Abstract
Background: In Uganda the neonatal mortality has remained between 24 and 27 deaths per 1000 live births for the last 14 years.
Aim: To determine the impact on neonatal mortality of the introduction of infection prevention and treatment guidelines in a resource poor setting.
Methods: A prospective study was carried out in Kagando Hospital, a rural hospital in Western Uganda of infants live-born in hospital and infants admitted from the community or other hospitals between 2013 and 2017. Guidelines were developed from a literature review and informed by local doctors and nurses and a visiting paediatrician. The guidelines highlighted that unwell infants should be admitted to the neonatal unit which was a section of the paediatric ward, emphasized hand hygiene, separation of infants with and without sepsis, unwell infants should be treated with evidence based antibiotic regimes and enteral feeds withheld from unwell infants. Mortality within 28 days from birth was audited for three months prior and post intervention; the audit was repeated three and five years later.
Results: Pre-intervention, there were 137 neonatal admissions and 79 neonatal deaths in three months (0.58 deaths per admission). Post-intervention there were 187 admissions, the death rate was lower (0.26 deaths per admission, p<0.001). Three years post intervention, there were 60 deaths of 233 admissions (0.26 deaths per admission, p<0.001) and at five years 53 deaths of 315 admissions (0.17 deaths per admission, p<0.001).
Conclusion: These data suggest introducing infection, prevention and treatment guidelines can reduce neonatal mortality in a resource poor setting.
| Original language | English |
|---|---|
| Article number | doi: 10.1080/20469047.2018.1528757. |
| Pages (from-to) | 1-4 |
| Number of pages | 4 |
| Journal | Paediatrics and International Child Health |
| Early online date | 17 Oct 2018 |
| DOIs | |
| Publication status | E-pub ahead of print - 17 Oct 2018 |
