Warm Chain Research Articles

A study to assess the knowledge, attitude, and practice regarding maintenance of warm chain for prevention of hypothermia of newborns among nursing personnel at labor rooms of selected health care facilities of West Bengal

A study to assess the knowledge, attitude, and practice regarding maintenance of warm chain for prevention of hypothermia of newborns among nursing personnel at labor rooms of selected health care facilities of West Bengal

Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality.

Reports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes. This study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality. A retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C-36.4°C) and hypothermia (<36.0°C). Factors associated with neonatal mortality, including hypothermia defined as body temperature below 36.0°C, were also explored using logistic regression. A total of 58,804 newborns from newborn units in 21 study hospitals were included in the analysis. Out of these, 47,999 (82%) had their admission temperature recorded and 8,391 (17.5%) had hypothermia. Hypothermia prevalence decreased over the study period while admission temperature documentation increased. Significant associations were found between low birthweight and very low (0-3) APGAR scores with hypothermia at admission. Odds of hypothermia reduced as ambient temperature and month of participation in the Clinical Information Network (a collaborative learning health platform for healthcare improvement) increased. Hypothermia at admission was associated with 35% (OR 1.35, 95% CI 1.22, 1.50) increase in odds of neonatal inpatient death. A substantial proportion of newborns are admitted with hypothermia, indicating a breakdown in warm chain protocols after birth and intra-hospital transport that increases odds of mortality. Urgent implementation of rigorous warm chain protocols, particularly for low-birth-weight babies, is crucial to protect these vulnerable newborns from the detrimental effects of hypothermia.

A retrospective data analysis on prevalence and risk factors for hypothermia among sick neonates at presentation to the neonatal intensive care unit of the Tamale Teaching Hospital.

Neonatal hypothermia, defined as an axillary temperature of <36.5C in a neonate, is common in neonatal intensive care units and is almost universal across all geographic and climatic regions of the world. This is even though environmental temperature is a known risk factor for its occurrence. We conducted a retrospective study in the Neonatal Intensive Care Unit of the Tamale Teaching Hospital (TTH) to document the prevalence and risk factors associated with hypothermia at presentation to the hospital. The study spanned the period from January 2019 to December 2019 and involved all neonates with axillary temperature documented at the time of admission. The prevalence of neonatal hypothermia in this study was 54.76%. Hypothermia was most common in neonates diagnosed with meconium aspiration syndrome (87/105, 82.86%), prematurity and low birth weight (575/702, 81.91%), and birth asphyxia (347/445, 77.98%). Neonates who were delivered vaginally were less likely to develop hypothermia compared to those delivered via Cesarean section. Inborn neonates (delivered in TTH) were 3.2 times more likely to be hypothermic when compared to those who were delivered at home. Neonates with low birth weight and APGAR scores < 7 at 1 and 5 minutes were more likely to be hypothermic. The dry season was found to be protective against hypothermia when compared to the rainy season. The overall mortality rate was 13.68% and the mortality in the subgroup with hypothermia at presentation was 18.87%. Our study documented a high prevalence of hypothermia with higher rates in neonates requiring intervention at birth. It is therefore crucial for perinatal care providers to adhere to the warm chain precautions around the time of birth.

A Study to Assess the Effectiveness of Structured Teaching Program on Knowledge and Practice Regarding Warm Chain in the Prevention of Hypothermia in Newborn Babies among Staff Nurses in Selected Hospital in Jaipur

Abstract: Thermal protection of the newborn is a series of measures taken at birth and in the first days of life to ensure that the newborn does not become either cold or overheated and maintains a normal body temperature of 36.5—37.50C. The newborn cannot regulate its temperature as well as an adult. The poor utilization of this care arises in many high-risk cases and sometimes it leads to the death of newborns. So the present study aim at knowledge and practice regarding warm chain in the prevention of hypothermia in newborn babies among staff nurse. Design/methodology/approach: The experimental research design was used for the study Information can be gathered by direct questioning and through observation method ( 60 samples) of staff nurses. The data were analyzed through chi-square by using pre-test and post-test knowledge. Findings: the findings show the significant influence of demographic variables in terms of age, gender, professional qualification, professional experience, experience in the labor room, working department, and previous knowledge Research limitations: the study was limited to hospitals of Jaipur with limited demographic variables.

