Risk Factors For Neonatal Sepsis Research Articles

Prevalence and antibiotic resistance pattern of bacteria from sepsis suspected neonates at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

BackgroundNeonatal sepsis is the major cause of neonatal mortality and morbidity, especially in low and middle-income countries. Continuous monitoring of pathogens and their antibiotic resistance pattern is crucial for managing neonatal sepsis. This study aimed to determine neonatal sepsis due to bacteria, antibiotic resistance patterns, associated risk factors and patient outcomes at St. Paul’s Hospital Millennium Medical College.MethodAn institutional-based cross-sectional study was conducted on 400 neonates suspected of sepsis at St. Paul’s Hospital Millennium Medical College from March 2020 to July 2020. A questionnaire was used to collect socio-demographic information, clinical parameters and potential risk factors from study participants. About 2ml of blood was drawn aseptically and inoculated into Tryptone Soya Broth at the patient’s bedside. Bacterial identification was performed by using standard microbiological techniques. The disk diffusion method was used to determine the antibiotic susceptibility patterns of each isolated bacteria. Data entry and analysis were done using Statistical Package for Social Sciences (SPSS) version 20 software. Bivariate and multivariable logistic regressions were used to assess associated risk factors of neonatal sepsis. A p-value less than 0.05 was considered statically significant with a 95% confidence interval.ResultsThe overall prevalence of neonatal septicemia was 21% (84/400). Of these, 67 (79.8%) and 17 (20.2%) were gram-negative and gram-positive bacteria, respectively. Klebsiella spp, 37 (44%), E. coli 19 (21.6%) and Coagulase negative Staphylococci 13 (15.47%) were the leading cause of neonatal sepsis. Ciprofloxacin and amikacin were the most effective antibiotics for gram-negative and gram-positive bacteria. Multidrug resistance was observed in 84% of the bacterial isolates. Low birth weight and preterm were associated with neonatal septicemia (AOR = 49.90, 95% CI = 15.14-123.081, P = 0.002) and (AOR = 18.20, 95% CI = 6.835–27.541, P = 0.004) respectively.ConclusionKlebsiella spp and E. coli were frequently isolated bacteria in our study. The proportion of multidrug-resistance was significantly high. Most isolated bacteria were resistant to ampicillin, ceftazidime, cefotaxime and gentamycin, which indicates the necessity of continuous evaluation of antibiotic resistance rate.

Sepsis Risk Factors in Neonatal Intensive Care Units of Public Hospitals in Southeast Ethiopia, 2020: A Retrospective Unmatched Case-Control Study.

Neonatal sepsis is a significant contributor to neonatal morbidity and mortality worldwide. It is more prevalent in developing countries. Thus, understanding the risk factors for neonatal sepsis is critical to minimizing the incidence of infection, particularly in Ethiopia. The purpose of this study was to identify the risk factors for neonatal sepsis in neonates admitted to neonatal intensive care units of public hospitals in Southeast Ethiopia in 2020. An institution-based, retrospective unmatched case-control study was conducted on 97 cases and 194 controls in neonatal intensive care units of public hospitals in Southeast Ethiopia. A pretested, structured questionnaire was used to collect the data. Data was entered using EpiData 3.1 and analyzed using SPSS version 23. Bivariable and multivariable logistic regression analyses were performed to identify associated factors. An adjusted odds ratio with a 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p value of < 0.05. In this study, 97 cases and 194 controls were included. About two-thirds (63.9%) of cases were with early onset neonatal sepsis (<7 days). Mode of delivery with spontaneous vaginal delivery (AOR:5.032; 95% CI (1.887-13.418)), type of birth attendant (traditional birth attendant) (AOR: 4.407 95% CI (1.213,16.004)), history of STI/UTI (AOR:2.543; 95% CI (1.313,4.925)), intrapartum fever (AOR:4.379; 95% CI (2.170,8.835)), APGAR score at the 5thminute < 7 (AOR:4.832; 95% CI (1.862,12.537)), neonate received resuscitation (AOR:3.830; 95% CI (1.753,8.369)), low birth weight (AOR:6.101; 95% CI (2.124,17.525)) were the identified risk factors for neonatal sepsis. Both maternal and neonatal factors contribute to the risk of neonatal sepsis. Spontaneous vaginal delivery, birth attended by the traditional birth attendant, history of STI/UTI, presence of intrapartum fever, low APGAR score at the 5th minute, neonate receiving resuscitation, and low birth weight were identified as independent risk factors for neonatal sepsis. Prompt identification of the aforementioned factors and management should be sought for all newborns.

