Cefuroxime (50%). Conclusion: Pneumonia is still one of the most common reasons for hospitalization, particularly for those admitted to ICU. It has been observed in several studies that the majority of the cases are communityacquired pneumonia. Many mechanically ventilated patients often develop VAP, which is fatal if timely diagnosis and appropriate antibiotics administration are not made. Streptococcus spp. was the most common organism responsible for CAP, and Staphylococcus spp. mainly was responsible for VAP.


2021 ◽  
pp. 41-43
Author(s):  
Chavan L. G ◽  
Bangal V. B. ◽  
Poorna M. N.

Introduction- Stillbirth rates are unacceptably high in developing countries. It reects the suboptimum quality of maternal and child health services. Material And Methods- Prospective observational cross sectional study, carried out for one year duration at tertiary care referral hospital in central India. Results-There were 9165 deliveries and 9318 babies born in the hospital.There were 318 stillbirths of which 245(77%) were antepartum stillbirths and 73(23%) were intra-partum stillbirths. The stillbirth rate in the present study was 34/1000 births. Ante-partum haemorrhage (36%) and pregnancy induced hypertension (21%) were most common causes of ante-partum stillbirths where as extreme prematurity with very low birth weight (41%), birth asphyxia, meconium aspiration (21%) and intra-partum haemorrhage (15%) were common causes of intra-partum stillbirths. Conclusion- There is high rate of stillbirths in the present study. Health education, improvement of maternal nutrition, regular antenatal check-ups, high risk pregnancy identication and timely referral and institutional deliveries will help in preventing large number of stillbirths.


2019 ◽  
Vol 73 (7) ◽  
pp. 660-667
Author(s):  
Omar Karlsson ◽  
Rockli Kim ◽  
William Joe ◽  
S V Subramanian

BackgroundIn India, excess female under-5 mortality is well documented. Under-5 mortality is also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal and child mortality in India.MethodsRepeated cross-sectional study of nationally representative samples of 298 955 children 0–60 months old from the National Family Health Surveys conducted in 2005–2006 and 2015–2016. The study used logistic regression models as well as Cox proportional hazards models.ResultsOverall, boys had greater neonatal mortality than girls and the difference increased between 2005–2006 and 2015–2016. Girls had greater postneonatal and child mortality, but the difference decreased between the surveys and was not statistically significant for child mortality in 2015–2016. A negative wealth gradient was found for all mortality outcomes. Neonatal mortality was persistently greater for boys. Girls had higher child mortality than boys at low levels of wealth and greater postneonatal mortality over much of the wealth distribution. The wealth gradient in neonatal mortality increased between surveys. Females had a stronger wealth gradient than boys for child mortality.ConclusionNot distinguishing between neonatal, postneonatal and child mortality masks important gender-specific and wealth-specific disparities in under-5 mortality in India. Substantial gains towards the Sustainable Development Goals can be made by combating neonatal mortality, especially at low levels of wealth. Although impressive improvements have been made in reducing the female disadvantage in postneonatal and child mortality, concerted engagements are necessary to eliminate the gender gap—especially in poor households and in north India.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Temesgen Debero Mere ◽  
Tilahun Beyene Handiso ◽  
Abera Beyamo Mekiso ◽  
Markos Selamu Jifar ◽  
Shabeza Aliye Ibrahim ◽  
...  

Background.Breech deliveries have always been topical issues in obstetrics. Neonates undergoing term breech deliveries have long-term morbidity up to the school age irrespective of mode of delivery.Objective. To determine prevalence and perinatal outcomes of singleton term breech delivery.Methods. Hospital based cross-sectional study was conducted on 384 participants retrospectively. Descriptive and analytical statistics was used.Result. A total of 384 breech deliveries were included. Prevalence of singleton breech deliveries in the hospital was 3.4%. The perinatal outcome of breech deliveries was 322 (83.9%). Adverse perinatal outcome of singleton term breech delivery was significantly associated with women’s age of greater than or equal to 35 years (AOR = 2.62, 95% CI = 1.14–6.03), fully dilated cervix (AOR = 0.48, 95% CI = 0.25–0.91), ruptured membrane (AOR = 5.11, 95% CI = 2.25–11.6), and fetal weight of <2500 g (AOR = 6.77, 95% CI = 3.22–14.25).Conclusion. Entrapment of head, birth asphyxia, and cord prolapse were the most common causes of perinatal mortality. Factors like fetal weight <2500 gm, mothers of age 35 years and above, those mothers not having a fully dilated cervix, and mothers with ruptured membrane were associated with increased perinatal mortality.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David R. Soriano-Moreno ◽  
Daniel Fernandez-Guzman ◽  
Fabricio Ccami-Bernal ◽  
Cristhian Rojas-Miliano ◽  
Wendy Nieto-Gutierrez

