Perceived Demographic and Socio-Economic Factors Contributing to Poor Outcome of Neonatal Sepsis at Paediatric Unit Kenyatta National Hospital
Introduction: Globally sepsis is still a known case of high mortality and mobility rates among neonates. This is despite having been advances in healthcare quality. The World Health Organization estimates that more than 40% of deaths occurring among infants aged below five years happen during the neonatal phase and they result in 3.1 infant deaths annually. Objective: This study sought to establish the perceived demographic and socioeconomic status of poor outcomes of neonatal sepsis at Kenyatta national hospital paediatric unit. Methodology: This was a hospital-based descriptive cross-sectional study conducted in the Paediatric Unit of Kenyatta National Hospital. A total of 175 mothers of neonates with neonatal sepsis admitted in KNH selected using consecutive sampling methods were recruited into the study. A validated researcher-administered semi-structured questionnaire was used to collect the data. Descriptive statistics involved the calculation of measures of central tendencies like means, modes and medians between variables. Association between the study variables was estimated using both chi-square and odds ratio statistics at a 95% confidence interval. The study results were presented in tables, graphs and charts, as appropriate. Results: Maternal demographic factors associated with poor outcomes of neonatal sepsis included - younger or advanced maternal age (X2 = 4.735, df = 2, p = 0.031); low education level (X2 = 6.362, df = 1, p = 0.012) and short birth intervals of < 2 years (X2 = 5.108, df = 2, p = 0.023). Maternal socioeconomic factors associated with poor outcomes of neonatal sepsis included - low household income level (X2 = 6.163, df = 1, p = 0.014); large family sizes of ≥5 members (X2 = 4.844, df = 1, p = 0.028) and lack of a health insurance cover (X2 = 5.382, df = 1, p = 0.019). Conclusion: Various maternal demographics, maternal socio-economic were significant perceived determinants of poor outcomes of neonatal sepsis in Kenyatta National Hospital’s Paediatric Unit. Recommendations: The national government with the help of county governments and development partners should invest in community empowerment programs that aim to improve the socioeconomic status of caregivers and their households. In addition, further investments in the health care system are needed to make it more affordable to all and particularly to the low-income group.
Abu-Salah, O. (2011). Unfavourable outcomes associated with late preterm birth: Observations from Jordan. Journal of the Pakistan Medical Association, 61(1), 769-772.
Adatara, P., Afaya, A., Salia, S. M., Afaya, R. A., Konlan, K. D., Agyabeng-Fandoh, E., ... & Boahene, I. G. (2019). Risk factors associated with neonatal sepsis: a case study at a specialist hospital in Ghana. The Scientific World Journal, 2019.
Alemu, M., Ayana, M., Abiy, H., Minuye, B., Alebachew, W., & Endalamaw, A. (2019). Determinants of neonatal sepsis among neonates in the northwest part of Ethiopia: case-control study. Italian Journal of Paediatrics, 45(1), 150.
Al-Lawama, M., Badran, E., & Khuri Bulos, N. (2014). Neonatal gram negative sepsis in a tertiary hospital in Jordan: when fever means multidrug resistance. Pediat Therapeut, 4(212), 2161-0665.
Al-Matary, A., Heena, H., AlSarheed, A. S., Ouda, W., AlShahrani, D. A., Wani, T. A., ... & Abu-Shaheen, A. (2019). Characteristics of neonatal Sepsis at a tertiary care hospital in Saudi Arabia. Journal of infection and public health, 12(5), 666-672.
Arowosegbe, A. O., Ojo, D. A., Dedeke, I. O., Shittu, O. B., & Akingbade, O. A. (2017). Neonatal sepsis in a Nigerian Tertiary Hospital: Clinical features, clinical outcome, aetiology and antibiotic susceptibility pattern. Southern African Journal of Infectious Diseases, 32(4), 127-131.
Boia, M., Cioboata, D., & Manea, A. (2017). P373 Clinical aspects and evolution in the early neonatal sepsis. Archives of Disease in Childhood, 102(2), A17-A28
Boundy, E. O., Dastjerdi, R., Spiegelman, D., Fawzi, W. W., Missmer, S. A., Lieberman, E., ... & Chan, G. J. (2016). Kangaroo mother care and neonatal outcomes: a meta-analysis. Paediatrics, 137(1), e20152238.
Bunduki, G. K., & Adu-Sarkodie, Y. (2019). Clinical outcome and isolated pathogens among neonates with sepsis in Democratic Republic of the Congo: a cross-sectional study. BMC research notes, 12(1), 303.
Demisse, A.G., Alemu, F., Gizaw, M.A. & Tigabu, Z. 2017, “Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia”, Paediatric health, medicine and therapeutics, vol. 8, pp. 57-64.
Denscombe, M. (2014). The Good Research Guide: For Small-Scale Social Research Projects. Buckingham, England: Open University Press
Fisher, R.A., Haseman, J.K., Kramer, M., & Greenhouse, S.W. (1998). Statistical Methods for Scientific Inference, 5th ed. London: Hafner Press
Fleischmann-Struzek, C., Goldfarb, D. M., Schlattmann, P., Schlapbach, L. J., Reinhart, K., & Kissoon, N. (2018). The global burden of paediatric and neonatal sepsis: a systematic review. The Lancet Respiratory Medicine, 6(3), 223-230.
