Uganda Paediatric Association, Kampala, Uganda.
Disease Control and Elimination Theme, Medical Research Council Unit, Banjul, The Gambia.
Paediatr Int Child Health. 2020 May;40(2):92-104. doi: 10.1080/20469047.2019.1638131. Epub 2019 Jul 10.
: Accurate documentation of neonatal morbidity and mortality is limited in many countries in sub-Saharan Africa. This project aimed to establish a surveillance system for neonatal conditions as an approach to improving the quality of neonatal care.: A systematic data capture and surveillance system was established at Jinja Regional Referral Hospital, Uganda using a standardised neonatal medical record form which collected detailed individual patient level data. Additionally, training and mentorship were conducted and basic equipment was provided.: A total of 4178 neonates were hospitalised from July 2014 to December 2016. Median (IQR) age on admission was one day (1-3) and 48.0% (1851/3859) were male. Median (IQR) duration of hospitalisation was 17 days (IQR 10-40) and the longest duration of hospitalisation was 47 days (IQR 41-58). The majority were referrals from government health facilities (54.4%, 2012/3699), though 30.6% (1123/3669) presented as self-referrals. Septicaemia (44.9%, 1962/4371), prematurity (21.0%, 917/4371) and birth asphyxia (19.1%, 833/4371) were the most common diagnoses. The overall mortality was 13.8% (577/4178) and the commonest causes of death included septicaemia (26.9%, 155/577), prematurity (24.3%, 140/577), birth asphyxia (21.0%, 121/577), hypothermia (9.9%, 57/577) and respiratory distress (8.0%, 46/577). The majority of deaths (51.5%, 297/577) occurred within the first 24 h of hospitalisation although a significant proportion of deaths also occurred after 7 days of hospitalisation (24.1%, 139/577). A modest decrease in mortality and improvement in clinical outcome were observed.: Improvement in neonatal data capture and quality of care was observed following establishment of an enhanced surveillance system, training and mentorship.: aOR: adjusted odds ratio; CHRP: Centre for Health research and Programmes; HC: health centre; HMIS: Health Management Information System; JRRH: Jinja Regional Referral Hospital; NMRF: neonatal medical record form; PMTCT: prevention of mother-to-child transmission of HIV; UPA: Uganda Paediatric Association.
在撒哈拉以南非洲的许多国家，新生儿发病率和死亡率的准确记录受到限制。本项目旨在建立新生儿疾病监测系统，以此作为提高新生儿护理质量的一种方法。
在乌干达金贾地区转诊医院建立了一个系统的数据采集和监测系统，使用标准化的新生儿病历表格，收集详细的个体患者数据。此外，还进行了培训和指导，并提供了基本设备。
2014 年 7 月至 2016 年 12 月期间，共有 4178 名新生儿住院。入院时的中位数（IQR）年龄为 1 天（1-3），48.0%（1851/3859）为男性。中位数（IQR）住院时间为 17 天（IQR 10-40），最长住院时间为 47 天（IQR 41-58）。大多数为政府卫生机构转诊（54.4%，2012/3699），但 30.6%（1123/3669）为自行转诊。败血症（44.9%，1962/4371）、早产（21.0%，917/4371）和出生窒息（19.1%，833/4371）是最常见的诊断。总死亡率为 13.8%（577/4178），最常见的死亡原因包括败血症（26.9%，155/577）、早产（24.3%，140/577）、出生窒息（21.0%，121/577）、体温过低（9.9%，57/577）和呼吸窘迫（8.0%，46/577）。大多数死亡（51.5%，297/577）发生在住院后 24 小时内，尽管相当一部分死亡也发生在住院后 7 天（24.1%，139/577）。死亡率略有下降，临床结局有所改善。
建立强化监测系统、培训和指导后，新生儿数据采集和护理质量得到改善。
aOR：调整后的优势比；CHRP：健康研究和计划中心；HC：卫生中心；HMIS：健康管理信息系统；JRRH：金贾地区转诊医院；NMRF：新生儿病历表；PMTCT：预防艾滋病毒母婴传播；UPA：乌干达儿科协会。
