Factors associated with clinical sepsis in neonates admitted in Iganga hospital : a cross-sectional study.

Abstract

Neonatal sepsis is the second commonest cause of neonatal mortality and morbidity after asphyxia and is responsible for about 30% to 50% of total neonatal death in developing countries each year. With a global neonatal death of 2.5million per year and a very high and stagnating neonatal mortality rate of 27 per 1000 live births in Uganda for the last 15 years amidst all interventions, it is important to understand the contributing factors to this high and stagnating mortality rate. The objectives of this study therefore were to determine the prevalence and factors associated with clinical sepsis among neonates admitted to Iganga hospital. The study was a cross-sectional survey using hospital-based records of 424 neonates admitted in the neonatal unit and their index mothers collected during hospital delivery. Data were analyzed at three different levels of univariate, bivariate, and multivariate. Chi-square tested for statistical significance and multivariate analysis was by logistic regression.

This study found that the prevalence of clinical neonatal sepsis in Iganga hospital was 36.1%. The study also found that maternal obstetric and neonatal factors were associated with clinical neonatal sepsis. The Maternal obstetric risk factors for Neonatal sepsis included; having a foul-smelling per vaginal discharge (AOR=11.2; 95%CI 5.6-22.4), prolonged labor =24hours (AOR=2.1; 95%CI 1.01-4.45), developing UTI during pregnancy (AOR=38.1; 95%CI 13.6-106.9), and gestational age of = 36 weeks (AOR=9.1; 95%CI 2.4-34.30). Also, this study found that neonatal risk factors for neonatal sepsis were; birth weight =2.5 kg (AOR=3.3; 95%CI 1.4-7.7), and Apgar score =7 (AOR=6.7; 95%CI 3.7-12.0). From this study, it emerges that there is a need for deliberate efforts to reduce the high rates of neonatal sepsis in Iganga hospital. Further, mothers with foul-smelling vaginal discharge and those who develop urinary tract infections during pregnancy need to be screened, identified, and treated early and effectively to minimize the risk of developing neonatal sepsis.