Determinants of Neonatal Sepsis among Neonates Admitted to Public Hospitals in Central Ethiopia: Unmatched Case-control Study

Abstract

Background. Neonatal sepsis is the cause of substantial morbidity and mortality, mostly affecting the developing countries including Ethiopia. Previously conducted studies also highlighted the high prevalence of neonatal sepsis in Ethiopia. Therefore, this study was aimed at assessing the determinants of neonatal sepsis in the central Ethiopia. Method. Institution based un-matched case control study was conducted among 192 cases (neonates with sepsis) and 384 controls (without sepsis) in public hospitals in Central Ethiopia. The data were collected through face-to-face interview using structured questionnaire and extraction from maternal and neonatal charts. Binary logistic regression (bi-variable and multi-variable) model was fitted. Adjusted odds ratio with respect to 95% confidence interval was employed for the strength and directions of the association. Results. Younger maternal-age; 30 to 34 years (AOR = 0.41, 95%CI: 0.19-0.85) and 25 to 29 years (AOR = 0.38, 95%CI: 0.17-0.84), not having antenatal care (ANC) follow-ups (AOR = 1.89, 95%CI: 1.02-3.49), place of delivery; home (AOR = 12.6, 95%CI: 5.32-29.82) and health center (AOR = 2.74, 95%CI: 1.7, 4.41), prolonged duration of labor (AOR = 1.90, 95%CI: 1.22, 2.96), prolonged rupture of membrane 12 to 17 hours (AOR = 3.26, 95%CI: 1.46, 7.26) and ≥18 hours (AOR = 5.18, 95%CI: 1.98, 13.55) were maternal related determinants of neonatal sepsis. Whereas, prematurity (AOR = 2.74, 95%CI: 1.73, 4.36), being resuscitated (AOR = 1.93, 95%CI: 1.22, 3.06) and not having meconium aspiration syndrome (AOR = 2.55, 95%CI: 1.34, 4.83) were identified as neonatal related determinants of neonatal sepsis. Conclusion. Younger maternal age, not having antenatal care follow-up, home, and health center delivery, prolonged duration of labor, prolonged duration of rupture of membrane, prematurity, had resuscitation, and neonates without meconium aspiration syndrome were found to be determinants of neonatal sepsis. Therefore, the concerned stakeholders should consider those identified determinants during an intervention for improvement of neonatal health.

Keywords: West Shewa zone; determinants; neonatal sepsis.