Predictors of mortality among neonates hospitalized with neonatal sepsis at durame general hospital, southern Ethiopia, case control study

Abstract

: Neonatal sepsis, resulted from bacterial, viral and fungal invasions of the blood stream is the major cause of neonatal mortality and neurodevelopmental impairment among neonates. It is responsible for more than one third of neonatal deaths in Ethiopia. Assessing and preventing the predictors of mortality in neonatal sepsis helps to reduce the burden of neonatal mortality. OBJECTIVES: To determine predictor of mortality among neonate admitted with sepsis at durame general hospital, southern Ethiopia, 2020. METHODS: Institution based case­control study was carried­out using secondary data among a 219 neonates (55 cases and 164controls) in Durame General Hospital (DGH), march 2020. Neonates admitted with sepsis and died were considered as cases and neonates admitted with sepsis and survived (discharged alive) as controls. Cases were selected by taking the deaths of neonates consecutively among those neonates admitted with the diagnosis of neonatal sepsis. The next immediate three corresponding controls were selected by lottery method from the NICU case registration book. Data was collected by using structured pretested checklists from neonates’ record and then entered into Epi data version 3.1 and exported to SPSS version 20. Logistic regression was used to identify the predictors of mortality. Statistical significance was declared at P<0.05. RESULTS: A total of 55 cases and 164 controls were included in this study. More than three quarters (81.8%) of cases had early onset sepsis. The multivariable logistic regression analysis showed that predictors of mortality in this study were; poor feeding [AOR = 4.15; 95% CI (1.64, 10.49), p­value=0.003], respiratory distress [AOR = 2.72; 95% CI (1.31,5.61), p­value=0.007], estimated gestational age less than 37 weeks [AOR = 4.64; 95% CI (2.17, 9.91) p­value=<0.001], and convulsion [AOR = 3.13; 95% CI (1.12, 8.76) p­value=0.030]. CONCLUSION: Generally this study concludes that; prematurity, convulsion, poor feeding and respiratory distress are the predictors of sepsis­related neonatal mortality. These factors are preventable and manageable by good antenatal care, intrapartum care, and neonatal care.