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Abstract
BackgroundThe current neonatal mortality rate in Nigeria (37/1000) is among the highest in the world and the major causes have consistently been reported as sepsis, perinatal asphyxia and prematurity. However, case-specific fatality which defines the risk of dying from these and other neonatal morbidities is rarely emphasized. Determination of case-specific fatality rates (CSFR) may inform a change in our current approach to neonatal care interventions which may eventually bring about the much-needed reduction in our neonatal mortality rate. Our aim was to determine the case-specific fatality rates for the common causes of mortality among hospitalized neonates at the National Hospital Abuja (NHA).MethodsRelevant demographic and clinical data on all neonates admitted into the NICU at the NHA over a period of 13 months (January 2017 to February 2018) were extracted from the Neonatal Registry database and analyzed using appropriate statistical methods with the SPSS version 20 software. The case-specific fatality rates were computed for the predominant morbidities in addition to determination of the neonatal mortality rates and associated risk factors.Results and conclusionA total of 730 neonates were admitted, out of which 391 (53.6%) were females, 396 (54.5%) were inborn and 396 (54.2%) were term. The three most prevalent morbidities were prematurity 272(37.2%), neonatal Jaundice 208(28.4%) and perinatal asphyxia 91(12.5%) while the most common causes of mortality were prematurity 47/113(41.6%), congenital malformations 27/113(23.9%) and perinatal asphyxia 26/113(23%). Congenital malformations had the highest case-specific fatality 27/83(32.5%) followed by Perinatal Asphyxia 26/91(28.6%) and prematurity 47/272(20.7%). The mortality pattern differed between inborn and out born babies. Implications of these case-specific fatality rates for targeted interventions are discussed.
Highlights
The current neonatal mortality rate in Nigeria (37/1000) is among the highest in the world and the major causes have consistently been reported as sepsis, perinatal asphyxia and prematurity
There are facilities for non-invasive respiratory support [bubble continuous positive airway pressure (BCPAP)], and all inborn very preterm babies are commenced on BCPAP as soon as they are stabilized in the labour room but surfactant administration is limited by parental affordability
One hundred and thirteen babies died giving an overall mortality of 15.5%
Summary
The current neonatal mortality rate in Nigeria (37/1000) is among the highest in the world and the major causes have consistently been reported as sepsis, perinatal asphyxia and prematurity. Perinatal asphyxia and prematurity have remained the leading causes of neonatal deaths reported from different parts of (the) Nigeria [1,2,3,4,5]. A more appropriate measure of this risk is the casespecific fatality rate which defines ‘the proportion of death within a designated population of a specified disease [10]. This is an indication of both the severity of the disease and standard of interventions available for the treatment of specific diseases. It is important to identify the most common neonatal illnesses with high casespecific fatality rates as a step towards designing and implementing targeted interventions that will include a comprehensive inter-hospital referral protocol, to reduce neonatal mortality in Nigeria
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