PDF(Pubmed)
Abstract：
More than one million neonatal deaths occur every year worldwide, of which 99% take place in low-income countries. In Rwanda, nearly 71% of neonatal deaths are preventable and among these, 10% are due to neonatal sepsis. Nevertheless, limited information exists on neonatal sepsis and its associated factors in Rwanda. The objectives of the study were to find prevalence and factors associated with neonatal sepsis among neonates admitted in Kibungo Referral Hospital, Ngoma District, Rwanda. We used a retrospective cross-sectional study design reviewing a subset of neonatal, maternal and laboratory records from Kibungo Hospital in 2017. Data were reviewed and collected from March to May, 2018. Logistic regression and odds ratios were calculated to identify the factors associated with neonatal sepsis at 95% CI, p < 0.05. Of the 972 total neonates\' medical records from 2017, we randomly selected 422 of which 12.8% (n = 54) had neonatal sepsis. When blood cultures were positive, 62% grew Klebsiella pneumoniae. Among neonates with sepsis, 38 (70%) recovered while 16 (30%) died. Neonatal sepsis was strongly associated with neonatal age less than or equal to three days (aOR: 2.769, 95% CI 1.312-5.843; p = 0.008); and gestational age less than 37 weeks (aOR: 4.149; CI 1.1878-9.167; p ≤ 0.001). Increased use of blood cultures including sensitivity testing, routine surface cultures of the neonatology and maternity wards facilities, and systematic ward cleaning are all important approaches to prevent and treat neonatal infections in additional to regular neonatal sepsis evaluations.
摘要：
全世界每年有超过一百万的新生儿死亡。其中99%发生在低收入国家。在卢旺达,近71%的新生儿死亡是可以预防的，其中，10%是由于新生儿败血症。然而，卢旺达新生儿败血症及其相关因素的信息有限。本研究的目的是发现Kibungo转诊医院新生儿败血症的患病率和相关因素。Ngoma区,卢旺达。我们使用回顾性横断面研究设计，回顾了一部分新生儿，2017年Kibungo医院的孕产妇和实验室记录。数据从3月到5月进行了审查和收集，2018.在95%CI(p<0.05)计算Logistic回归和比值比以确定与新生儿败血症相关的因素。在2017年的972例新生儿病历中，我们随机选择了422例，其中12.8％（n=54）患有新生儿败血症。当血液培养呈阳性时，62%生长肺炎克雷伯菌。在败血症的新生儿中，38人（70％）康复，16人（30％）死亡。新生儿败血症与新生儿年龄小于或等于3天（aOR：2.769，95％CI1.312-5.843；p=0.008）；胎龄小于37周（aOR：4.149；CI1.1878-9.167；p≤0.001）密切相关。增加血液培养物的使用，包括敏感性测试，新生儿科和产科病房设施的常规表面培养，除了定期进行新生儿败血症评估外，系统的病房清洁都是预防和治疗新生儿感染的重要方法。