Improved chilling tolerance in glasshouse-grown potted sweet basil by end-of-production, short-duration supplementary far red light.

Sweet basil is a popular culinary herb used in many cuisines around the world and is widely grown commercially for retail as a live potted plant. However, basil is easily damaged by temperatures below 12 °C meaning plants must be transported from the grower to the retailer in a warm transport chain, adding considerable commercial cost in temperate countries. Improvement of chilling tolerance has been demonstrated in post-harvest crops such as tomato fruits and, indeed, fresh cut basil, by manipulation of the red:far red ratio of light provided to plants throughout the photoperiod and for a significant duration of the growing process in controlled environment chambers. We tested the effectiveness of periodic short-duration end-of-production supplementary far red light treatments designed for use with basil plants grown in a large scale commercial glasshouse for the live potted basil market. Four days of periodic, midday supplementary far red light given at end of production induced robust tolerance to 24 h of 4 °C cold treatment, resulting in greatly reduced visual damage, and reduced physiological markers of chilling injury including electrolyte leakage and reactive oxygen species accumulation. Antioxidant levels were also maintained at higher levels in live potted basil following this cold treatment. RNAseq-based analysis of gene expression changes associated with this response pointed to increased conversion of starch to soluble raffinose family oligosaccharide sugars; increased biosynthesis of anthocyanins and selected amino acids; inactivation of gibberellin signaling; and reduced expression of fatty acid desaturases, all previously associated with increased chilling tolerance in plants. Our findings offer an efficient, non-invasive approach to induce chilling tolerance in potted basil which is suitable for application in a large-scale commercial glasshouse.

Clinical detection of ‘cold stress’ is overlooked: an online survey of healthcare workers to explore the gap in neonatal thermal care in low-resource settings

BackgroundNeonatal hypothermia has been widely regarded as a major contributory factor to neonatal mortality and morbidity in low-resource settings. The high prevalence of potentially preventable hypothermia today urges an investigation...

Development of an End-to-End Demonstration Readout Chain for Athena/X-IFU

The X-ray Integral Field Unit (X-IFU) of the Athena observatory, scheduled for launch in the mid 2030's, will provide X-ray spectroscopy data with unprecedented spectral and spatial resolution. This will be achieved with a 2 kilo-pixel array of transition-edge sensor (TES) microcalorimeters. The complete detection chain is under development by a large international collaboration. In order to perform an end-to-end demonstration of the X-IFU readout chain, a 50 mK test bench is being developed at IRAP in collaboration with CNES. The test bench uses a two-stage ADR cryostat from Entropy GmbH, a 1024-pixel array, and will initially be operated using a warm electronics chain from NIST and NASA Goddard Space Flight Center. We describe the complete system being installed in the cryostat and the current results obtained with these electronics. We also review the status of the integration of the digital readout electronics (DRE) prototype into the demonstration chain and the plan for integrating and testing the complete X-IFU readout chain.

Descriptive Cross-sectional Study on Mothers’ Knowledge Regarding Prevention of Neonatal Hypothermia

