RISK FACTORS, CURRENT PRACTICES AND OUTCOME OF MANAGEMENT OF NEONATAL SEPSIS AT NEONATAL INTENSIVE CARE UNIT, EDWARD FRANCIS SMALL TEACHING HOSPITAL BANJUL, THE GAMBIA

Abstract

Background:
Neonatal sepsis is an important cause of morbidity and mortality among neonates in developing countries accounting for 30-50% of total neonatal deaths each year. The first 28 days of life is the most vulnerable time for child survival. Worldwide, neonatal sepsis accounts for an estimated 26% of under-five deaths, with sub-Saharan Africa having the highest mortality rates. Severe neonatal infections such as meningitis may be associated with long-term complications, such as cerebral palsy and mental retardation.

Objective
The aim of the study was to determine the risk factors and outcome of neonatal sepsis at the neonatal intensive care unit (NICU), at the Edward Francis Small Teaching Hospital Banjul (EFSTH).

Materials and Methods
An unmatched retrospective case-control study was conducted among 100 neonates admitted from November to December 2021 at the Edward Francis Small Teaching Hospital NICU. All admitted neonates folders at the NICU were reviewed and data extraction was done on neonates with and without the diagnoses of neonatal sepsis to identify some common risk factors of neonatal sepsis.

Results: 
Majority of mothers [48(48%)] were aged between 25years and 35years, while 2(2%) of them were < 16years, with a mean age of 30
(0.7). Multiple antenatal visits predominated with 41 (41%) mothers having more than 4 antenatal care visits. Identified probable maternal risk factors included urinary tract infection, prolonged labour, prolonged rupture of fetal membranes and being born outside the health facility. The results revealed that 36% of the mothers were primiparous and the mean parity was 3 (1.6) Majority of the neonates had early onset neonatal sepsis (57%). The common organisms identified were Staphylococcus aureus, Streptococcal pneumoniae and Escherichia coli, all of which responded well to the antibiotics in routine use in the unit.

Conclusion
The study identified both maternal and neonatal risk factors were strong contributors to developing neonatal sepsis. Antenatal care
utilization and giving birth at skilled health facility would reduce the risk factors with appropriate interventions to reduce the risk of
developing sepsis.