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Determinants and Outcome of Community-Acquired Late-Onset Neonatal Sepsis in Rural Bangladesh

Background. This study examined the sociodemographic as well as other determinants and outcome of community-acquired late-onset neonatal sepsis (LONS) in rural Bangladesh at Matlab. Methods. In this retrospective chart review, we used an unmatched case-control design (1:2 ratio) to evaluate the fact...

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Detalles Bibliográficos
Autores principales: Saqeeb, Kazi Nazmus, Hasan, S. M. Tafsir, Khan, Md. Alfazal, Ahmed, Tahmeed, Chisti, Mohammod Jobayer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421610/
https://www.ncbi.nlm.nih.gov/pubmed/30906816
http://dx.doi.org/10.1177/2333794X19833730
Descripción
Sumario:Background. This study examined the sociodemographic as well as other determinants and outcome of community-acquired late-onset neonatal sepsis (LONS) in rural Bangladesh at Matlab. Methods. In this retrospective chart review, we used an unmatched case-control design (1:2 ratio) to evaluate the factors associated with LONS and their outcomes among babies admitted to the neonatal ward of Matlab Hospital of icddr,b, from January 2012 to December 2014. Neonates presenting with any of the clinical signs of serious bacterial infection during 3 to 28 days of life constituted the cases (LONS), and those without LONS constituted the controls. All the data were retrieved from the electronic databases of Matlab Hospital and Matlab Health and Demographic Surveillance System. Results. Among 1482 admitted neonates, 202 were cases and 404 were randomly selected controls. In babies with LONS, case fatality rate (1% vs 0%, P = .037), duration of inpatient stay (4 days vs 2 days, P < .001), and referral to higher center (9% vs 5%, P = .020) were higher. In an adjusted model, undernutrition (weight for length Z score < −2; odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.2-2.94), admission in winter season (OR = 1.62, 95% CI = 1.09-2.41), mother’s schooling <10 years (OR = 1.76, 95% CI = 1.09-2.85), primiparity (OR = 1.55, 95% CI = 1.05-2.29), home delivery (OR = 1.87, 95% CI = 1.07-3.26), and household food insecurity (OR = 2.78, 95% CI = 1.31-5.88) were found to be independently associated with LONS. Conclusion. LONS posed considerable socioeconomic burden to the rural community. Further studies are required to consolidate our findings.