INTRODUCTIONIn today’s era neonatal hypothermia is ranked as high risk factor for newborn survival. Practicing kangaroo mother, mummifying newborn, delaying first bath etc are useful practices for maintaining warm chain and thermo-protection of newborns. MATERIAL AND METHODSA cross-sectional descriptive study was used for the study. Setting of the study was post natal ward of Gandaki Medical College Teaching Hospital and Research Center with total sample of 70. Probability convenient sampling technique was used for the study. Data analysis was done through descriptive and inferential statistics. RESULTSAmong the respondents 41.4% mothers were of age between 26-30yrs, majority 75.7% were Hindu, 42.9% had completed secondary level education, more than half 51.4% were residing in nuclear family, 45.7% were housewife, more than half 52.9% had income/month as 15001-20000, more than half 61.4% had normal delivery, and more than half 51.4% had two children. Almost half of the mothers 45.7% of mothers had inadequate level of knowledge, 32.9% had moderate knowledge and 21.4% had adequate knowledge, also there showed significant association between mothers level of knowledge on neonatal hypothermia with educational status, type of family and type of delivery at 5% level (ie., p&lt;0.05). CONCLUSIONBased on the findings it is concluded that almost half of the mothers have inadequate knowledge regarding neonatal hypothermia. Mothers knowledge might be helpful to prevent newborn from neonatal hypothermia, so training should be provided to mothers and family members during their antenatal period regarding thermal protection of the newborn.

Neonatal hypothermia and its association with delayed initiation of breastfeeding and low birth weight in Ethiopia: Systematic review and meta-analysis

BackgroundDespite applying the thermal care principle recommended by WHO and though predisposing factors for neonatal hypothermia are easily preventable, the problem of neonatal hypothermia remains a challenge. Inconsistency of prevalence and associated factors among different studies has been observed through time. ObjectiveThis study aimed to estimate the national pooled prevalence of neonatal hypothermia and its association with delayed initiations of breastfeeding and low birth weight in the Ethiopian context. MethodPub Med, Cochrane library, and Google Scholar databases were used for searching. In addition, reference lists of included studies and Ethiopian research repositories were used. Appropriate searching terms were used to retrieve studies from databases. Searching was limited to studies conducted in Ethiopia, published in the English language, and done with a design of cohort, cross-sectional, and case-control. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. A weighted inverse variance random-effects- model was used. The I2 test statistics and Egger’s test were computed to test heterogeneity and publication bias respectively. Furthermore, sensitivity was conducted. ResultIn this systematic review and meta-analysis, a total of 5 studies with 1,790 study participants were included. The overall pooled prevalence of neonatal hypothermia in Ethiopia was found to be 62.68 % (95% CI; (54.66, 70.70). Delayed initiation of breastfeeding (OR: 3.26 (95% CI = 2.07, 5.13) and low birth weight (OR: 2.63 (95% CI = 1.37, 5.07)) were significantly associated with high odds of neonatal hypothermia. ConclusionThe overall prevalence of neonatal hypothermia in Ethiopia was high. Delayed initiation of breastfeeding and low birth weight were a predictor of neonatal hypothermia. Therefore, health workers who are working in the maternal, neonatal, and child health units need to adhere to the warm chain principle; particularly counseling caregivers about the initiation of early breastfeeding has to be improved.

Incidence and predictors of preterm neonatal mortality at Mbarara Regional Referral Hospital in South Western Uganda.

