Facteurs associes aux décès des nouveau-nés suspects d'infections bactériennes au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou, Burkina Faso

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Abstract

Introduction

Il s'agit d’étudier les facteurs associés au décès des nouveau-nés suspects d'infections bactériennes au centre hospitalier universitaire pédiatrique Charles de gaulle de Ouagadougou.

Méthodes

Nous avons mené une étude de cohorte rétrospective du 1er janvier 2009 au 31 décembre 2012 au centre hospitalier universitaire pédiatrique Charles de gaulle de Ouagadougou.

Résultats

La fréquence hospitalière des nouveau-nés suspects d'infection bactérienne sur était de 62,8%. L’âge médian à l'admission était de trois jours et le sex ratio de 1,1. Parmi ces nouveau-nés, 351 (22,8%) ont bénéficié d'au moins un examen bactériologique, et 28 (8%) ont eu la confirmation de l'origine bactérienne de l'infection. Au cours de la période néonatale, 138(9%) nouveau-nés sont décédés avec un taux de létalité précoce et tardive respectivement de 9,6% et 8,3%. Le lieu de résidence, le mode d'admission, le nombre de consultations prénatales, le poids de naissance, la présence de signes de gravité et l'année d'admission étaient les facteurs de risque indépendants associés au décès.

Conclusion

Les facteurs associés au décès devraient être pris en compte dans les interventions de santé pour réduire la mortalité néonatale.

Most cited references 28

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Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan.

Muhammad Sohail Salat, Omrana Pasha, Janet Finer-Moore … (2009)

To evaluate the prevalence, sex distribution and causes of neonatal mortality, as well as its risk factors, in an urban Pakistani population with access to obstetric and neonatal care. Study area women were enrolled at 20-26 weeks' gestation in a prospective population-based cohort study that was conducted from 2003 to 2005. Physical examinations, antenatal laboratory tests and anthropometric measures were performed, and gestational age was determined by ultrasound to confirm eligibility. Demographic and health data were also collected on pretested study forms by trained female research staff. The women and neonates were seen again within 48 hours postpartum and at day 28 after the birth. All neonatal deaths were reviewed using the Pattinson et al. system to assign obstetric and final causes of death; the circumstances of the death were determined by asking the mother or family and by reviewing hospital records. Frequencies and rates were calculated, and 95% confidence intervals were determined for mortality rates. Relative risks were calculated to evaluate the associations between potential risk factors and neonatal death. Logistic regression models were used to compute adjusted odds ratios. Birth outcomes were ascertained for 1280 (94%) of the 1369 women enrolled. The 28-day neonatal mortality rate was 47.3 per 1000 live births. Preterm birth, Caesarean section and intrapartum complications were associated with neonatal death. Some 45% of the deaths occurred within 48 hours and 73% within the first week. The primary obstetric causes of death were preterm labour (34%) and intrapartum asphyxia (21%). Final causes were classified as immaturity-related (26%), birth asphyxia or hypoxia (26%) and infection (23%). Neither delivery in a health facility nor by health professionals was associated with fewer neonatal deaths. The Caesarean section rate was 19%. Almost all (88%) neonates who died received treatment and 75% died in the hospital. In an urban population with good access to professional care, we found a high neonatal mortality rate, often due to preventable conditions. These results suggest that, to decrease neonatal mortality, improved health service quality is crucial.

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Addressing the challenge of neonatal mortality.

H Blencowe, S. Cousens (2013)

Reducing neonatal mortality remains a challenge with an estimated 3.0 million neonatal deaths in 2011, three-quarters of these in sub-Saharan Africa and Southern Asia. The leading causes of neonatal death globally are complications of preterm birth, intrapartum-related causes and infections. While post-neonatal, under-5 deaths fell by 47% between 1990 and 2011, neonatal deaths only fell by 32% and they now account for 43% of all under-5 child deaths. This article reviews the progress in reducing neonatal deaths in high-burden countries and presents an overview of known effective interventions to reduce neonatal mortality and the challenges faced in implementing these in high-burden settings. Effective action is possible to reduce neonatal mortality, but innovative approaches to implementation will be required if these preventable deaths are to be avoided. © 2013 Blackwell Publishing Ltd.

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Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

Abdoulaye Diallo, Nicolas Meda, Emmanuel Zabsonré … (2010)

Background There is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso. Study objectives To measure the perinatal mortality rate (PNMR) in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death. Methods We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR) and early neonatal mortality rate (ENMR). We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death. Results 895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99), 54 per 1000 (95% CI: 38-69) and 27 per 1000 (95% CI: 9-44), respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0), primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9), twins (RR = 4.0, 95% CI: 2.3-6.9) and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3) were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre Conclusion Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.

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Author and article information

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (iso-abbrev): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 04 May 2016

Publication date Collection: 2016

Volume: 24

Electronic Location Identifier: 7

Affiliations

[1 ]A Unité de Formation et de Recherche en Sciences de la Santé (UFR/SDS), Université de Ouagadougou, Burkina Faso

[2 ]Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle Ouagadougou, Burkina Faso

[3 ]Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso

Author notes

[& ]Corresponding author: Solange Odile Ouédraogo/Yugbaré, Charles de Gaulle Pediatric University Hospital in Ouagadougou, Burkina Faso

Article

Publisher ID: PAMJ-24-7

DOI: 10.11604/pamj.2016.24.7.6599

PMC ID: 4992375

SO-VID: a24d42a4-9af9-43a8-8652-63ee758aac36

License:

The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 17 March 2015

Date accepted : 29 March 2016

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Abstract

Introduction

Méthodes

Résultats

Conclusion

Most cited references 28

Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan.

Addressing the challenge of neonatal mortality.

Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

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