Neonatal Sepsis Treatment Outcome And Associated Factors Among Neonates Admitted To Neonatal Intensive Care Unit At Public Hospitals In West Shoa Zone, Oromia, Ethiopia

Abstract

Background: Globally, neonatal sepsis is a major cause of neonatal death. A definitive early diagnosis and appropriate antimicrobial therapy which significantly reduce poor neonatal sepsis treatment outcome are challenging in resource limited settings like Ethiopia. This study aimed to assess the treatment outcome and factors associated with neonatal sepsis treatment outcome among those treated at the neonatal intensive care unit of west Shoa zone public hospitals. Objectives: The objective of this study was to assess neonatal sepsis treatment outcome and associated factors among neonates admitted in NICU at public hospitals in west Shoa zone, Ethiopia, 2023. Method: An institution-based cross-sectional study was conducted among 335 participants in the public hospitals of West Shoa zone, Ethiopia from April 20 to July 20, 2023. The study participants were selected by a systematic random sampling technique from the selected hospital. Data were collected using structured pretested questionnaire through interviewing mothers or care givers and reviewing newborns medical card. The collected data was entered into Epi Info 7 and exported to SPSS version 25 for analysis. Descriptive statistics were used to summarize descriptive data. Binary logistic regression analysis was computed and variables with p-value < 0.25 were considered candidates for multivariable logistic regression. Adjusted Odds Ratios (AOR) with 95% confidence interval were estimated to identify the association. Statistical significance was declared at < 0.05 p-value. Results: A total of 335 neonates were included in the study with a response rate of 100%. About 30.4% study participants had a poor treatment outcome. Multivariable analysis showed that gestational age less than 37 weeks (AOR=2.553, [95% CI: 1.077- 6.053]), APGAR score at first minute (AOR=2.830, [95% CI: 1.356- 5.907]), meconium aspiration syndrome (AOR=4.356, [95% CI: 1.791-7.556]), premature rupture of membrane (AOR=2.594, [95% CI: 1.310- 5.134]), maternal fever (AOR=2.732, [95% CI: 1.357- 5.500]), respiratory distress (AOR=2.937, [95% CI: 1.524- 5.661]), and ANC Visits (AOR=0.223, [95% CI: 0.064- 0.778]) were associated with poor treatment outcome of neonatal sepsis. Conclusion and recommendation: in this study the poor outcome of neonatal sepsis was 102(30.4%). This study indicated that poor neonatal sepsis treatment outcome was relatively high. Recommendations to improve neonatal outcome are: treating mothers with infection during pregnancy, prevent maternal obstetric complication, performing essential newborn care for all newborns and arranging appropriate follow up until the end of neonatal period, give prophylactic antibiotics for neonates with documented risk factors for infection, and early detection and management of neonatal infections or problems.