Preterm neonatal mortality contributes substantially to the high neonatal mortality globally. In Uganda, preterm neonatal mortality accounts for 31% of all neonatal deaths. Previous studies have shown variability in mortality rates by healthcare setting. Also, different predictors influence the risk of neonatal mortality in different populations. Understanding the predictors of preterm neonatal mortality in the low-resource setting where we conducted our study could guide the development of interventions to improve outcomes for preterm neonates. We thus aimed to determine the incidence and predictors of mortality among preterm neonates born at Mbarara Regional Referral Hospital (MRRH) in South Western Uganda. We prospectively enrolled 538 live preterm neonates born at MRRH from October 2019 to September 2020. The neonates were followed up until death or 28 days, whichever occurred first. We used Kaplan Meier survival analysis to describe preterm neonatal mortality and Cox proportional hazards regression to assess predictors of preterm neonatal mortality over a maximum of 28 days of follow up. The cumulative incidence of preterm neonatal mortality was 19.8% (95% C.I: 16.7-23.5) at 28 days from birth. Birth asphyxia (adjusted hazard ratio [aHR], 14.80; 95% CI: 5.21 to 42.02), not receiving kangaroo mother care (aHR, 9.50; 95% CI: 5.37 to 16.78), delayed initiation of breastfeeding (aHR, 9.49; 95% CI: 2.84 to 31.68), late antenatal care (ANC) booking (aHR, 1.81 to 2.52; 95% CI: 1.11 to 7.11) and no ANC attendance (aHR, 3.56; 95% CI: 1.51 to 8.43), vaginal breech delivery (aHR, 3.04; 95% CI: 1.37 to 5.18), very preterm births (aHR, 3.17; 95% CI: 1.24 to 8.13), respiratory distress syndrome (RDS) (aHR, 2.50; 95% CI: 1.11 to 5.64) and hypothermia at the time of admission to the neonatal unit (aHR, 1.98; 95% CI: 1.18 to 3.33) increased the risk of preterm neonatal mortality. Attending more than 4 ANC visits (aHR, 0.35; 95% CI: 0.12 to 0.96) reduced the risk of preterm neonatal mortality. We observed a high cumulative incidence of mortality among preterm neonates born at a low-resource regional referral hospital in Uganda. The predictors of mortality among preterm neonates were largely modifiable factors occurring in the prenatal, natal and postnatal period (lack of ANC attendance, late ANC booking, vaginal breech delivery, birth asphyxia, respiratory distress syndrome, and hypothermia at the time of admission to the neonatal unit, not receiving kangaroo mother care and delayed initiation of breastfeeding). These findings suggest that investment in and enhancement of ANC attendance, intrapartum care, and the feasible essential newborn care interventions by providing the warm chain through kangaroo mother care, encouraging early initiation of breastfeeding, timely resuscitation for neonates when indicated and therapies reducing the incidence and severity of RDS could improve outcomes among preterm neonates in this setting.

Evidence Based Skin Care in Preterm Neonates- A Short Review

Preterm neonates are the neonates born alive before completion of 37 weeks of gestation. Prematurity is the real threat for survival of these neonates, especially those who are very-preterm (less than 32 weeks). In developing countries due to lack of basic care such as maintenance of warm chain, breast feeding support, infection control and scarcity of resources to tackle respiratory difficulties; the mortality in preterm infants is very high. Good skin care is a critical component of the basic neonatal care, that can directly reduce complications of prematurity as well address issues arising during the handling of these preterm infants such as injuries due to adhesives or devices, skin dryness, the use of skin emollients and disinfectants etc. In contemporary era, evidence-based practices are the need of hour to guide clinical practice. There are limited research articles dealing with skin care in preterm neonates that offer strong recommendations for skin care modalities. In this short review, the authors have compiled the recent evidences to address various issues related to skin care in very preterm neonates. In this article the evidences related to bathing practices in preterm infants, and the use of disinfectants and emollients for premature skin care has been discussed; besides making general recommendation related to skin care in preterm infants. Keywords: Preterm, skin care, emollients, disinfectant, neonate, prematurity, premature skin.

Neonatal hypothermia and adherence to World Health Organisation thermal care guidelines among newborns at Moi Teaching and Referral Hospital, Kenya.

