Aynalem Yared Asmare, Shiferaw Wondimeneh Shibabaw, Akalu Tadesse Yirga, Dargie Abate, Assefa Hilina Ketema, Habtewold Tesfa Dejenie
College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
Int J Pediatr. 2021 Feb 17;2021:7478108. doi: 10.1155/2021/7478108. eCollection 2021.
Although neonatal death is a global burden, it is the highest in sub-Saharan African countries such as Ethiopia. Moreover, there is disparity in the prevalence and associated factors of studies. Therefore, this study was aimed at providing pooled national prevalence and predictors of neonatal mortality in Ethiopia.
The following databases were systematically explored to search for articles: Boolean operator, Cochrane Library, PubMed, EMBASE, Hinari, and Google Scholar. Selection, screening, reviewing, and data extraction were done by two reviewers independently using Microsoft Excel spreadsheet. The modified Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute Prevalence Critical Appraisal tools were used to assess the quality of evidence. All studies conducted in Ethiopia and reporting the prevalence and predictors of neonatal mortality were included. Data were extracted using Microsoft Excel spreadsheet software and imported into Stata version 14s for further analysis. Publication bias was checked using funnel plots and Egger's and Begg's tests. Heterogeneity was also checked by Higgins's method. A random effects meta-analysis model with 95% confidence interval was computed to estimate the pooled effect size (i.e., prevalence and odds ratio). Moreover, subgroup analysis based on region, sample size, and study design was done.
After reviewing 88 studies, 12 studies fulfilled the inclusion criteria and were included in the meta-analysis. Pooled national prevalence of neonatal mortality in Ethiopia was 16.3% (95% CI: 12.1, 20.6, = 98.8%). The subgroup analysis indicated that the highest prevalence was observed in the Amhara region, 20.3% (95% CI: 9.6, 31.1), followed by Oromia, 18.8% (95% CI: 11.9, 49.4). Gestational age [AOR: 1.32 (95% CI: 1.07, 1.58)], neonatal sepsis [AOR: 1.23 (95% CI: 1.05, 1.4)], respiratory distress syndromes (RDS) [AOR: 1.18 (95% CI: 0.87, 1.49)], and place of residency [AOR: 1.93 (95% CI: 1.13, 2.73)] were the most important predictors.
Neonatal mortality in Ethiopia was significantly decreased. There was evidence that neonatal sepsis, gestational age, and place of residency were the significant predictors. RDS were also a main predictor of mortality even if not statistically significant. We strongly recommended that health care workers should give a priority for preterm neonates with diagnosis with sepsis and RDS.
尽管新生儿死亡是一项全球负担，但在埃塞俄比亚等撒哈拉以南非洲国家最为严重。此外，各项研究在患病率及相关因素方面存在差异。因此，本研究旨在提供埃塞俄比亚全国新生儿死亡率的汇总患病率及预测因素。
系统检索了以下数据库以查找文章：布尔运算符、考克兰图书馆、PubMed、EMBASE、Hinari和谷歌学术。两名评审员独立使用Microsoft Excel电子表格进行筛选、审查和数据提取。采用改良的纽卡斯尔-渥太华量表（NOS）和乔安娜·布里格斯研究所患病率批判性评价工具评估证据质量。纳入所有在埃塞俄比亚开展并报告新生儿死亡率患病率及预测因素的研究。使用Microsoft Excel电子表格软件提取数据，并导入Stata 14s版本进行进一步分析。使用漏斗图以及Egger检验和Begg检验检查发表偏倚。还通过Higgins方法检查异质性。计算具有95%置信区间的随机效应荟萃分析模型，以估计汇总效应量（即患病率和比值比）。此外，基于地区、样本量和研究设计进行了亚组分析。
在审查88项研究后，12项研究符合纳入标准并被纳入荟萃分析。埃塞俄比亚全国新生儿死亡率的汇总患病率为16.3%（95%置信区间：12.1，20.6，I² = 98.8%）。亚组分析表明，阿姆哈拉地区患病率最高，为20.3%（95%置信区间：9.6，31.1），其次是奥罗米亚地区，为18.8%（95%置信区间：11.9，49.4）。胎龄[AOR：1.32（95%置信区间：1.07，1.58）]、新生儿败血症[AOR：1.23（95%置信区间：1.05，1.4）]、呼吸窘迫综合征（RDS）[AOR：1.18（95%置信区间：0.87，1.49）]和居住地点[AOR：1.93（95%置信区间：1.13，2.73）]是最重要的预测因素。
埃塞俄比亚的新生儿死亡率显著下降。有证据表明新生儿败血症、胎龄和居住地点是显著的预测因素。即使在统计学上不显著，RDS也是死亡率的主要预测因素。我们强烈建议医护人员应优先关注诊断为败血症和RDS的早产新生儿。
