Treatment outcome of neonatal sepsis and its predictors among neonates admitted to pediatric unit of jimma university medical center, south-west Ethiopia

Abstract

Neonatal sepsis is a major cause of morbidity and mortality in newborns. It accounts more than one third of neonatal deaths in Ethiopia. Identifying, preventing, and prompt management of factors predicting this burden will reduce impacts associated with neonatal sepsis. Objective: To assess treatment outcome of neonatal sepsis and its predictors among neonates admitted to pediatric ward of Jimma University Medical Center, South-West Ethiopia. Methods: A Hospital based prospective cohort study was conducted at Jimma University Medical Center. Semi-structured questionnaire was used to collect data. The data was collected between May1 and July 31, 2018 G.C. Data was coded and entered intoEpi data4.2 then exported to the Statistical Package for Social Science 20 for analysis. Descriptive analysis was done to present baseline characteristics with Chi-squared test (χ2). Bivariate Cox regression was done to see associations between the dependent and independent variables. Multivariate Cox-regression analysis was conducted to evaluate the predictors of mortality. Variables having P-values < 0.05 was considered as statistically significant. Results: The study included 201 neonates (62.2% were males) with clinically diagnosed sepsis patients admitted to pediatrics ward of Jimma University medical center. From this 45(22.4%) incidence of in hospital death were recorded. The mean length of hospital stay was 10.50 ± 7.237days. About 37.3% of neonatal sepsis patients developed in hospital complication. Male gender [AHR= 0.32, 95%CI, [0.16-.66], P=0.002], neonatal age at admission ≤7days (EONS) [AHR= 4.82, 95%CI, [1.82-12.78], P=0.002], urban residency of the family [AHR= 2.38, 95%CI, [1.13-5.02], P=0.023], maternal age >35years [AHR= 3.86, 95%CI, [1.50-9.87], P=0.005], convulsion [AHR= 2.87, 95%CI, [1.34-6.14], P=0.006], hypothermia [AHR= 4.16, 95%CI, [1.58-10.91], P=0.004], low red blood cell count [AHR= 3.65, 95%CI, [1.80-7.39], P<0.001], and thrombocytosis [AHR= 5.10, 95%CI, [1.94- 13.40],P=0.001] were independent predictors of in hospital mortality. Conclusion and Recommendation: Neonatal sepsis contributes high mortality. It is important to pay attention to septicemic babies with any of the identified predictors of mortality such as neonatal age at admission ≤7days (EONS), family urban residency, maternal age >35years, patients presented with convulsion and hypothermia at admission, low red blood cell count, and thrombocytosis.