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Burden of Neonatal Surgical Conditions in Northern Ghana
BACKGROUND: Congenital anomalies have risen to become the fifth leading cause of under-five mortality globally. The majority of deaths and disability occur in low- and middle-income countries including Ghana. This 3-year retrospective review aimed to define, for the first time, the characteristics a...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925064/ https://www.ncbi.nlm.nih.gov/pubmed/31583459 http://dx.doi.org/10.1007/s00268-019-05210-9 |
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author | Abdul-Mumin, Alhassan Anyomih, Theophilus T. K. Owusu, Sheila A. Wright, Naomi Decker, Janae Niemeier, Kelli Benavidez, Gabriel Abantanga, Francis A. Smith, Emily R. Tabiri, Stephen |
author_facet | Abdul-Mumin, Alhassan Anyomih, Theophilus T. K. Owusu, Sheila A. Wright, Naomi Decker, Janae Niemeier, Kelli Benavidez, Gabriel Abantanga, Francis A. Smith, Emily R. Tabiri, Stephen |
author_sort | Abdul-Mumin, Alhassan |
collection | PubMed |
description | BACKGROUND: Congenital anomalies have risen to become the fifth leading cause of under-five mortality globally. The majority of deaths and disability occur in low- and middle-income countries including Ghana. This 3-year retrospective review aimed to define, for the first time, the characteristics and outcomes of neonatal surgical conditions in northern Ghana. METHODS: A retrospective study was conducted to include all admissions to the Tamale Teaching Hospital (TTH) neonatal intensive care unit (NICU) with surgical conditions between January 2014 and January 2017. Data were collected on demographics, diagnosis and outcomes. Descriptive analysis was performed on all data, and logistic regression was used to predict determinants of neonatal mortality. p < 0.05 was deemed significant. RESULTS: Three hundred and forty-seven neonates were included. Two hundred and sixty-one (75.2%) were aged 7 days or less at presentation, with males (n = 177, 52%) slightly higher than females (n = 165, 48%). The majority were delivered by spontaneous vaginal delivery (n = 247, 88%); 191 (58%) were born in hospital. Congenital anomalies accounted for 302 (87%) of the neonatal surgical cases and 45 (96%) deaths. The most common anomalies were omphalocele (n = 48, 13.8%), imperforate anus (n = 34, 9.8%), intestinal obstruction (n = 29, 8.4%), spina bifida (n = 26, 7.5%) and hydrocephalus (n = 19, 5.5%). The overall mortality rate was 13.5%. Two-thirds of the deaths (n = 30) from congenital anomalies were conditions involving the digestive system with gastroschisis having the highest mortality of 88%. Omphalocele (n = 11, 23.4%), gastroschisis (n = 7, 14.9%) and imperforate anus (n = 6, 12.8%) contributed to the most deaths. On multivariate analysis, low birthweight was significantly associated with mortality (OR 3.59, CI 1.4–9.5, p = 0.009). CONCLUSION: Congenital anomalies are a major global health problem associated with high neonatal mortality in Ghana. The highest burden in terms of both caseload and mortality is attributed to congenital anomalies involving the digestive system, which should be targeted to improve outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00268-019-05210-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6925064 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-69250642020-01-03 Burden of Neonatal Surgical Conditions in Northern Ghana Abdul-Mumin, Alhassan Anyomih, Theophilus T. K. Owusu, Sheila A. Wright, Naomi Decker, Janae Niemeier, Kelli Benavidez, Gabriel Abantanga, Francis A. Smith, Emily R. Tabiri, Stephen World J Surg Surgery in Low and Middle Income Countries BACKGROUND: Congenital anomalies have risen to become the fifth leading cause of under-five mortality globally. The majority of deaths and disability occur in low- and middle-income countries including Ghana. This 3-year retrospective review aimed to define, for the first time, the characteristics and outcomes of neonatal surgical conditions in northern Ghana. METHODS: A retrospective study was conducted to include all admissions to the Tamale Teaching Hospital (TTH) neonatal intensive care unit (NICU) with surgical conditions between January 2014 and January 2017. Data were collected on demographics, diagnosis and outcomes. Descriptive analysis was performed on all data, and logistic regression was used to predict determinants of neonatal mortality. p < 0.05 was deemed significant. RESULTS: Three hundred and forty-seven neonates were included. Two hundred and sixty-one (75.2%) were aged 7 days or less at presentation, with males (n = 177, 52%) slightly higher than females (n = 165, 48%). The majority were delivered by spontaneous vaginal delivery (n = 247, 88%); 191 (58%) were born in hospital. Congenital anomalies accounted for 302 (87%) of the neonatal surgical cases and 45 (96%) deaths. The most common anomalies were omphalocele (n = 48, 13.8%), imperforate anus (n = 34, 9.8%), intestinal obstruction (n = 29, 8.4%), spina bifida (n = 26, 7.5%) and hydrocephalus (n = 19, 5.5%). The overall mortality rate was 13.5%. Two-thirds of the deaths (n = 30) from congenital anomalies were conditions involving the digestive system with gastroschisis having the highest mortality of 88%. Omphalocele (n = 11, 23.4%), gastroschisis (n = 7, 14.9%) and imperforate anus (n = 6, 12.8%) contributed to the most deaths. On multivariate analysis, low birthweight was significantly associated with mortality (OR 3.59, CI 1.4–9.5, p = 0.009). CONCLUSION: Congenital anomalies are a major global health problem associated with high neonatal mortality in Ghana. The highest burden in terms of both caseload and mortality is attributed to congenital anomalies involving the digestive system, which should be targeted to improve outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00268-019-05210-9) contains supplementary material, which is available to authorized users. Springer International Publishing 2019-10-03 2020 /pmc/articles/PMC6925064/ /pubmed/31583459 http://dx.doi.org/10.1007/s00268-019-05210-9 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Surgery in Low and Middle Income Countries Abdul-Mumin, Alhassan Anyomih, Theophilus T. K. Owusu, Sheila A. Wright, Naomi Decker, Janae Niemeier, Kelli Benavidez, Gabriel Abantanga, Francis A. Smith, Emily R. Tabiri, Stephen Burden of Neonatal Surgical Conditions in Northern Ghana |
title | Burden of Neonatal Surgical Conditions in Northern Ghana |
title_full | Burden of Neonatal Surgical Conditions in Northern Ghana |
title_fullStr | Burden of Neonatal Surgical Conditions in Northern Ghana |
title_full_unstemmed | Burden of Neonatal Surgical Conditions in Northern Ghana |
title_short | Burden of Neonatal Surgical Conditions in Northern Ghana |
title_sort | burden of neonatal surgical conditions in northern ghana |
topic | Surgery in Low and Middle Income Countries |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925064/ https://www.ncbi.nlm.nih.gov/pubmed/31583459 http://dx.doi.org/10.1007/s00268-019-05210-9 |
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