Neonatal Sepsis in Sub-Saharan Africa: A Scoping Review on Prevalence and Associated Factors

Abstract

Background: Neonatal sepsis has been a major cause of infant mortality and morbidity in sub-Saharan Africa. Normally, the infection sets in within the first 72 hours after birth (early onset), while infections above 72 hours after birth (late onset) also affect these children. There are a number of causes associated with sepsis: prematurity, poor hygienic conditions during delivery, limited access to quality neonatal care, infections during pregnancy and poor feeding methods during early infancy. The purpose of this scoping review is to identify the prevalence and point out the various associated factors that will help make new policies to improve general practices in the health sector to improve the health of the neonates and infants. Objective of the study: Determining the patterns of prevalence rates and risk factors associated with neonatal sepsis will help the health care sector and the Ministry of Health in general to develop different approaches to improve care delivery among neonates. Methods: Most of the data was obtained from global databases, which were lastly updated on 25th March 2025. These databases include: PubMed, PLO journals, the Neonatal Institute of Health, South Sudan medical journals, ScienceDirect.com, Google Scholar, and BMC Pregnancy and Childbirth.  PRISMA (Preferred Reporting Items to Systematic Reviews and Meta-Analyses extension to Scoping Reviews) framework was used to present data; a systematic search was conducted from 21st October 2025 to 20th November 2025. Results: This review included 50 studies with 3,347neonates. High prevalences of neonatal sepsis were found in sub-Saharan Africa, up to 40%. History of urinary tract infections and sexually transmitted infections, infections from poor cord care after birth, premature rupture of membranes, preterm babies, low birth weight below 2300grams, poor Apgar score and late initiation of breastfeeding were among the leading causes. Conclusion:  The continent of Africa is the leading region in cases of neonatal sepsis globally. Attention needs to be given to various issues to improve the overall well-being of neonates and babies below 5 years. Screening during antenatal clinics to identify and treat infections. Timely interventions during labour and delivery to avoid complications of birth, to reduce the number of babies with poor Apgar scores and improve birth outcomes. Careful monitoring of the labour process during delivery to avoid cases of foetal distress, hence reducing neonatal complications after birth. Midwives and caregivers should ensure mothers breastfeed their neonates within the first hour of birth