Proportion and associated factors of neonatal sepsis among neonates admitted to neonatal intensive care units in central Gondar zone primary hospitals, Northwest Ethiopia, 2019.

Abstract

Background: Neonatal sepsis contributes substantially to neonatal morbidity and mortality and is an ongoing major global public health challenge. It is estimated to cause 26% of all neonatal deaths worldwide and 17% of neonatal deaths in in sub-Saharan Africa. Identification of risk factors and early institution of therapy can improve neonatal mortality and morbidity. Objective: To assess proportion and associated factors of neonatal sepsis among neonates admitted to neonatal intensive care units in central Gondar zone primary hospitals. Methods: institution based cross-sectional study was conducted and structured interviewer administered questionnaire was employed to collect the data. The data were entered into EPI INFO statistical software version 7.0 and imported to SPSS version 20 for further analysis by binary logistic regression model. Both bivariable and multivariable analysis was used to see the association of different variables. Adjusted odds ratio with 95% confidence interval was used to measure the presence and degree of association between variables. P-value of < 0.05 was considered as statically significant in the multivariable logistic regression. Results: A total of 352 neonates with the response rate of 338(96%) were included in the study. The overall prevalence of neonatal sepsis was 64.8 %( 95% CI (59.2, 69.2). In the multivariable analysis, neonatal sepsis was associated being male neonate[AOR=3.7; 95% CI(1.76,7.89)], history of urinary tract infections during the index pregnancy[AOR =6,26; 95% CI (1.16,33.62)], frequency of per-vaginal examination greater than three during labor[AOR=6.06; 95% CI((2.45,14.99)], neonatal resuscitation at birth [AOR=6.1; 95% CI (1.71,21.84)], place of delivery(health center)[AOR=3.05; 95% CI(1.19,7.79)], lack of training of health workers [AOR=2.14; 95% CI (1.04,4.44)], late age of neonate at onset of illness[AOR=0.05; 95% CI(0.01, 0.21] and maternal age 30-34 years [AOR=0.19; 95% CI(.047, 0.81)]. Conclusion and recommendation: The proportion of neonatal sepsis is high. Maternal, neonatal and health service related factors were identified for neonatal sepsis. Therefore; training of health workers, provision health care services as per standards and monitoring and evaluation of obstetrical/neonatal cares during labor and delivery are mandatory.