Prevalence and presentation of neonatal sepsis at a paediatric emergency department in Johannesburg, South Africa

Clotilde, Tchouambou SN; Motara, Feroza; Laher, Abdullah E.

doi:10.1016/j.afjem.2022.07.013

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Twenty-one studies were from Ethiopia ( 28 , 31 , 44–46 , 49 , 51–56 , 60–64 , 66 , 68 , 69 , 71 ), five from Tanzania ( 22 , 30 , 33 , 67 , 72 ), five from Nigeria ( 34 , 47 , 59 , 73 , 74 ), four from Ghana ( 35 , 48 , 65 , 75 ), two from Uganda ( 50 , 70 ), one from Kenya ( 29 ), and one from South Africa ( 32 ). The total study population was 12,777, including 10,494 newborns and 2,283 women.…”

Section: Resultsmentioning

confidence: 99%

“…The maternal factors were history of urinary tract infection in the mother (13 studies) ( 31 , 45 , 53 , 55 , 56 , 61 , 62 , 65 , 66 , 68–71 ), parity (10 studies) ( 31 , 45 , 48 , 53 , 56 , 61 , 62 , 65 , 67 , 68 ), prolonged labor (5 studies) ( 31 , 53 , 62 , 69 , 73 ), intrapartum fever (13 studies) ( 31 , 45 , 48 , 52 , 55 , 56 , 61 , 64 , 66 , 68 , 70 , 72 , 73 ), multiple vaginal examinations (7 studies) ( 45 , 53 , 61 , 64 , 66–68 ), performance of ANC (13 studies) (45, 48, 50, 55, 61, 64, 65, 67–71), prolonged rupture of membranes (18 studies) ( 31 , 33 , 45 , 46 , 52 , 53 , 56 , 61 , 62 , 65–73 ), and mode of delivery (14 studies) ( 31 , 32 , 35 , 44 , 46 , 48 , 52 , 61 , 62 , 64 , 66–68 …”

Section: Resultsmentioning

confidence: 99%

“…A recent meta-analysis carried out in SSA in 2022 identified several risk factors for neonatal sepsis ( 27 ) but did not explore the magnitude of neonatal and/or maternal sepsis nor the factors associated with maternal sepsis. Other studies have shown that the prevalence of maternal sepsis was 39% in Ethiopia ( 28 ), 12.20% in Keyna ( 29 ), and 20% in Tanzania ( 30 ); for neonatal sepsis, it was 77.9 in Ethiopia ( 31 ), 20.5% in South Africa ( 32 ), 49.8 in Tanzania ( 33 ), 37.6 in Nigeria ( 34 ), and 17.5 in Ghana ( 35 ). Although these single studies reported data on the prevalence and factors associated with maternal and neonatal sepsis, there are no regionally representative pooled data on the magnitude and factors associated with maternal and neonatal sepsis in SSA.…”

Section: Introductionmentioning

confidence: 98%

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Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

Traoré,

Sidibé,

Diallo

et al. 2024

Front. Public Health

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ObjectivesThis study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa.MethodsThis systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger’s regression test were used to assess the publication bias.ResultsA total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46–26.97) and 36.02% (CI: 26.68–45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6–3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8–4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9–4.1), male sex (OR: 1.2, 95% CI: 1.1–1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5–3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4–5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01–10.9), parity (OR: 0.5, 95% CI: 0.3–0.7), prolonged labor (OR: 3.4, 95% CI: 1.6–6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3–14.3) were significantly associated with maternal sepsis.ConclusionThe prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data.Systematic review registration: PROSPERO (ID: CRD42022382050).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

Traoré,

Sidibé,

Diallo

et al. 2024

Front. Public Health

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“…One possible explanation for this prophylaxis is that it was used for a diagnosis of suspected sepsis in full-term newborns with major risk factors for sepsis. The antibiotic prophylaxis in neonates was combination therapies (except in 2017), including a third-generation cephalosporin and an aminoglycoside, which contrasts with our local guideline’s recommendation of second-generation cephalosporin as well as the WHO recommendation for penicillin and an aminoglycoside [ 45 , 51 , 52 ]. Absence of documented indications for use may be the reason for assigning them as prophylaxes, since a follow-up was not part of the PPS, the final reason cannot be ascertained.…”

