Treatment Outcome and Associated Factors Of Neonatal Sepsis At Mizan Tepi University Teaching Hospital, South West Ethiopia: A Prospective Observational Study

Abstract

Background: Neonatal sepsis is the most serious problem in neonates, resulting in significant morbidity and mortality. Globally 6.9 million neonates were diagnosed with possible serious bacterial infection needing treatment and 2.6 million of these occurred in sub Saharan Africa (SSA). Sepsis is the commonest cause of neonatal mortality and is probably responsible for 30-50% of the total neonatal deaths each year in developing countries. Objectives: The aim of this study is to evaluate, treatment outcome and associated factors of neonatal sepsis at Mizan Tepi university teaching hospital, south west Ethiopia. Method: Hospital based prospective observational study was conducted at Mizan Tepi University Teaching Hospital from May to October. Data was collected by using semistructured questionnaires for interviewing mothers of the patients, and checklists for which abstraction of information from patients chart, these adapted from review of related literatures. Data was collected by four data collectors. Bivariate and multivariate Cox regression used to analyze the association between dependent and independent variables and P-value <0.05 at 95% CI was declared statistically significant association. Finally statement, tables, charts and graphs were used for data presentation. Result: Of 211 neonatal sepsis patients, 110 (52.1%) were females, 161(76.3%) were admitted with late onset of sepsis, 16 (7.6%) were very low birth weight, and 156(73.9%) were term (37–42 weeks). Most, 165 (78.2%) neonates were treated with ampicillin plus gentamycin. About 143 (67.8%) were discharged with good outcome after completing the treatment, 68(32.2%) were discharged with poor outcome, of these, 31 (14.7%) were died, 12(5.7%) complicated, 12(5.7%) deteriorated, 8(3.3%) self-discharged and 6(2.8%) were referred. Very low birth weight [P=0.006, AHR=1.692, 95% CI: (1.245, 4.36)], age of neonate less than 4 days at admission [P= 0.001, AHR=9.67, 95%CI: (2.24, 41.70)], maternal infection [P=0.032, AHR=3.186, 95%CI: (1.32,30.68)], prolonged length of hospital stay [(P= 0.017, AHR=12.29, 95%CI: (1.55, 96.31), were significantly associated to mortality. Conclusion: This study indicated that neonatal sepsis was the frequently occurring neonatal disease. Mortality rate of neonatal sepsis was found to be high. Age of neonate <4 days, birth weight of the neonate < 1500gm, prolonged length of hospital stay, maternal infection during pregnancy were found to be independently associated with mortality