Determinants of neonatal sepsis among neonates admitted to neonatal intensive care units in ethiopian hospitals: A systematic review and meta-analysis

ObjectiveSeveral studies have identified risk factors for neonatal sepsis, but they are limited to specific geographical areas with results that may not be generalizable to other populations. Hence, the objective of this study was to determine the contributing factors, representative at a national level, that influence the occurrence of neonatal sepsis in neonates receiving hospital care in Ethiopia. Methods and materialsA thorough search was conducted across PubMed/Medline, Hinari, Cochrane Library, and Google Scholar to identify relevant studies. The pooled odds ratio was estimated using the random effect model. The heterogeneity among the included studies was evaluated using the I2 and Cochrane Q-statistics tests. Egger's tests used to assess publication bias. ResultsA total of 19 studies comprising 6190 study participants were included. Neonatal sepsis was positively associated with several factors, namely: prolonged premature rupture of membrane (OR: 3.85, 95% CI: 2.31–6.42), low first minute APGAR score (OR: 3.74, 95% CI: 1.29–10.81), low fifth minute APGAR score (OR: 4.17, 95% CI: 1.76–9.91), delayed initiation of breastfeeding (OR: 3.41, 95% CI: 2.18–5.36), and infection of the maternal urinary tract (OR: 3.17, 95% CI: 1.87–5.35). ConclusionDuration of rupture of membrane, APGAR score, time of initiation of breastfeeding, and urinary tract infection have a role in the development of neonatal sepsis.

Early Onset Sepsis in Neonates

Background Neonatal sepsis is one of the most important causes of neonatal morbidity and mortality. The most common risk factors associated with early onset sepsis (EOS) are preterm delivery, low birth weight, premature rupture of membranes, maternal urinary tract infection, Clinical manifestations of neonatal sepsis are nonspecific. These include temperature instability, respiratory distress, apnea, poor feeding, lethargy, irritability, convulsions, hypotonia, poor perfusion and abdominal distension Aim and objectives To describe epidemiology, demographic and incidence of early onset sepsis in neonate with risk factors at NICUS of Ain Shams University Hospitals. Subjects and methods This study is prospective cohort study, was carried out on 80 neonates with one or more maternal risk factors associated with EOS. Neonates will be completely evaluated and subsequently discriminated over the period of 1st 72hours of life in Neonates with risk factors for early-onset sepsis. diagnosis of EOS will be established based on the presence of any clinical evidence suggestive of sepsis, quantitatie C-reactive protein (CRP) levels ≥6 mg/dL, Rodwell’s hematological scores ≥3 and/or Tollner’s scores ≥ 10 with or without positive blood culture results, within the 1st 72 hours postnatal age. Result Among the studied maternal risk factors of neonatal sepsis in our study, 73.8% had PROM being the most common maternal risk factor for early neonatal sepsis followed by ceserian mode (C.S) of delivery 66.3%, and 26.2% had Chorioamintis. The gestational age was distributed as 36.76±3.01 with minimum 30 and maximum 42 weeks, of Ballard score 37.05±2.88 and weight was 2.87±0.82. 58.8% were females and 41.3% were males. Also, 42.5% of the studied group was preterm. 42.5% of studied group was diagnosed with sepsis. Conclusion Early diagnosis is important for early intervention and treatment. This diagnosis in neonates is usually based on clinical and laboratory findings.

Neonatal sepsis and its associated factors among neonates admitted to the neonatal intensive care unit in Wachemo University Comprehensive Specialized Hospital, Southern Ethiopia, 2022.