Neonatal hypothermia is a great concern with near epidemic levels globally. In Kenya, its prevalence is as high as 87% with limited local data on the associated factors such as adherence to warm chain guidelines as recommended by the World Health Organisation (WHO) is limited. This study aimed to determine the prevalence of hypothermia and level of adherence to the WHO thermal care guidelines among newborns admitted at Moi Teaching and Referral Hospital (MTRH). It adopted a prospective study design of following up neonates for the first 24 hours of admission to the MTRH newborn unit. Thermometry, interview of mothers and observation of thermal care practices was done. Descriptive and inferential statistical techniques were adopted. Specifically, Pearson's chi-square test of associations between predictors of neonatal hypothermia and management outcomes was conducted with their corresponding risk estimates at 95% confidence interval. Among the 372 participants, 64.5% (n = 240) were born at MTRH, 47.6% (177) were preterm and 53.2% (198) had birth weights below 2500 grams. Admission hypothermia was noted among 73.7% (274) and 13% (49) died on the first day of admission. Only 7.8% (29) newborns accessed optimal thermal care. Prematurity, day one mortality and adherence to the warm chain were significantly (p<0.001) associated with admission hypothermia. Inappropriate thermal appliance, inadequate clothing and late breastfeeding significantly increased the risk of neonatal hypothermia. Absence of admission hypothermia increased the likelihood of neonatal survival more than twenty-fold (AOR = 20.91, 95% CI: 2.15-153.62). Three out four neonates enrolled had admission hypothermia which was significantly associated with prematurity, lack of adherence to warm chain and increased risk of neonatal mortality on the first day of life. There was low adherence to the WHO thermal care guidelines. This should be optimized among preterm neonates to improve likelihood of survival.

Role of Hypothermia Detecting Device during Transitional Adaptation of Healthy Full Term Infant: A Pilot Study

Introduction: Maintenance of warm chain and prevention of hypothermia to ensure smooth transitional adaptation of a newborn during early postnatal period is an important component of essential newborn care. Early detection of hypothermia in term normal weight newborns, kept in busy postnatal wards is essential, but is a challenge for healthcare personnels. Empowering the mothers with a simple tool to recognise hypothermia can decrease the burden on the healthcare personnels and also increase awareness among the mother and family members. Aim: The present study aimed at detecting hypothermia in healthy term newborns in the postnatal ward using a hypothermia alert (BEMPU TempWatch) device while simultaneously recording the abdominal skin temperature. Materials and Methods: The pilot study conducted from June 2018 to September 2018, recruited 51 full-term healthy infants in the postnatal ward and monitored them for hypothermia using BEMPU TempWatch on the wrist for 6 hours. Simultaneously, abdominal skin temperature was also recorded for these babies using a portable monitor. The number of hypothermia episodes detected using Bempu TempWatch and simultaneous abdominal skin temperature were recorded and analysed using R i386.3.5.1 and Microsoft Excel ver. 2010. Results: The device beeped when the temperature was &lt;36.5°C; 68 episodes of hypothermia using TempWatch were recorded in 51 infants within 6 hours of transfer to the postnatal ward. The hypothermic incidence was significantly more (p-value 0.006) during the day shift (70%) than during the night shift (30%). Conclusion: The hypothermia alert BEMPU TempWatch was useful to detect hypothermia in healthy term neonates.

Protect, promote and support: a warm chain of breastfeeding for oncological women—results from a survey of young Italian cancer mothers

The topic of lactation following cancer diagnosis will become increasingly more current. Although oncological research confirms that breastfeeding after cancer might be possible, there is a lack of guidelines and a good recommendation for oncological women. In the absence of specific recommendations, women with past cancer may be at higher risk for psychological distress related to breastfeeding.The objective of this article was to analyse the experience of breastfeeding in new mothers with a history of cancer compared to women without a cancer diagnosis. First, we explored the impact of the cancer diagnosis on the breastfeeding choice. Second, we evaluated the relationship between different feeding methods and the mother’s mood states in women with and without a history of cancer.The sample was composed of 74 mothers divided into two groups: 34 with a cancer history (clinical sample) and 40 without a cancer diagnosis (control group). Participants were requested to complete a questionnaire three months after childbirth which assessed: socio-demographic and clinical data, feeding modes (breastfeeding, formula and mixed feeding) and the profile of mood states (POMS).Results showed that women in the clinical group breastfeed significantly less and use formula more than those in the control group. Moreover, in the clinical group, women who breastfeed feel reported higher levels of confusion (according to POMS) than mothers who bottle-feed or use a mixed feeding method. On the contrary, in the control sample, women who breastfeed feel significantly more vigorous than puerperae who bottle-feed or use mixed methods according to POMS.Our findings suggest the need for a specific warm chain of support and the development of guidelines with clear and specific information for women with a cancer diagnosis in order to reduce their confusion around breastfeeding.

