Reasons for Admission, Outcome and Factors Associated with Outcome of Neonate Admitted at Neonatal Intensive Care Unit (NICU) of Yekatit 12 Hospital Medical College, Addis Ababa

Shewaminale, Yohannes (2016) Reasons for Admission, Outcome and Factors Associated with Outcome of Neonate Admitted at Neonatal Intensive Care Unit (NICU) of Yekatit 12 Hospital Medical College, Addis Ababa. Masters thesis, Addis Ababa University.

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Abstract

Background: More than 80% of newborn death results from three preventable and treatable conditions: prematurity, intrapartum birth asphyxia and neonatal infections. Cognizant of this, the government of Ethiopia has launched CBNC (Community Based Newborn Care) at community level, newborn corner in health centers and NICU (Neonatal Intensive Care Unit) in hospitals since 2013. Understanding management practice and outcome of NICU may inform these facility based programs to better visualize the situation on the ground. Objective: To describe the clinical profile and management outcome of neonates admitted at NICU of Yekatit 12 hospital medical college from October, 2014 to September, 2015. Methods: A retrospective medical record review of neonate admitted at NICU of Yekatit 12 hospital medical college in Addis Ababa from October, 2014 to September, 2015 was conducted using pretested checklist. Data from 1,971 medical records were entered into computer using Epi Info version 7 and analyzed using SPSS 20. Result: The five most important admission diagnosis were neonatal sepsis (both early and late onset) 1258(63.8%), prematurity388 (19.7%), hyperbilurubinemia 354(18%), perinatal asphyxia 308(15.6%), and meconium aspiration syndrome271(13.7%). In relation to management outcome 88.2% discharged improved and 182(9.2%) died. The three leading cause of death were found to be sepsis 56 (31.6%), prematurity 56(31.64%), and perinatal asphyxia 43(24.29%). Neonate born of mothers with premature rupture of membrane are more likely to die than those neonate born of mothers without premature rupture of membrane (AOR=1.6; 95%CI: 1.1,2.3 and P=0.020), neonate born twins are more likely to die than single born neonate (AOR=1.8; 95%CI: 1.1,2.96 and P=0.021) and neonate born with apgar score of 4-6 at 5 minutes (mild depression) are more likely to die than neonate with apgar score of 7-10 (normal /without depression) (AOR=2.7; 95%CI: 1.7,4.3 and P=0.000) as in the table below. The likelihood of dying was significantly higher in neonates who were diagnosed as having prematurity (AOR=4.24; 95%CI: 2.8,6.3 and P=0.000), perinatal asphyxia (AOR=4.69; 95%CI:3.16,6.9 and P=0.000 ), Early onset neonatal sepsis (AOR=1.46; 95%CI:1.05,2.02 and P=0.024),Congenital Malformations (AOR=3.29; 95%CI:1.72,626 and P=0.000) and Very low birth weight (AOR=3.786; 95%CI: 2.3,6.19 and P=0.000). Conclusion and recommendations: The NICU of Yekatit 12 hospital medical college was practically saving the lives of near miss newborns from preventable causes of death. Most of them would have been lost unnecessarily if this specialized NICU were not functional. Since this hospital NICU is now functioning as a specialized NICU for referral of most severely compromised neonates its setup should be strengthened and expanded further.

Item Type:	Thesis (Masters)
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Africana
Depositing User:	Emmanuel Ndorimana
Date Deposited:	29 Nov 2018 10:18
Last Modified:	29 Nov 2018 10:18
URI:	http://thesisbank.jhia.ac.ke/id/eprint/8003

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