Section: Discussionmentioning

confidence: 99%

Point prevalence surveys of antibiotic prescribing in children at a tertiary hospital in a resource constraint, low-income sub-Saharan African country—the impact of an antimicrobial stewardship program

Akintan,

Oshun,

Osuagwu

et al. 2024

BMC Pediatr

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Background Resistance to multiple antibiotics by several pathogens has been widely described in children and has become a global health emergency. This is due to increased use by parents, caregivers, and healthcare providers. This study aims to describe the prevalence rates of antibiotic prescribing, ascertain the impact of antimicrobial stewardship programs, and target improving the quality of antibiotic prescribing in the paediatric population over time in a hospital. Method A point prevalence survey of antibiotic use was performed yearly for 4 years to monitor trends in antibiotic prescribing. Data from all patients admitted before 8 a.m. on the day of the PPS were included. A web-based application designed by the University of Antwerp was used for data entry, validation, and analysis (http://www.global-pps.com). Results A total of 260 children, including 90 (34.6%) neonates and 170 (65.4%) older children, were admitted during the four surveys. Overall, 179 (68.8%) patients received at least one antibiotic. In neonates, the prevalence of antibiotic use increased from 78.9 to 89.5% but decreased from 100 to 58.8% in older children. There was a reduction in the use of antibiotics for prophylaxis from 45.7 to 24.6%. The most frequently prescribed antibiotic groups were third generation cephalosporins and aminoglycosides. The most common indications for antibiotic prescription were sepsis in neonates and central nervous system infection in older children. The documentation of reason in notes increased from 33 to 100%, while the stop-review date also increased from 19.4 to 70%. Conclusion The indicators for appropriate antibiotic prescription improved over time with the introduction of antibiotic stewardship program in the department.

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Determinants and Magnitude of Neonatal Sepsis at Hiwot Fana Comprehensive Specialized University Hospital, in Eastern Ethiopia: A Cross-Sectional Study

Alemayehu,

Yusuf,

Demissie

et al. 2024

Clin Med Insights Pediatr

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Background: Neonatal sepsis is a serious blood bacterial infection in neonates at the age of equal to or less than 28 days of life, and it’s still the major significant cause of death and long-term morbidity in developing countries. Objective: This study aimed to assess the prevalence and related factors with neonatal sepsis among newborns admitted to the neonatal intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital, Harar, Ethiopia. Methods: An institutional-based retrospective cross-sectional study design was conducted among 386 neonates admitted to Neonatal Intensive Care Unit from September 2017 to August 2019. A systematic random sampling method was used. Data were analyzed using SPSS V.26. Descriptive summary statistics were done. Bivariate regression and multivariate analysis were computed. Variables with P-value <.05 were declared as having a statistically significant association. Result: The prevalence of neonatal sepsis was 53.1%. Among the total neonates who had sepsis, 67.8% had early neonatal sepsis. Among neonatal factors, preterm neonates (AOR: 8.1, 95%CI: 2.1, 31.2), birth asphyxia (AOR: 4.7, 95%CI: 1.6, 13.6); and among maternal factors, urban residence (AOR: 0.26, 95%CI: 0.1, 0.5), antenatal care attendance (AOR: 0.32, 95%CI: 0.2, 0.6), spontaneous vaginal delivery (AOR: 0.047, 95%CI: 0.01, 0.2), and maternal antibiotic use (AOR: 0.39; 95%CI: 0.2, 0.8) were found to have significant association with neonatal sepsis. Conclusion: Overall, the magnitude of neonatal sepsis was high. Provision of neonatal and obstetrics care as per standard during prenatal, intranatal, and postnatal periods is needed. Training of health professionals on infection prevention and safe delivery practice should be provided.

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Prevalence and presentation of neonatal sepsis at a paediatric emergency department in Johannesburg, South Africa

Cited by 4 publications

References 22 publications

Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

Point prevalence surveys of antibiotic prescribing in children at a tertiary hospital in a resource constraint, low-income sub-Saharan African country—the impact of an antimicrobial stewardship program

Determinants and Magnitude of Neonatal Sepsis at Hiwot Fana Comprehensive Specialized University Hospital, in Eastern Ethiopia: A Cross-Sectional Study

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