Risk factors for neonatal sepsis in public hospitals, Southwest Ethiopia: a case control study

Abstract

Background: - Despite numerous interventions resulted in remarkable progress against neonatal death, neonatal sepsis still a major cause of mortality and morbidity worldwide with the largest share in Sub-Saharan Africa. In Ethiopia, neonatal sepsis is one of the major contributors of health problem. It is the fourth leading cause of admission and the third leading cause of mortality in the 2014/2015. Moreover, no studies were previously conducted to verify the risk factors of neonatal sepsis in the study area. Objective: - To identify risk factors for neonatal sepsis in public hospitals, Southwest Ethiopia, 2018. Methods: - A facility based case control study was conducted in three public hospitals of Southwest Ethiopia from March to April 30, 2018. Consecutive sampling technique was employed to enroll study subjects. Data was collected by structured questionnaire and checklists, coded and entered using Epi-data version 3.1 and analyzed by SPSS for windows version 23. Candidate variables with P-value < 0.25 in bivariate analysis were fitted in multivariable analysis to identify independent predictors and P-value <0.05 was used to declare statistically significant association. Results: - A total of 65 neonates with sepsis (cases) and 139 neonates without sepsis (controls) participated in the study. Forty-three (66.2%) of cases had early onset neonatal sepsis. The independent positive predictors of neonatal sepsis in this study were being male neonate [AOR = 3.875, 95% CI (1.57, 9.569)], meconium stained amniotic fluid [AOR = 3.76, 95% CI (1.171, 12.077)], history of urinary tract infections/sexually transmitted infections [AOR = 2.963, 95% CI (1.263, 6.947)], premature rapture of membrane [AOR =3.315, 95% CI (1.34, 8.2)], being low birth weight [AOR = 3.433, 95% CI (1.044, 11.293)], low APGAR score at 5th minute [AOR = 3.738, 95% CI (1.28, 10.915)] and resuscitation at birth [AOR = 3.961, 95% CI (1.743, 9.0)]. Conclusion and Recommendation: - socio-demographic, maternal and neonatal health related factors had contributed to the risk of neonatal sepsis. Strengthening screening of all pregnant mothers and aseptic peri-natal care of newborns are recommended