Neonatal sepsis is a major public health problem worldwide. It is one of the leading causes of neonatal mortality and morbidity worldwide. The neonatal mortality rate is higher in developing countries, where the extent and causes of neonatal sepsis are not yet known. Neonatal sepsis is a leading cause of neonatal mortality in Ethiopia. As a result, this study aimed to assess the proportion and identify maternal and neonatal risk factors for neonatal sepsis among neonates admitted to the neonatal intensive care unit. An institutional-based cross-sectional study was conducted from May 2022 to July 2022 at the Wachemo University Comprehensive Specialized Teaching Hospital, Neonatal Intensive Care Unit, southern Ethiopia. A total of 205 neonates with indexed mothers participated in the study. Using a consecutive sampling technique, a structured, pretested questionnaire was used to collect data from the study subjects. Data were entered into EpiData Manager version 3.1 for Windows and then exported to SPSS version 22 for further data cleaning and analysis. Descriptive analyses were performed by using frequency, percentage, and summary statistics to describe the key variables. A multivariate regression model was used to identify factors associated with neonatal sepsis. Finally, statistical significance was declared at a p-value of less than 0.05, and an adjusted odds ratio (AOR) with a 95% confidence level was used to declare the variable's association with the outcome variable. The overall prevalence rate of neonatal sepsis was 39.5% (95% CI: 33.7-45.9). Multivariable analysis was performed by taking a variable that is statistically significant in bivariate logistic regression as a candidate variable. Multivariable model analysis showed that unmarried status AOR = 18.37 (95% CI: 1.56-216.14), maternal fever during delivery AOR = 4.74 (95% CI: 1.63-13.8), and premature rupture of membrane AOR = 7.53 (95% CI: 2.19-25.6) were variables that increased the odds of developing neonatal sepsis. The study's findings indicate that neonatal sepsis is highly prevalent. Unmarried maternal status, maternal fever during delivery, and premature rupture of the membrane were predictors of neonatal sepsis. Therefore, providing training for health workers and close monitoring and evaluation during obstetric and neonatal care are crucial to halt the occurrence of neonatal sepsis.

The association between premature rupture of membranes (PROM) and preterm gestational age with neonatal sepsis: a systematic review and meta-analysis

Background Sepsis is one of the main causes of neonatal mortality. The morbidity and mortality rates due to neonatal sepsis are as high as 9-20%. Premature rupture of membranes (PROM) and preterm gestational age are among the risk factors of neonatal sepsis.&#x0D; Objective To evaluate for potential associations between PROM as well as preterm gestational age to neonatal sepsis by meta-analysis and systematic review.&#x0D; Methods A meta-analysis and systematic review were performed using literature sourced from PubMed, Cochrane, and Google Scholar according to PRISMA guidelines. We calculated the incidence of sepsis in neonates with and without PROM and premature gestational age. Journal quality was assessed according to the Newcastle-Ottawa Scale (NOS) criteria.&#x0D; Results From the literature search for PROM, 21 case-control studies met the inclusion criteria. Neonatal sepsis was more common in neonates who had a maternal history of PROM than in those without [OR 2.69 (95%CI 1.56 to 4.65); P&lt;0.00001]. From the literature search for gestational age, we found 17 case-control studies that met the inclusion criteria. Neonatal sepsis was more common in preterm than term neonates [OR 2.55 (95%CI 1.61 to 4.04); P&lt;0.00001].&#x0D; Conclusion Neonates with a maternal history of PROM and/or preterm gestational age are at high risk of developing neonatal sepsis.

Risk factors for neonatal sepsis among neonates in the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia.

