Nlend Anne Esther Njom, Zeudja Cécile, Nsoa Lydie
Centre Hospitalier d'Essos, Caisse Nationale de Prévoyance Sociale, Service de Pédiatrie et de Prévention Infantile, BP 5777 Yaoundé, Cameroun.
Pan Afr Med J. 2016 Dec 6;25:214. doi: 10.11604/pamj.2016.25.214.9642. eCollection 2016.
This study aims to describe transfer modalities of newborn babies in vital distress to the ESSOS Hospital Center in Yaoundé, Cameroon.
We conducted a prospective cross-sectional study from October 2014 to January 2015. Data were collected using a short questionnaire from the transfer operator. Main parameters: means of transport, reason for transfer, transfer delay, number of detours (itinerary before admission) prevalence for hypothermia, neonatal mortality rate.
We recorded 73 transfers during the study period. Nearly 1/5 (22%) of infants were born within the health district of the reference structure. 24/73 newborns were referred for tertiary care centers (33%). The main reason for transfer was prematurity (40%) followed by neonatal asphyxia (26%). Medical transfer was performed in 5/73 (7%) cases, inter-hospital transfer effected through a nurse was performed in 10/73 (13.6%) cases. The average transfer time was 17 hours, 60% of babies were transferred within the first 6 hours of life, 22% (16/73) within the first two hours of life. For more than half of newborns, a transfer to another hospital was done before admission. Hypothermia (central temperature less than 36° C) on arrival was found in 20% of cases. 15/73 (20.5%) of transferred newborns died. The mean temperature in the dead infants upon their arrival to the hospital was 35.5° C versus 37° C in the non-deceased (p = 0.006). The percentage of newborns who underwent =2 tranfers was 57% in the deceased infants versus 30% in the non-deceased ones (p=0,02).
In Yaoundé, transfers conditions of newborns in precarious conditions of life hinder early neonatal prognosis because of an erratic itinerary, which increases the risk of hypothermia and death. This reinforces the need for a perinatal network.
本研究旨在描述生命垂危的新生儿被转运至喀麦隆雅温得ESSOS医院中心的转运方式。
我们于2014年10月至2015年1月进行了一项前瞻性横断面研究。数据通过向转运操作人员发放简短问卷收集。主要参数包括：运输方式、转运原因、转运延迟、绕行次数（入院前行程）、体温过低患病率、新生儿死亡率。
研究期间共记录了73次转运。近五分之一（22%）的婴儿在参考机构所在的卫生区出生。24/73例新生儿被转诊至三级护理中心（33%）。转运的主要原因是早产（40%），其次是新生儿窒息（26%）。5/73例（7%）进行了医疗转运，10/73例（13.6%）通过护士进行了医院间转运。平均转运时间为17小时，60%的婴儿在出生后6小时内被转运，22%（16/73）在出生后两小时内被转运。超过一半的新生儿在入院前被转至另一家医院。20%的病例在到达时体温过低（中心温度低于36°C）。15/73例（20.5%）转运的新生儿死亡。死亡婴儿入院时的平均体温为35.5°C，而非死亡婴儿为37°C（p = 0.006）。死亡婴儿中接受≥2次转运的比例为57%，而非死亡婴儿为30%（p = 0.02）。
在雅温得，处于生命危险状态的新生儿的转运条件因行程不稳定而妨碍了早期新生儿预后，增加了体温过低和死亡的风险。这进一步凸显了建立围产期网络的必要性。