Fottrell, E., Osrin, D., Alcock, G., Azad, K., Bapat, U., Beard, J., Bondo, A., Colbourn, T., Das, S., King, C., Manandhar, D., Manandhar, S., Morrison, J., Mwansambo, C., Nair, N., Nambiar, B., Neuman, M., Phiri, T., Saville, N., Sen, A., Seward, N., Shah Moore, N., Shrestha, B.P., Singini, B., Tumbahangphe, K.M., Costello, A. & Prost, A. 2015, “Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India”, Archives of Disease in Childhood - Fetal and Neonatal Edition, vol. 100, no. 5, pp. F439-F447.
Gavidia, R., Fuentes, S. L., Vasquez, R., Bonilla, M., Ethier, M. C., Diorio, C., & Sung, L. (2012). Low socioeconomic status is associated with prolonged times to assessment and treatment, sepsis and infectious death in Paediatric fever in El Salvador. PLoS One, 7(8), 61.
Gebremedhin, D., Berhe, H., & Gebrekirstos, K. (2016). Risk factors for neonatal sepsis in public hospitals of Mekelle City, North Ethiopia, 2015: unmatched case control study. PloS one, 11(5).
Ghosh, R., & Sharma, A. K. (2011). Determinants of tetanus and sepsis among the last neonatal deaths at household level in a peri-urban area of India. Postgraduate medical journal, 87(1026), 257-263.
GSA. (2019). World sepsis day 2018 – preventable maternal and neonatal sepsis a critical priority for WHO and Global Sepsis Alliance. Available from: https://static1.squarespace.com/static/58a7025b8419c215b30b2df3/t/59b1b9d52994caee6bc0eba7/1504819673100/Press_Release_WSD_WSC_English_Letterhead+(PDF).pdf. Accessed January 08, 2020.
Hammad, E., & Zainab, M.S. (2018). Meta-Analysis on Factors Influencing Early Onset Neonatal Sepsis. Scholar Journal of Applied Sciences and Research, 1(8), 20-22.
Jabiri, A., Wella, H. L., Semiono, A., Saria, A., & Protas, J. (2016). Prevalence and factors associated with neonatal sepsis among neonates in Temeke and Mwananyamala Hospitals in Dar es Salaam, Tanzania. Tanzania Journal of Health Research, 18(4), 1–7.
John, B., David, M., Mathias, L., & Elizabeth, N. (2015). Risk factors and practices contributing to newborn sepsis in a rural district of Eastern Uganda, August 2013: a cross sectional study. BMC research notes, 8(1), 339.
Kayom, V. O., Mugalu, J., Kakuru, A., Kiguli, S., & Karamagi, C. (2018). Burden and factors associated with clinical neonatal sepsis in urban Uganda: a community cohort study. BMC Paediatrics, 18(1), 355-363.
Kumar, G. V., Rahman, H. F., & Vatsalakumari & Viswanathakumar, H. M. (2016). Cross-sectional study of risk factors associated with neonatal sepsis in a tertiary care teaching hospital. Indian J Child Health, 3(1), 73-75.
Mersha, A., Worku, T., Shibiru, S., Bante, A., Molla, A., Seifu, G., ... & Teshome, T. (2019). Neonatal sepsis and associated factors among newborns in hospitals of Wolaita Sodo Town, Southern Ethiopia. Research and Reports in Neonatology, 9(1), 31.
Mitra, D. K., Mullany, L. C., Harrison, M., Mannan, I., Shah, R., Begum, N., ... & Baqui, A. H. (2018). Incidence and risk factors of neonatal infections in a rural Bangladeshi population: a community-based prospective study. Journal of Health, Population and Nutrition, 37(1), 6.
Murthy, S., Godinho, M. A., Guddattu, V., Lewis, L. E. S., & Nair, N. S. (2019). Risk factors of neonatal sepsis in India: A systematic review and meta-analysis. PloS one, 14(4).
Muthwii, F.K. (2016). Characterization of neonatal sepsis among patients admitted in Kenyatta National Hospital Paediatric Wards. Unpublished MSc in Nursing, University of Nairobi.
Siakwa, M., Kpikpitse, D., Mupepi, S. C., & Semuatu, M. (2014). Neonatal sepsis in rural Ghana: A case control study of risk factors in a birth cohort. Int J Res Med Sci., 4(5), 77–88.
Tewabe, T., Mohammed, S., Tilahun, Y., Melaku, B., Fenta, M., Dagnaw, T., ... & Belete, H. (2017). Clinical outcome and risk factors of neonatal sepsis among neonates in Felege Hiwot referral Hospital, Bahir Dar, Amhara Regional State, North West Ethiopia 2016: a retrospective chart review. BMC research notes, 10(1), 265.
Copyright (c) 2021 Kimaiyo Jepkosgei, Abednego Ongeso, PhD, Blasio Omuga, PhD
This work is licensed under a Creative Commons Attribution 4.0 International License.