Neonatal sepsis (NS) is a serious blood bacterial infection in children of 28 days or younger, manifested by systemic signs and symptoms of infection. Neonatal sepsis has become one of the leading causes of admission and death in developing countries like Ethiopia. Understanding different risk factors for neonatal sepsis is essential for early diagnosis and treatment. So, this study aimed to assess the risk factors for neonatal sepsis among neonates at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia. A case-control study design was employed on 264 neonates (66 cases and 198 controls) in Hawassa University Comprehensive Specialized Hospital and Adare General Hospital from April to June 2018. Data were collected by interviewing the mothers and reviewing neonates' medical records. The data were edited, cleaned, coded, and entered into Epi info version 7 and were transported and analyzed using SPSS version 20. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the significance of the associations. A total of 264 neonates (66 cases and 198 controls) with 100% response rate. The mean (±SD) age of mothers was 26 ± 4.042 years. The majority (84.8%) of the cases were found in children under 7 days, with a mean age of 3.32 days ± 3.376 SD. Factors such as prolonged rupture of the membrane [AOR = 4.627; 95% CI (1.997-10.72)], history of the urinary tract or sexually transmitted infections [AOR = 2.5; 95% CI (1.151-5.726)], intrapartum fever [AOR = 3.481; 95% CI (1.18-10.21)], foul smelling liquor [AOR = 3.64; 95% CI (1.034-12.86)], and low APGAR score in the fifth minute [AOR = 3.38; 95% CI (1.107-10.31)] were the independent predictors of neonatal sepsis. Prolonged rupture of the membrane, intrapartum fever, urinary tract infection, foul-smelling liquor, and low APGAR score were independent risk factors of neonatal sepsis, and this study also observed that the onset of neonatal sepsis was higher in the first week of a neonate's life. Routine sepsis evaluation must focus on neonates born with the aforementioned characteristics and make interventions for babies born with these risk factors.

Study of Risk factors of Neonatal Sepsis

Study of Risk factors of Neonatal Sepsis

Examining the Utility of Rapid Salivary C-Reactive Protein as a Predictor for Neonatal Sepsis: An Analytical Cross-Sectional Pilot Study.

This study aimed to compare the rapid bedside quantitative assessment of C-reactive protein (CRP) in saliva to serum CRP to predict blood culture-positive sepsis in neonates. The research was carried out over eight months at Fernandez Hospital in India (February 2021-September 2021). The study included 74 randomly selected neonates with clinical symptoms or risk factors of neonatal sepsis requiring blood culture evaluation. SpotSense rapid CRP test was conducted to estimate salivary CRP. In analysis, the area under the curve (AUC) on the receiver operating characteristics (ROC) curve was used. The study population's mean gestational age and median birth weight were 34.1 weeks (SD: ±4.8) and 2370 g (IQR: 1067-3182). The AUC on ROC curve analysis for predicting culture-positive sepsis was 0.72 (95% CI: 0.58 to 0.86, p-value: 0.002) for serum CRP and 0.83 (95% CI: 0.70 to 0.97, p-value: <0.0001) for salivary CRP. The Pearson correlation coefficient between salivary and serum CRP was moderate (r = 0.352, p-value: 0.002). Salivary CRP cut-off scores were comparable to serum CRP in terms of sensitivity, specificity, PPV, NPV, and accuracy in predicting culture-positive sepsis. The rapid bedside assessment of salivary CRP appears to be an easy and promising non-invasive tool in culture-positive sepsis prediction.

Predictive value of CRP and albumin ratio in neonatal sepsis

Background: The role of hypoalbuminemia and raised C-reactive protein (CRP) levels in predicting critical prognosis has been described extensively in adult literature. However, there are limited studies in pediatrics, particularly neonates. The study was conducted to assess the predictive value of the CRP vs Serum albumin in earlier identification and as a prognostic indicator of neonatal sepsis. Methods: In this research, from July 2021 to February 2022 a total of 150 studies were enrolled at Adichunchanagiri Institue of medical sciences. Complete clinical and laboratory data were collected. To identify the potential independent risk factor for neonatal sepsis, multivariate logistic regression analysis was performed. Receiver operating characteristic curve analysis was used to evaluate the prediction accuracy of CAR in identifying neonatal sepsis. Results: A total of 150 neonates were included in the study out of which 78 neonates were preterm, 32 neonates were late preterm and 40 neonates were term neonates. CAR levels were higher in neonates with sepsis and showed a gradual increase among the control group, mild sepsis group, and severe sepsis group. The prevalence of neonates with overall sepsis, mild sepsis, and severe sepsis increased significantly from CAR tertile 1 to tertile 3. Multiple logistic regression analysis showed that CAR was an independent risk factor for the presence of sepsis (OR = 11.123, 95% CI 6.74–14.5, p&lt;0.001) and severe sepsis (OR=1.568, 95% CI 1.3-2.4, p&lt;0.001). ROC curve analysis showed that CAR had a well-discriminatory power in predicting sepsis (area under the curve= 0.74, 95% CI, 0.71-0.77, p&lt;0.001) and severe sepsis (AUC=0.70, 95% CI, 0.67-0.74, p&lt;0.001). Conclusions: CAR was an independent predictor for the presence and severity of neonatal sepsis.

