Helen M Nabwera1,2, Dingmei Wang3, Olukemi O Tongo4, Pauline E A Andang'o5, Isa Abdulkadir6, Chinyere V Ezeaka7, Beatrice N Ezenwa7, Iretiola B Fajolu7, Zainab O Imam8, Martha K Mwangome9, Dominic D Umoru10, Abimbola E Akindolire4, Walter Otieno5,11, Grace M Nalwa5,11, Alison W Talbert9, Ismaela Abubakar1, Nicholas D Embleton12,13, Stephen J Allen1,2. 1. Liverpool School of Tropical Medicine, Liverpool, United Kingdom. 2. Alder Hey Children's Hospital NHS Trust, Liverpool, United Kingdom. 3. Children's Hospital of Fudan University, Minhang District, Shanghai, China. 4. University College Hospital, Ibadan, Nigeria. 5. Maseno University, Maseno, Kenya. 6. Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria. 7. Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria. 8. Massey Street Children's Hospital, Lagos, Nigeria. 9. KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya. 10. Maitama District Hospital, Maitama, Abuja, Nigeria. 11. Jaramogi Oginga Odinga Teaching and Referral Hospital, Jomo Kenyatta Highway Kaloleni Kisumu KE, Central, Kenya. 12. Newcastle University, Newcastle upon Tyne, United Kingdom. 13. The Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle upon Tyne, United Kingdom.
Abstract
OBJECTIVE: To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria. STUDY DESIGN: In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period. RESULTS: 2280 newborns were admitted. Mean birthweight was 2.3 kg (SD 0.9); 57.0% (1214/2128) infants were low birthweight (LBW; <2.5kg) and 22.6% (480/2128) were very LBW (VLBW; <1.5 kg). Median gestation was 36 weeks (interquartile range 32, 39) and 21.6% (483/2236) infants were very preterm (gestation <32 weeks). The most common morbidities were jaundice (987/2262, 43.6%), suspected sepsis (955/2280, 41.9%), respiratory conditions (817/2280, 35.8%) and birth asphyxia (547/2280, 24.0%). 18.7% (423/2262) newborns died; mortality was very high amongst VLBW (222/472, 47%) and very preterm infants (197/483, 40.8%). Factors independently associated with mortality were gestation <28 weeks (adjusted odds ratio 11.58; 95% confidence interval 4.73-28.39), VLBW (6.92; 4.06-11.79), congenital anomaly (4.93; 2.42-10.05), abdominal condition (2.86; 1.40-5.83), birth asphyxia (2.44; 1.52-3.92), respiratory condition (1.46; 1.08-2.28) and maternal antibiotics within 24 hours before or after birth (1.91; 1.28-2.85). Mortality was reduced if mothers received a partial (0.51; 0.28-0.93) or full treatment course (0.44; 0.21-0.92) of dexamethasone before preterm delivery. CONCLUSION: Greater efforts are needed to address the very high burden of illnesses and mortality in hospitalized newborns in sub-Saharan Africa. Interventions need to address priority issues during pregnancy and delivery as well as in the newborn.
OBJECTIVE: To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria. STUDY DESIGN: In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period. RESULTS: 2280 newborns were admitted. Mean birthweight was 2.3 kg (SD 0.9); 57.0% (1214/2128) infants were low birthweight (LBW; <2.5kg) and 22.6% (480/2128) were very LBW (VLBW; <1.5 kg). Median gestation was 36 weeks (interquartile range 32, 39) and 21.6% (483/2236) infants were very preterm (gestation <32 weeks). The most common morbidities were jaundice (987/2262, 43.6%), suspected sepsis (955/2280, 41.9%), respiratory conditions (817/2280, 35.8%) and birth asphyxia (547/2280, 24.0%). 18.7% (423/2262) newborns died; mortality was very high amongst VLBW (222/472, 47%) and very preterm infants (197/483, 40.8%). Factors independently associated with mortality were gestation <28 weeks (adjusted odds ratio 11.58; 95% confidence interval 4.73-28.39), VLBW (6.92; 4.06-11.79), congenital anomaly (4.93; 2.42-10.05), abdominal condition (2.86; 1.40-5.83), birth asphyxia (2.44; 1.52-3.92), respiratory condition (1.46; 1.08-2.28) and maternal antibiotics within 24 hours before or after birth (1.91; 1.28-2.85). Mortality was reduced if mothers received a partial (0.51; 0.28-0.93) or full treatment course (0.44; 0.21-0.92) of dexamethasone before preterm delivery. CONCLUSION: Greater efforts are needed to address the very high burden of illnesses and mortality in hospitalized newborns in sub-Saharan Africa. Interventions need to address priority issues during pregnancy and delivery as well as in the newborn.
Authors: Melissa M Medvedev; Helen Brotherton; Abdou Gai; Cally Tann; Christopher Gale; Peter Waiswa; Diana Elbourne; Joy E Lawn; Elizabeth Allen Journal: Lancet Child Adolesc Health Date: 2020-02-28
Authors: Olukemi O Tongo; Macrine A Olwala; Alison W Talbert; Helen M Nabwera; Abimbola E Akindolire; Walter Otieno; Grace M Nalwa; Pauline E A Andang'o; Martha K Mwangome; Isa Abdulkadir; Chinyere V Ezeaka; Beatrice N Ezenwa; Iretiola B Fajolu; Zainab O Imam; Dominic D Umoru; Ismaela Abubakar; Nicholas D Embleton; Stephen J Allen Journal: Front Pediatr Date: 2022-05-11 Impact factor: 3.569
Authors: Estomih Mduma; Tinto Halidou; Berenger Kaboré; Thomas Walongo; Palpouguini Lompo; Justine Museveni; Joshua Gidabayda; Jean Gratz; Godfrey Guga; Caroline Kimathi; Jie Liu; Paschal Mdoe; Robert Moshiro; Max Petzold; Jan Singlovic; Martine Guillerm; Melba F Gomes; Eric R Houpt; Christine M Halleux Journal: PLoS One Date: 2022-02-25 Impact factor: 3.240