Effectiveness of Structured Teaching Programme on Knowledge Regarding Maintenance of Warm Chain in Prevention of Hypothermia in Newborn Babies: A Quasi-experimental Study

Effectiveness of Structured Teaching Programme on Knowledge Regarding Maintenance of Warm Chain in Prevention of Hypothermia in Newborn Babies: A Quasi-experimental Study

Effectiveness of Planned Teaching Program On Knowledge Regarding Prevention of Neonatal Hypothermia Among Postnatal Mothers

Background:Neonatal hypothermia is increasingly recognized as a risk factor for newborn survival. The World Health Organization recommends maintaining a warm chain and skin-to-skin care for thermo protection of newborn children. OBJECTIVE To assess the knowledge of postnatal mothers regarding prevention of neonatal hypothermia.To prepare and conduct planned teaching program for postnatal mothers regarding prevention of neonatal hypothermia. To evaluate the effectiveness of planned teaching program for postnatal mothers regarding prevention of neonatal hypothermia.To find out the association of pretest knowledge score and selected demographic variables. METHOD The pre experimental (pretest-post test group) design was adopted . Convenient sample technique was used to select the 30 postnatal mothers as sample. Pretest was conducted using questionnaire after that pretest a planned teaching program was conducted for the post test . RESULT The findings of the study revealed that majority (90%) had low knowledge, 10% had average knowledge regarding prevention of neonatal hypothermia in pre test.Similarly, the post test scores depicted that majority (80%) had good knowledge, 20% had average knowledge and none of them had low knowledge regarding prevention of neonatal hypothermia. Most of demographic variables were not significantly associated with level of pre knowledge of postnatal mothers regarding prevention of neonatal hypothermia. Only mother’s education status (x2 = 8.585 in the pretest and df=2 and p=0.014) were found to be statistically significant at 0.05 level of significance. CONCLUSION This study showed that, the postnatal mother’s knowledge regarding prevention of neonatal hypothermia was low and planned teaching program is effective to improve their knowledge.

Prevalence, risk factors and outcomes of neonatal hypothermia at admission at a tertiary neonatal unit, Kigali, Rwanda – a cross-sectional study

Introduction Thermoregulation remains a key physiological challenge faced by a neonate after delivery. We assessed the prevalence, risk factors and outcomes of hypothermia in admitted neonates at a tertiary teaching hospital of Kigali city in Rwanda. Materials and methods A cross-sectional study was conducted, from July 2013 to September 2017, of neonates who were admitted in the neonatology unit of the University Teaching Hospital of Kigali (CHUK) and whose admission temperature were recorded. Data were extracted from the neonatal database (registry). Results The neonatal database contained 1021 eligible neonates of which 15% were outborn. Hypothermia was found at admission in 280 of the 1021 eligible neonates (27%). The extremely preterm (<28 weeks) were significantly more likely to become hypothermic compared to term neonates (AOR = 6.81, CI: 3.39–13.71, p < .001). Mortality rate was higher in hypothermic infants (AOR = 1.89, CI: 1.16–3.1, p = .011). Length of hospital stay (22 versus 13 days, p < .001), in all surviving infants was higher in neonates admitted hypothermic, though not in the subgroups of infants < 32-week gestation. Discussion Thermal protection of the neonate immediately after birth is essential. In our tertiary neonatal unit, we identify nearly one-third of neonates are hypothermic at admission and this is associated with higher mortality and increased length of hospital stay. The ten-steps of the WHO “warm chain” may present an analytic roster for maternity and neonatal teams to pinpoint targets for interventional research and quality improvement work in order to achieve better outcomes.