Correlation Between Prematurity and The Onset of Neonatal Sepsis: A Cross-Sectional Study in NICU of a Tertiary Hospital in East Java, Indonesia

INTRODUCTION: The incidence of neonatal sepsis in developing countries is still high, reaching 170 out of 1000 births. An increased premature birth rate has become the leading cause of death in children under five years old. Studies examining the correlation between prematurity and neonatal sepsis onset have not been widely reported. Therefore, we assessed the correlation between gestational age and the onset of sepsis in neonatal patients.METHODS: Hospital-based cross-sectional study was performed on all neonates diagnosed with neonatal sepsis in the NICU of a tertiary referral hospital in East Java between 1 January 2019 – 31 December 2019. Logistic regression was used to analyze the obtained data. P-value &lt;0.05 was considered statistically significant. RESULTS: Of the 241 patients identified with neonatal sepsis at Dr. Soetomo General Hospital in 2019, we found that 161 patients met the inclusion criteria, with most patients being early-onset sepsis patients (67.7%), low birth weight (75.8%), premature (65.2%), singleton deliveries (92.5%), and cesarean section births (65.2%). Statistical analysis showed a non-significant correlation between prematurity and the onset of neonatal sepsis (p&gt;0.05).CONCLUSION: Although preterm birth is often reported as one of the most important risk factors of neonatal sepsis, prematurity does not appear to be an independent risk factor of neonatal sepsis onset

Umbilical Cord Stump Infections in Central Uganda: Incidence, Bacteriological Profile, and Risk Factors

Umbilical cord stump infection (omphalitis) is a risk factor for neonatal sepsis and death. We assessed the incidence of omphalitis, described the bacteriological and antibiotic-resistance profile of potentially pathogenic bacteria isolated from the umbilical cord stump of omphalitis cases, and evaluated whether bacteria present in the birth canal during birth predicted omphalitis. We enrolled 769 neonates at birth at three primary healthcare facilities and followed them for 28 days with scheduled visits on days 3, 7, 14, and 28. Cox regression models were used to estimate the rates of omphalitis associated with potential risk factors. Sixty-five (8.5%) neonates developed omphalitis, with an estimated incidence of 0.095 cases per 28 child-days (95% CI 0.073, 0.12). Potentially pathogenic bacteria were isolated from the cord stump area of 41 (63.1%) of the 65 neonates with omphalitis, and the most commonly isolated species were Escherichia coli (n = 18), Klebsiella pneumoniae (n = 10), Citrobacter freundii (n = 5), and Enterobacter spp. (n = 4). The Enterobacteriaceace isolates were resistant to gentamicin (10.5%, 4/38), ampicillin (86.8%, 33/38), and ceftriaxone (13.2%, 5/38). Delayed initiation of breastfeeding was associated with an increased risk of omphalitis (aHR 3.1; 95% CI 1.3, 7.3); however, vaginal colonization with potentially pathogenic bacteria did not predict omphalitis.

Length of Hospital Stay and Its Predictors Among Neonatal Sepsis Patients: A Retrospective Follow-Up Study

Sepsis is common among neonates, and is often fatal. Hospitalization results in severe nosocomial infections which could be resistant to antibiotics. It also incurs higher fees for medical care. A retrospective follow-up study, which includes 206 neonates, was conducted to assess the length of hospital stay among neonatal sepsis patients from September 2018 to September 2020 at TASH Hospital, Addis Ababa, Ethiopia. Data were collected from medical charts. Mean length of hospital stay was compared using independent sample t-tests. Risk factors for length of stay were identified using binary logistic regression analysis. All neonates stayed a total of 325 days, which gives 75,512 neonate-days. Neonates who stayed more than 7 days had low mean birth weight and higher mean age at admission. Mean length of stay was higher among neonates with comorbid illness, neonates with drug therapy problems and male neonates. Even though the mean length of stay is shorter among neonates with maternal PROM and CS delivery, these maternal factors were found to be insignificant in the multivariate logistic regression. Similar to other studies, neonates with low birth weight and comorbidity had a longer hospital stay. Neonates with maternal PROM and CS delivery had a shorter stay. But these maternal factors, identified by prior studies as risk factors for neonatal sepsis and its mortality, are not found to be predictors of prolonged hospitalization. Having neurologic features and drug therapy problems among neonates with sepsis prolonged hospital stay. The mean length of stay varies with respect to maternal and neonatal factors. Lower birth weight, presence of neurologic features, presence of comorbidity, presence of drug therapy problems and being male are found to be predictors of a longer hospital stay among neonates with sepsis.

