Abstract
BackgroundNeonatal hypothermia plays a significant role in increasing neonatal death by 80% for every 1 degree Celsius decrease of body temperature, especially in sub Saharan countries. A global burden of neonatal hypothermia indicated that 53% of Ethiopian newborns developed hypothermia due to different socio-demographic, behavioral, physiological and birth context related factors. However, the significance of these factors along the spectrum of public health institutions in the study area hasn’t been yet studied.ObjectiveTo assess the prevalence and associated factors of neonatal hypothermia within six hours of delivery at public health institutions of Harar city, Eastern Ethiopia, 2018.MethodsAn institution based cross sectional study was conducted at Harar city after stratified followed by random selection of 3 public health institutions. Every other eligible newborn was included by systematic sampling to yield a sample of 403 newborns and their axillary temperature was measured by a calibrated digital thermometer within six hours of delivery from January 25 to February 19, 2018. A pre-tested anonymous questionnaire and checklist were used. The collected data were cleaned, coded and entered into Epi -data version 4.2 and exported to STATA version 12. Binary logistic regression model was considered and those variables with P < 0.25 in the bivariable analysis were included in to final model after which statistical significance was declared at P < 0.05. The goodness of fit was tested by Hosmer-Lemeshow statistic and Omnibus tests. Multi co-linearity was diagnosed using standard error and correlation matrix.ResultsThe prevalence of neonatal hypothermia in the study area was 66.3% (95% CI: 61.1, 70.5%). No skin to skin contact (AOR = 2.87, 95% CI:1.48, 5.57), no wearing cap (AOR = 2.10, 95% CI:1.17, 3.76), no warm intra-facility transportation (AOR = 3.18, 95% CI: 1.84, 5.48), born to mothers having obstetric complication (AOR = 2.42, 95% CI:1.28, 4.57), prematurity (AOR = 3.37, 95% CI:1.53, 7.44) and neonatal health problem (AOR = 4.24, 95% CI:1.92, 9.34) were significantly associated with hypothermia.ConclusionThe prevalence of neonatal hypothermia was relatively high. Therefore, adherence should be made to the thermal care mainly the cost effective ones like wearing cap, skin to skin contact and warm transportation.
Highlights
Neonatal hypothermia plays a significant role in increasing neonatal death by 80% for every 1 degree Celsius decrease of body temperature, especially in sub Saharan countries
An institution based cross sectional study was conducted at Harar city after stratified followed by random selection of 3 public health institutions
No skin to skin contact (AOR = 2.87, 95% Confidence Interval (CI):1.48, 5.57), no wearing cap (AOR = 2.10, 95% CI:1.17, 3.76), no warm intra-facility transportation (AOR = 3.18, 95% CI: 1.84, 5.48), born to mothers having obstetric complication (AOR = 2.42, 95% CI: 1.28, 4.57), prematurity (AOR = 3.37, 95% CI:1.53, 7.44) and neonatal health problem (AOR = 4.24, 95% CI:1.92, 9.34) were significantly associated with hypothermia
Summary
Neonatal hypothermia plays a significant role in increasing neonatal death by 80% for every 1 degree Celsius decrease of body temperature, especially in sub Saharan countries. According to World Health Organization, neonatal hypothermia is defined as an abnormal thermal state in which the newborn’s body temperature is below 36.5 °C [1]. It is classified into three different categories based on core temperature of a new-born below 36.5 °C measured as skin temperature in the axilla: mild hypothermia (36.0 °C–36.4 °C), moderate hypothermia (32.0 °C–35.9 °C) and severe hypothermia (< 32.0 °C) [1,2,3]. Morbidity and mortality of newborns is uniformly higher among premature and low birth weight newborns as compared to their counter parts [9]
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