Incidence and Risk Factors of Thrombocytopenia in Neonates Admitted With Surgical Disorders to Neonatal Intensive Care Unit of Tikur Anbessa Specialized Hospital; A One-Year Observational Prospective Cohort Study From a Low-Income Country

Background: Chorioamnionitis (CAM) is one of the major risk factors for neonatal early-onset sepsis (EOS). Different international guidelines have been developed for diagnosis and care of such neonates. This research aimed to evaluate our neonates and compare them with the guidelines. Methods: This prospective cohort study was conducted during five years (March 2012 to March 2017), and comprised of neonates (any gestational age) born to mothers with CAM (any criteria). The neonates’ clinical findings and interventions were collected and analyzed. Results: In total, out of 28,988 live born neonates, CAM was found in mothers of 169 neonates (1.7%). Among the studied neonates, 30.8% were born ≤34 week of gestation, 39% had birth weight <2500 g, and 58.6% were asymptomatic. Out of 99 asymptomatic neonates, 47 were observed near mothers and 52 admitted to the neonatal intensive care unit (NICU). The frequency of abnormal tests was 23.07% in asymptomatic vs. 35.7% in symptomatic neonates; three neonates developed culture positive EOS (2.75%) and 68.05% of the neonates received antibiotics. The length of stay was 2.59 ± 1.13 (median = 2.00, IQR = 1.00) days in asymptomatic vs. 15.15 ± 13.67 (median = 7.00, IQR = 15.25) days in symptomatic neonates (P<0.001). Conclusion: The use of guidelines increased the length of stay, lab tests, and antibiotics in asymptomatic and neonates with negative blood culture. In addition to the mother-neonate separation, these guidelines may increase nosocomial infection, antibiotic resistance, and costs; therefore, new guidelines are needed to be developed.

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Risk Factors for Peripherally-Inserted Central Catheter Blood Stream Infection at a Neonatal Intensive Care Unit: A Retrospective Cohort Study

Japanese Journal of Infection Prevention and Control ◽

10.4058/jsei.34.287 ◽

2019 ◽

Vol 34 (6) ◽

pp. 287-295

Author(s):

Sayuri KAWANO ◽

Koji YONEMOTO ◽

Tomoko SAKIHAMA

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Retrospective Cohort ◽

Neonatal Intensive Care ◽

Blood Stream Infection ◽

Blood Stream ◽

Peripherally Inserted Central Catheter ◽

Central Catheter

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An Outbreak of Influenza A in a Neonatal Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1086/501786 ◽

2000 ◽

Vol 21 (7) ◽

pp. 449-454 ◽

Cited By ~ 103

Author(s):

Robert J. Cunney ◽

Anne Bialachowski ◽

Diane Thornley ◽

Fiona M. Smaill ◽

Ross A. Pennie

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Cohort Study ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Influenza A ◽

Neonatal Intensive Care ◽

Twin Pregnancy ◽

Multiple Logistic Regression Analysis

Objectives:Investigation of an outbreak of influenza A in a neonatal intensive care unit (NICU) with examination of risk factors for infection and outcomes.Design:Retrospective cohort study of infants admitted to the unit during the outbreak period. Prospective survey of NICU staff and mothers of infants in the cohort study.Setting:Level III nursery in a university-affiliated tertiary referral center.Results:Nineteen infants in the NICU were infected with influenza A. There were six symptomatic cases and one death who had evidence of virus-associated hemophagocytic syndrome at autopsy. Amantadine prophylaxis was offered to the NICU staff, and amantadine therapy was given to five of the six symptomatic infants. Mechanical ventilation, gestational age, birth weight, Clinical Risk Index for Babies score, and twin pregnancy were associated with acquisition of influenza A on univariate analysis. Mechanical ventilation (odds ratio [OR], 6.2;P=.02) and twin pregnancy (OR, 7.0;P=.04) remained as significant risk factors for infection on multiple logistic regression analysis. Only 15% of respondents to the NICU staff survey were vaccinated against influenza. There was no association between a history of an influenza-like illness during pregnancy and acquisition of influenza A by infants of mothers who responded to the maternal survey (OR, 0.91;P=1.0).Conclusions:Influenza A is an important pathogen in the neonatal population and is readily transmissible in the NICU setting.

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Non-Medical Risk Factors as Avoidable Determinants of Excess Mortality in Children with Chronic Kidney Disease. A Prospective Cohort Study in Nicaragua, a Model Low Income Country

PLoS ONE ◽

10.1371/journal.pone.0153963 ◽

2016 ◽

Vol 11 (5) ◽

pp. e0153963 ◽

Cited By ~ 5

Author(s):

Giovanni Montini ◽

Alberto Edefonti ◽

Yajaira Silva Galán ◽

Mabel Sandoval Díaz ◽

Marta Medina Manzanarez ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Low Income ◽

Prospective Cohort ◽

Excess Mortality ◽

Medical Risk ◽

Low Income Country ◽

Medical Risk Factors

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Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420160000100003 ◽

2016 ◽

Vol 50 (1) ◽

pp. 22-28 ◽

Cited By ~ 7

Author(s):

Mitzy Tannia Reichembach Danski ◽

Priscila Mingorance ◽

Derdried Athanasio Johann ◽

Stela Adami Vayego ◽

Jolline Lind

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Cohort Study ◽

Neonatal Intensive Care ◽

Intermittent Infusion ◽

High Rate ◽

Intravenous Catheter ◽

Factors Associated ◽

Peripheral Intravenous Catheter ◽

Associated Risk Factors

Abstract OBJECTIVE To evaluate the incidence of complications related to the use of peripheral intravenous catheter in neonates and identify the associated risk factors. METHOD Prospective cohort study conducted in a Neonatal Intensive Care Unit. Participants were the hospitalized neonates undergoing peripheral intravenous puncture in the period from February to June 2013. RESULTS The incidence of complications was 63.15%, being infiltration/extravasation (69.89%), phlebitis (17.84%) and obstruction (12.27%). The risk factors were the presence of infection (p = 0.0192) and weight at the puncture day (p = 0.0093), type of intermittent infusion associated with continuous infusion (p <0.0001), endotracheal intubation (p = 0.0008), infusion of basic plan (p = 0.0027), total parenteral nutrition (P = 0.0002), blood transfusion associated with other infusions (p = 0.0003) and other drugs (p = 0.0004). Higher risk of developing complications in the first 48 hours after puncture. CONCLUSION A high rate of complications related to the use of peripheral intravenous catheter, and risk factors associated with infection, weight, drugs and infused solutions, and type of infusion.

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A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

Journal of Child Neurology ◽

10.1177/0883073819864516 ◽

2019 ◽

Vol 34 (13) ◽

pp. 842-850

Author(s):

Emmanuel Segnon Sogbossi ◽

Damienne Houekpetodji ◽

Toussaint G. Kpadonou ◽

Yannick Bleyenheuft

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

Low Income ◽

Classification System ◽

West African ◽

Low Income Countries ◽

Cross Sectional ◽

Common Cause ◽

Low Income Country ◽

Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

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