Elevated neutrophil - to - monocyte ratio as a prognostic marker for poor outcomes in neonatal sepsis

ObjectivesNeonatal sepsis is one of the leading causes of neonatal death. The aim of this study was to evaluate the value of neutrophil - to - monocyte ratio (NMR) in predicting mortality in neonatal sepsis. MethodsIn this present retrospective study, a total of 134 neonates with sepsis were included. Baseline laboratory parameters were collected. The best cutoff value of NMR was determined by receiver operating characteristic (ROC) curve. Univariate and multivariate analysis were carried out to survey the predict value of NMR. ResultsThe results showed that NMR in non-survival group was significantly higher than that in survival group. Results from multivariate analysis showed that high NMR was an independent risk factor for neonatal sepsis (Hazard ratio (HR): 7.519, p = 0.001). ROC displayed that the area under curve (AUC) of NMR was 0.740, sensitivity and specificity of NMR were 80% and 65.8% when 7.65 was selected. ConclusionsNMR could be a promising prognostic factor for neonatal sepsis.

Risk factors for neonatal sepsis in Sub-Saharan Africa: a systematic review with meta-analysis

ObjectivesTo identify the risk factors for neonatal sepsis in Sub-Saharan Africa.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Web of Science, African Index Medicus and ClinicalTrials.gov were searched for observational studies from...

Neonatal Sepsis and Associated Factors Among Newborns in Woldia and Dessie Comprehensive Specialized Hospitals, North-East Ethiopia, 2021.

IntroductionNeonatal sepsis is a clinical illness characterized by infection-related signs and symptoms in the first month of life, with or without bacteremia. Septicemia, meningitis, pneumonia, arthritis, osteomyelitis, and urinary tract infections are all examples of systemic illnesses that can affect newborns. Hence, the main aim of this study was to assess the prevalence and factors associated with neonatal sepsis among newborns in Woldia and Dessie Comprehensive Specialized Hospitals, northeast Ethiopia, from January 1 to July 30, 2021.MethodsThis institution-based cross-sectional study was conducted from January 1 to July 30, 2021, on 344 randomly selected neonates who visited the hospital. A systematic random sampling technique was used to select samples, and data were collected using a pre-tested standardized questionnaire. For data entry and analysis, Epi Data version 4.1 and SPSS version 24 applications were used, respectively. The goodness-of-fit was tested by the Hosmer–Lemeshow statistic test. Bivariable and multivariable binary logistic regressions were used to identify associated factors at a 95% confidence interval. Significance was considered at p-value <0.05.ResultsIn this study, the prevalence of neonatal sepsis was 79.4% (95% CI: 75.2–83.6%). Maternal UTI/STI history [AOR: 3.1; 95% CI (1.5–7.1)], gestational age <37 weeks [AOR: 4.4; 95% CI (1.0–8.9)], PROM [AOR: 4.9; 95% CI (2.5–6.8)], and new-born resuscitation history [AOR: 2.3; 95% CI (1.5–4.3)] were all significantly associated with neonatal sepsis.ConclusionThis study indicates that the proportion of neonatal sepsis is high. A history of maternal PROM, being a preterm neonate, a history of maternal UTI/STIs, and having received resuscitation at birth were identified as risk factors for neonatal sepsis.

