Determinants of Neonatal Sepsis Admitted In Neonatal Intensive Care Unit At Public Hospitals Of Kaffa Zone, South West Ethiopia

Abstract

AbstractBackgroundNeonatal sepsis is a systemic inflammatory response syndrome in the presence of infection during the first 28 days of life. Globally every year about 4 million children die in the first 4 weeks of life, of which 99% of the deaths occur in low and middle income countries and the most common causes of neonatal death in Ethiopia. Identification of the determinants for neonatal sepsis and treatment of newborns with sepsis is not adequate in low income countries like Ethiopia especially in southern part of the country.ObjectiveTo identify determinants of neonatal sepsis admitted in neonatal intensive care unit at public hospitals of Kaffa zone, south west Ethiopia 2021.MethodsInstitutional based unmatched case control study was conducted on a total sample of 248 (62 cases and 186 controls) in public Hospitals of kaffa zone from March to April 2021.The collected data were entered, coded and cleaned by Epidata version 3.1 and it was exported to SPSS version 25. Bi-variable and multivariable logistic regression was conducted. Variables with (p< 0.25) in bi-variable logistic regression analysis, were entered to multivariable logistic regression and then determinants which is statistical significant will be declared at P<0.05.ResultA total of 248 (62 cases and 186 controls) were included in the study. variables like prolonged rupture of membrane ≥18 hours [AOR =5.13, 95%CI=1.38-19.05], meconium stained amniotic fluid[AOR =6.03, 95%CI=2.16-16.90], intra-partum fever [AOR =8.26, 95%CI=3.12-21.97], urinary tract infections [AOR=14,55, 95%CI=4.91-43.10], breast feeding after a hour [AOR =3.9, 95%CI=1.27-12.02], resuscitation [AOR =13.25, 95%CI=3.44-51.01], no chlorohexidine application [AOR =4.27, 95%CI=1.65-11.08] were significantly associated with neonatal sepsis.Conclusion and RecommendationAmong the variables prolonged rupture of membranes, meconium stained amniotic fluid, intra-partum fever, UTI/STI, and not breast feeding with in a hour were maternal variables and resuscitation at birth and not application of chlorohexidine ointment on the umbilicus were neonatal variables that were found to be neonatal-related risk factors of neonatal sepsis. Infection prevention strategies and clinical management need to be strengthening and/or implementing by providing especial attention for the specified determinants.