Abstract
Introduction: In Nigeria’s public hospitals, facilities for specialized neonatal care are few and available only in tertiary hospitals. However a greater number of neonates are delivered at the primary and secondary health care centres where these facilities are lacking. Thus, sick newborns are managed in the general paediatric ward along with other children and there is a likelihood of increased mortality in this group of neonates compared to those managed in standard neonatal units. Objective: To determine the morbidity and mortality pattern among neonates admitted to a general paediatric ward of a secondary health care facility. Method: This was a prospective cross sectional study of neonatal admissions and mortalities from January 2012 to December 2013. Result: A total of 655 neonates were admitted during the study period of which 68 were excluded. Of the 587 neonates analysed. 360 were males. The leading causes of admissions were neonatal sepsis, prematurity, perinatal asphyxia, haemorrhagic disease of the newborn and neonatal jaundice. There were 122 (20.3%) deaths with a male: female ratio of 1.7:1. Neonatal jaundice, prematurity and birth asphyxia had the highest case fatality rate. Conclusions: There were 20.3% deaths. The leading causes of admissions were neonatal sepsis, prematurity, perinatal asphyxia, haemorrhagic disease of the newborn and neonatal jaundice. DOI: http://dx.doi.org/10.4038/sljch.v45i2.7981 (Key words: Neonate, mortality, general paediatric ward)
Highlights
In Nigeria’s public hospitals, facilities for specialized neonatal care are few and available only in tertiary hospitals
Neonates born in primary and most secondary health facilities requiring any form of inpatient treatment are referred to tertiary hospitals or any other hospital within that vicinity with a functional newborn unit
Several studies have been done in the neonatal units of most Nigeria tertiary health centres to determine the pattern of newborn morbidity and mortality
Summary
In Nigeria’s public hospitals, facilities for specialized neonatal care are few and available only in tertiary hospitals. Tertiary hospitals in Nigeria have functional newborn units but this is not the case in most secondary health care facilities across the country. Neonates born in primary and most secondary health facilities requiring any form of inpatient treatment are referred to tertiary hospitals or any other hospital within that vicinity with a functional newborn unit. Several studies have been done in the neonatal units of most Nigeria tertiary health centres to determine the pattern of newborn morbidity and mortality. The results of these studies showed a neonatal mortality ranging between 13% and 25.9% while the common causes of neonatal death included but were not limited to perinatal or birth asphyxia, jaundice, infections and prematurity[3,4,5,6]. A mortality record in a Kenyan hospital suggested that the mortality rate for neonates admitted into the general paediatric ward was higher than that in the newborn unit[7]
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