The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study.

Edem M A Tette,Benjamin D Nuertey,Augustine Alandu,Naa Barnabas Gandau,Nana Ayegua Hagan Seneadza,Emmanuel A Azusong,Judith Yirifere,Edmund T Nartey,Dominic Akaateba,Lorna A Renner,Cheryl A Moyer

doi:10.1371/journal.pone.0232406

Abstract

BackgroundHigh global neonatal deaths have triggered efforts to improve facility-based care. However, the outcomes achievable at different levels of care are unclear. This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality.ObjectiveThis study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortalityMethodsA cross-sectional study involving a records-review over one year at the Upper West Regional Hospital, and three years at St Joseph’s District Hospital, Jirapa was carried out. Age, sex, gestational age, weight, duration of admission, diagnosis, among others were examined. The data were analysed and statistical inference made.ResultsAltogether, 2004 newborns were examined, comprising 1,241(62%) from St Joseph’s District Hospital and 763(38%) from Upper West Regional Hospital. The proportion of neonatal deaths was similar, 8.94% (St Joseph’s District Hospital) and 8.91% (Upper West Regional Hospital). Prematurity, neonatal sepsis, birth asphyxia, low birth weight, neonatal jaundice and pneumonia contributed the most to mortality and suspected infections including malaria accounted for almost half (45.5%). Mortality was significantly associated with duration of stay of 48 hours, being premature, and being younger than 3 days.ConclusionMajority of the mortality among the neonates admitted was due to preventable causes. Better stabilization and further studies on the epidemiology of sepsis, prematurity, low birth weight, including the contribution of malaria to these and outcome of transferred neonates are needed.

Highlights

High global neonatal deaths have triggered efforts to improve facility-based care
According to the Ghana Demographic and Health Survey 2014, neonatal mortality decreased from 30 to 29 per 1000 live births during the 15 years preceding the survey [3]. Since this reduction was at a slower pace than that of the infant and child mortality rates, the contribution of neonatal mortality to under-5 mortality rose from 28% to 48% over the same period
We examined the pattern of neonatal morbidity and mortality at the Upper West Regional Hospital which had recently established a neonatal unit and St Joseph’s Hospital, Jirapa, a district hospital with an established neonatal unit, in order to determine risk factors and modifiable factors associated with mortality, compare outcomes and identify measures that can improve outcome in this and similar settings

Summary

Background

High global neonatal deaths have triggered efforts to improve facility-based care. The outcomes achievable at different levels of care are unclear. This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality. Data Availability Statement: All relevant data are within the manuscript and its Supporting Information files

Methods

Conclusion

Materials and methods

Findings

Study design and sampling

Discussion