Abstract Background Chlorine dioxide has been promoted as an alternative for the prevention and treatment of COVID-19, especially in Peru, despite the lack of evidence to support its efficacy. This study aimed to evaluate the factors associated with chlorine dioxide consumption in the Peruvian population. Methods Analytical cross-sectional study. An adult Peruvian population was evaluated where chlorine dioxide consumption was divided into two groups according to the purpose of use: as prevention (individuals without COVID-19 history) and as treatment (individuals with COVID-19 history). The associated factors in each group were evaluated using Poisson regressions with the bootstrapping resampling method. Results Of 3610 participants included, 3213 reported no history of COVID-19, and 397 had been infected. The prevalence of chlorine dioxide consumption to prevent or treat COVID-19 was 8 and 16%, respectively. Factors either positively or negatively associated with chlorine dioxide consumption for prevention were male sex (aPR: 1.36; 95% CI: 1.09–1.71), being an adult or older adult (aPR: 0.54; 95% CI: 0.35–0.82), having a health sciences student within the family unit (aPR: 1.38; 95% CI: 1.02–1.87), using medical information as the main source of information of COVID-19 (aPR: 0.57; 95% CI: 0.40–0.80), having comorbidities for COVID-19 (aPR: 1.36; 95% CI: 1.01–1.82), considering COVID-19 dangerous and deadly (aPR: 0.57; 95% CI: 0.45–0.74), using medications (aPR: 1.59; 95% CI: 1.25–2.06) and plants to prevent COVID-19 (aPR: 1.69; 95% CI: 1.21–2.36), considering chlorine dioxide ineffective (aPR: 0.18; 95% CI: 0.18–0.24), and being uninformed of its efficacy (aPR: 0.21; 95% CI: 0.16–0.28). In addition, factors associated with chlorine dioxide consumption for treatment were considering COVID-19 dangerous and deadly (aPR: 0.56; 95% CI: 0.33–0.96), considering chlorine dioxide ineffective (aPR: 0.22; 95% CI: 0.12–0.42), and being uninformed of its efficacy (aPR: 0.15; 95% CI: 0.07–0.32). Conclusions The prevalence of chlorine dioxide consumption to treat COVID-19 was higher than prevent. It is important to apply information strategies, prioritizing population groups with certain characteristics that are associated with a higher consumption pattern.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051161
Author(s):  
Bekahegn Girma ◽  
Jemberu Nigussie

ObjectiveThis study aimed to assess the magnitude of preterm neonatal mortality in hospitals and associated factors in northern Ethiopia.DesignInstitutional-based cross-sectional study.SettingComprehensive specialised hospitals in the Tigray region, northern Ethiopia.ParticipantsPreterm neonates admitted in Ayder and Aksum comprehensive specialised hospitalsPrimary outcomeMagnitude of preterm neonatal mortality.Secondary outcomeFactors associated with preterm neonatal mortalityResultThis study was conducted from 1 April 2019 to 15 May 2019 among 336 participants with a response rate of 96.8%. The magnitude of preterm neonatal mortality was 28.6% (95% CI: 24.0 to 33.7). In multivariable logistic regression, respiratory distress syndrome (adjusted odd ratio (AOR)=2.85; 95% CI: 1.35 to 6.00), apnoea of prematurity (AOR=5.45; 95% CI: 1.32 to 22.5), nulli parity (AOR=3.63; 95% CI: 1.59 to 8.24) and grand parity (AOR=3.21; 95% CI: 1.04 to 9.94) were significant factors associated with preterm neonatal mortality. However, receiving Kangaroo mother care (AOR=0.08; 95% CI: 0.03 to 0.20) and feeding initiated during hospitalisation (AOR=0.07; 95% CI: 0.03 to 0.15) were protective against preterm neonatal mortality.ConclusionsThe magnitude of preterm neonatal mortality in hospitals was still high. Interventions geared towards curbing preterm in-hospital neonatal mortality should strengthen early diagnosis and treatment of preterm newborns with respiratory distress syndrome and apnoea of prematurity; while concomitantly reinforcing the implementation of kangaroo care and early feeding initiation is important.


Author(s):  
Ambren Chauhan ◽  
M. Salman Shah ◽  
Najam Khalique ◽  
Uzma Eram

Background:Neonatal mortality rate is regarded as an important and sensitive indicator of the health status of a community. Children face the highest risk of dying in their first month of life. The present study was aimed to 1) determine the prevalence of neonatal mortality rate 2) identify socio-biological factors in relation to neonatal mortality.3) determine the causes of neonatal mortality. Methods:A community based cross sectional study was conducted in the field practice areas of Department of Community Medicine, AMU, Aligarh. All the live births and all neonatal deaths were taken for one year from June 2016 to May 2017. A standard Verbal autopsy questionnaire (WHO 2012) was used as a study tool. Results:The prevalence of neonatal mortality rate was38.2/1000 live births. The early neonatal mortality rate was 28.3/1000 live births and late neonatal mortality rate was 9.9/1000 live births. The associated socio –biological factors were gender [OR-2.381, 95% CI-1.037-5.468], birth order [OR-4.090, 95% CI-1.119-14.946] and gestational age [OR-12.62, 95% CI-3.26-48.82]. The leading causes of deaths among newborns were preterm births (22.2%), birth asphyxia (22.2%), other causes (19%), ARI (14.3%), congenital anomalies (14.3%) and diarrhoeaandneonatal sepsis accounted for (4.8%) each. Conclusions: The neonatal mortality rate assessed by verbal autopsy is higher than nationally reported. Most of the deaths were in early neonatal period. There is a need for programs encouraging the use of antenatal care, encouraging institutional deliveries and care of LBW neonates; as well as implementation of community-based newborn survival strategies.


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