Neonatal hypothermia and its associated factors in East Africa: a systematic review and meta-analysis

Abstract

Abstract Background : Neonatal hypothermia is a global health problem and a major contributing factor for neonatal morbidity, mortality, and for new-born survival, especially in low and middle-income countries. High prevalence of hypothermia has been reported from countries with the highest burden of neonatal mortality. Therefore, the aim of this systematic review and meta-analysis was to assess the prevalence of neonatal hypothermia and its associated factors in Eastern Africa. Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of neonatal hypothermia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result: A total of 12 potential studies with 20,911 participants were used for analysis. The pooled prevalence of neonatal hypothermia in East Africa was found to be 57.22% (95%CI; 39.48–74.95).Delay in initiation of breastfeeding (AOR=2.83; 95%CI: 1.398-4.259; I 2 = 49.2%; P=0.097), having neonatal health problem (AOR=2.68; 95%CI: 1.21-4.15; I 2 = 0.0%; P=0.98), being low birth weight (AOR =2.16; 95%CI: 1.03-3.29; I 2 =3.3%; P=0.005), being preterm(AOR=4.01; 95%CI: 3.02-5.00; I 2 = 0.0%; P=0.457), and night time delivery (AOR=4.01; 95%CI:3.02-5.00; I 2 =0.0%; P=0.457) were identified associated factors which significantly increase the risk of neonatal hypothermia. Conclusions : The prevalence of neonatal hypothermia in Eastern Africa remains high. Delay in initiation of breastfeeding, having neonatal health problem, being low birth weight, preterm, and nighttime delivery were identified associated factors which significantly increase the risk of neonatal hypothermia. It is recommended that early initiation of breast feeding should be promoted and emphasis should be given towards low birth weight, preterm and neonates with neonatal problems to prevent burdens of hypothermia in East Africa.