Plasma chain catalytic reforming of methanol for on-board hydrogen production

Hydrogen and fuel cell technologies are being deployed to increase energy reliability and environmental performance. On-board hydrogen production via thermocatalytic reforming of liquid fuels is not a new concept, but has not been realized previously due to mismatches in rates and sizes of the necessary reactors. Here we demonstrate an advanced on-board hydrogen production by warm plasma chain catalysis for fuel-cell electric vehicles (FCEVs) with high specific productivity and transient response. Methanol, air and steam reactants as two specific feeds are fed into the reactor without soot formation and catalyst sintering. Oxidative pyrolysis reaction (OPR) by plasma, steam reforming (SR), and pyrolysis at high temperature, and SR and water gas shift (WGS) at medium temperature over catalysts occur subsequently for the coupled process. The heat with OPR is efficiently utilized by the subsequent endothermic reactions. Hydrogen selectivity of 99% (59 vol%, 4.1 SLM) with methanol conversion of 92% is achieved. The CO concentration of 7 vol% approaches the thermodynamic equilibrium value of 6.65 vol%. A fascinating match of energy efficiency of 91% (of methanol to hydrogen) and the hydrogen atom utilization of 88% is stressed. It is attributed to the chain catalysis of (oxidative) pyrolysis and WGS in sequence (as well as SR), which is initiated by warm plasma. Such a coupled process can be scaled up and used for wide applications from FCEVs and hydrogen refueling stations.

Neonatal hypothermia and associated factors among neonates admitted to neonatal intensive care unit of public hospitals in Addis Ababa, Ethiopia

BackgroundNeonatal hypothermia is a worldwide problem and an important contributing factor for Neonatal morbidity and mortality especially in developing countries. High prevalence of hypothermia has been reported from countries with the highest burden of Neonatal mortality. So the aim of this study was to assess the prevalence of Neonatal hypothermia and associated factors among newborn admitted to Neonatal Intensive Care Unit of Public Hospitals in Addis Ababa.MethodsAn institutional based cross-sectional study was conducted from March 30 to April 30, 2016, in Public Hospitals in Addis Ababa and based on admission rate a total of 356 Neonates with their mother paired were enrolled for the study. Axillary temperate of the newborn was measured by a digital thermometer at the point of admission. Multivariate binary logistic regression, with 95% confidence interval and a p-value < 0.05 was used to identify variables which had a significant association.ResultsThe prevalence of Neonatal hypothermia in the study area was 64%. Preterm delivery (AOR = 4.81, 95% CI: 2.67, 8.64), age of Neonate ≤24 h old (AOR = 2.26, 95% CI: 1.27, 4.03), no skin to skin contact with their mother immediately after delivery (AOR = 4.39, 95% CI: 2.38, 8.11), delayed initiation of breastfeeding (AOR = 3.72, 95% CI: 2.07, 6.65) and resuscitation at birth (AOR = 3.65, 95%CI: 1.52, 8.78) were significantly associated with hypothermia.ConclusionsThe prevalence of Neonatal hypothermia in the study area was high. Preterm delivery, age ≤ 24 h old, no skin to skin contact immediately after delivery, delayed initiation of breastfeeding and resuscitation at birth were independent predictors of Neonatal hypothermia. Therefore attention is needed for thermal care of preterm newborn and use of low-cost thermal protection principles of warm chain especially on early initiation of breastfeeding, skin to skin contact immediately after delivery and warm resuscitation.

Raising Awareness and Improving Management of Neonatal Hypothermia

Background A high prevalence of hypothermia has been reported in countries with the greatest burden of neonatal mortality, and is associated with increased morbidity in babies with severe infection, prematurity, and asphyxia. In 1994, the World Health Organization recognized thermal protection as a critical component of newborn care and proposed a ten-step warm chain to prevent hypothermia. Despite increasing recognition and management of newborn hypothermia as an important risk factor in newborn survival, it remains underdiagnosed and undertreated. At a central referral hospital in Malawi with over 4000 annual neonatal …