Prevalence of Sepsis and Possible Severe Bacterial Infection among Neonates in Nepal

Gambhir Shrestha,Nibaran Joshi,Parashu Ram Shrestha,Rashmi Mulmi

doi:10.3126/jnhrc.v16i1.19352

Abstract

Nepal lacks adequate data on the prevalence of sepsis and Possible Severe Bacterial Infection (PSBI) among neonates. Thus, this systematic review was designed to estimate the prevalence of neonatal sepsis and PSBI status in Nepal. We searched PubMed and Nepal Journal Online for relevant studies on PSBI and neonatal sepsis published from 2006 to 2016. The eligibility criteria included those studies done in Nepal, evaluating the prevalence of PSBI/neonatal sepsis with denominators as the population at risk that is either total live births or total cases evaluated. Altogether, four studies met the review criteria, out of which three were hospital-based and one community-based. There is a vast difference in prevalence rate between hospital-based (2-4%) and community-based (9%) studies. Two studies used haematological scoring system and blood culture to base their diagnosis; one used signs and symptoms for PSBI while the other did not mention the diagnostic criteria. This systematic review suggests that though neonatal sepsis poses a big problem, it lacks a significant number of related studies. There is a need to conduct a nationwide survey on the prevalence of sepsis and PSBI among neonates, which will help to develop health policy.

Highlights

Possible Severe Bacterial Infection (PSBI) is a clinical syndrome used in the Integrated Management of Neonatal and Childhood Illness (IMNCI) package referring to a sick young infant who requires urgent referral to hospital.[7]
The review found that a small number of studies have been conducted on the true prevalence of Neonatal sepsis and PSBI in Nepal
Most studies explored blood culture-proven neonatal sepsis among the suspected neonates which did not give the true prevalence of the morbidity

Summary

Introduction

Infection is the most common cause of neonatal mortality worldwide.[1,2,3,4,5,6] Possible Severe Bacterial Infection (PSBI) is a clinical syndrome used in the Integrated Management of Neonatal and Childhood Illness (IMNCI) package referring to a sick young infant who requires urgent referral to hospital.[7]. After a decade of struggle, the neonatal mortality has declined from 33 to 21 deaths per 1000 live births in Nepal as reported in the most recent Nepal Demographic Health Survey 2016 (NDHS).[11] WHO’s Every Newborn Action Plan (ENAP) sets a target of 10 or fewer neonatal deaths per 1000 live birth in every country by 2035.12 Nepal is committed to achieving this target and has set up some strategies such as the upgrade of government hospitals, implementation of free newborn care services and development of training materials and capacity building of health workers.[13, 14].

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