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加纳上西部区域一家地区和区级医院的新生儿入院和死亡模式:一项横断面研究。

The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study.

机构信息

Department of Community Health, University of Ghana Medical School, Accra, Ghana.

Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, Accra, Ghana.

出版信息

PLoS One. 2020 May 4;15(5):e0232406. doi: 10.1371/journal.pone.0232406. eCollection 2020.

Abstract

BACKGROUND

High global neonatal deaths have triggered efforts to improve facility-based care. However, the outcomes achievable at different levels of care are unclear. This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality.

OBJECTIVE

This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality.

METHODS

A cross-sectional study involving a records-review over one year at the Upper West Regional Hospital, and three years at St Joseph's District Hospital, Jirapa was carried out. Age, sex, gestational age, weight, duration of admission, diagnosis, among others were examined. The data were analysed and statistical inference made.

RESULTS

Altogether, 2004 newborns were examined, comprising 1,241(62%) from St Joseph's District Hospital and 763(38%) from Upper West Regional Hospital. The proportion of neonatal deaths was similar, 8.94% (St Joseph's District Hospital) and 8.91% (Upper West Regional Hospital). Prematurity, neonatal sepsis, birth asphyxia, low birth weight, neonatal jaundice and pneumonia contributed the most to mortality and suspected infections including malaria accounted for almost half (45.5%). Mortality was significantly associated with duration of stay of 48 hours, being premature, and being younger than 3 days.

CONCLUSION

Majority of the mortality among the neonates admitted was due to preventable causes. Better stabilization and further studies on the epidemiology of sepsis, prematurity, low birth weight, including the contribution of malaria to these and outcome of transferred neonates are needed.

摘要

背景

全球新生儿高死亡率促使人们努力改善医疗机构的护理水平。然而,不同护理水平下可实现的结果尚不清楚。本研究比较了加纳一家地区医院和一家区级医院收治的新生儿的发病和死亡模式,以确定与死亡率相关的结局、风险和可改变因素。

目的

本研究比较了加纳一家地区医院和一家区级医院收治的新生儿的发病和死亡模式,以确定与死亡率相关的结局、风险和可改变因素。

方法

这是一项在加纳上西部地区医院进行的为期一年的回顾性研究,以及在 Jirapa 的圣约瑟夫区医院进行的为期三年的横断面研究。研究检查了年龄、性别、胎龄、体重、住院时间、诊断等因素。对数据进行了分析和统计推断。

结果

共有 2004 名新生儿接受了检查,其中 1241 名(62%)来自圣约瑟夫区医院,763 名(38%)来自上西部地区医院。新生儿死亡率相似,分别为 8.94%(圣约瑟夫区医院)和 8.91%(上西部地区医院)。早产儿、新生儿败血症、出生窒息、低出生体重、新生儿黄疸和肺炎是导致死亡的主要原因,疑似感染(包括疟疾)占近一半(45.5%)。死亡率与住院时间超过 48 小时、早产和年龄小于 3 天显著相关。

结论

大多数入住新生儿的死亡是由可预防的原因造成的。需要更好地稳定病情,并进一步研究败血症、早产、低出生体重的流行病学,包括疟疾对这些疾病的贡献以及转院新生儿的结局。

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