Risk factors for early neonatal sepsis: retrospective Cohort in the brazilian amazon

Objective: to analyze risk factors for neonatal sepsis in a capital of the Brazilian Amazon region. Methods: Retrospective cohort of 411 mothers and their newborns assisted at the municipal maternity hospital from December 2019 to February 2020. Sociodemographic information, history of prenatal care, childbirth type and characteristics of the newborn were collected from the medical records of the binomial mother-child. To estimate the gross and adjusted Relative Risk and 95% confidence intervals, Poisson Robust Regression using Stata®, version 16.0 was used. Result: The incidence of sepsis was 75.42 per 1,000 live births. The risk factors for neonatal sepsis were previous infectious disease (RR: 2.40; 95% CI: 1.21; 4.76), APGAR score less than seven in the first minute (RR: 2.96; 95% CI:1.17; 7.47) and low birth weight (RR: 5.60 CI; 95%: 1.69; 18.50). Conclusion: The identification of predictors for the outcome and early monitoring of pregnant women in prenatal care are important actions to minimize the occurrence of neonatal sepsis. For future studies, it is suggested research in the scope of primary health care and maternity for the qualification of professionals working in the line of care for pregnant women and their families.

OEIS complex: A case report and literature review of a rare polymalformative syndrome

Introduction: The OEIS complex or syndrome is the most severe form of the exstrophy-epispadias complex and is characterized by the existence of an omphalocele, bladder exstrophy, anal imperforation and spina bifida. We report an atypical case of OEIS complex associated with further birth defects admitted to our department. The diagnostic and therapeutic approach to the complex congenital malformations involved are highlighted, as well as difficulties encountered in a limited resource setting. Case Report: This was a neonate referred for the management of a congenital malformation on the first day of life. The baby was born vaginally at 35 weeks of gestation with a birth weight of 2000 g and significant major risk factors for neonatal sepsis. Two antenatal ultrasounds had revealed fetal uropathy. On admission, the clinical exam revealed: a type 1 omphalocele, an anorectal malformation with a recto-urinary fistula and a covered lumbosacral dysraphism. Paraclinical examinations revealed an associated cardiac anomaly. The karyotype analysis was not done due to lack of financial means. Supportive care was given and the neonate underwent surgical reconstruction of birth defects on day 20. Conclusion: The OEIS complex is a rare morbid congenital polymalformative syndrome in neonates. Patients require keen diagnostic enquiry and immediate postnatal multidisciplinary management, with long-term follow-up.

PREVALENCE AND DETERMINANT FACTORS OF NEONATAL SEPSIS AMONG NEONATES ADMITTED AT HIWOT-FANA SPECIALIZED REFERRAL HOSPITAL, HARAR, ETHIOPIA, 2020

Background: Neonatal sepsis is a systemic infection occurring in neonatal life and is a major cause of morbidity and mortality in newborns .It accounts for five million newborn deaths Objectives:- The objective of this study was to assess Prevalence of neonatal sepsis and its determinant factors among neonates admitted in Hiwot-Fana Specialized Referral Hospital, Harar, Ethiopia, 2020 Methods: An institution based cross-sectional study with retrospective document review method was conducted in Hiwot-Fana Specialized Referral Hospital in Harar town. Sample size was calculated by using single population proportion sample formula and the final sample size was 292.The study subject was selected by using systematic random sampling method, and adopted data collection tool was used. Data was analyzed by using SPSS version-20. Descriptive analyses were performed and bivariate analyses were used to find out the association of independent variables. Result: The overall prevalence of neonatal sepsis in this study was 52.7%..This study found out that PROM of the mother, gestational age of neonates and birth weight of the neonate were significantly associated with neonatal sepsis.. Conclusion: The associated risk factors for neonatal sepsis were identified as PROM of the mother, gestational age of neonates and birth weight of the neonate. Recommendation:Therefore, preventive efforts should focus on high risk neonates such as neonates born from mothers who have PROM, neonate with low birth weight and neonates born prematurely. Thus, a careful monitoring and follow up as well as rigorous treatment are needed.

Determinants of neonatal sepsis among neonates admitted to the neonatal intensive care unit of public hospitals in Hawassa City Administration, Sidama Region, Ethiopia, 2020: an unmatched, case–control study

ObjectiveThis study was conducted to assess the determinants of neonatal sepsis in the neonatal intensive care units of public hospitals in Hawassa City Administration, Sidama Region, Ethiopia, in 2020.DesignInstitutional-based, unmatched,...