Department of Pediatrics and Child Health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
PLoS One. 2024 Jul 25;19(7):e0306297. doi: 10.1371/journal.pone.0306297. eCollection 2024.
Globally, with a neonatal mortality rate of 27/1000 live births, Sub-Saharan Africa has the highest rate in the world and is responsible for 43% of all infant fatalities. In the first week of life, almost three-fourths of neonatal deaths occur and about one million babies died on their first day of life. Previous studies lack conclusive evidence regarding the overall estimate of early neonatal mortality in Sub-Saharan Africa. Therefore, this review aimed to pool findings reported in the literature on magnitude of early neonatal mortality in Sub-Saharan Africa.
This review's output is the aggregate of magnitude of early neonatal mortality in sub-Saharan Africa. Up until June 8, 2023, we performed a comprehensive search of the databases PubMed/Medline, PubMed Central, Hinary, Google, Cochrane Library, African Journals Online, Web of Science, and Google Scholar. The studies were evaluated using the JBI appraisal check list. STATA 17 was employed for the analysis. Measures of study heterogeneity and publication bias were conducted using the I2 test and the Eggers and Beggs tests, respectively. The Der Simonian and Laird random-effect model was used to calculate the combined magnitude of early neonatal mortality. Besides, subgroup analysis, sensitivity analysis, and meta regression were carried out to identify the source of heterogeneity.
Fourteen studies were included from a total of 311 articles identified by the search with a total of 278,173 participants. The pooled magnitude of early neonatal mortality in sub-Saharan Africa was 80.3 (95% CI 66 to 94.6) per 1000 livebirths. Ethiopia had the highest pooled estimate of early neonatal mortality rate, at 20.1%, and Cameroon had the lowest rate, at 0.5%. Among the included studies, both the Cochrane Q test statistic (χ2 = 6432.46, P <0.001) and I2 test statistic (I2 = 99.80%, p <0.001) revealed statistically significant heterogeneity. Egger's weighted regression (p <0.001) and funnel plot show evidence of publication bias in this meta-analysis.
This review demonstrated that the pooled magnitude of early neonatal mortality in sub-Saharan Africa is substantial. Therefore, governmental and nongovernmental agencies, international organizations, healthcare providers and institutions and academic and research institutions should give a due attention and design strategies to reduce early neonatal mortality in Sub-Saharan Africa.
在全球范围内，撒哈拉以南非洲的新生儿死亡率为每 1000 例活产 27 例，是世界上死亡率最高的地区，占所有婴儿死亡人数的 43%。在生命的第一周，近四分之三的新生儿死亡发生，约有 100 万名婴儿在出生第一天死亡。先前的研究缺乏关于撒哈拉以南非洲早期新生儿死亡率总体估计的确凿证据。因此，本综述旨在汇总文献中关于撒哈拉以南非洲早期新生儿死亡率的研究结果。
本综述的结果是撒哈拉以南非洲早期新生儿死亡率的总和。截至 2023 年 6 月 8 日，我们对 PubMed/Medline、PubMed Central、Hinary、Google、Cochrane Library、African Journals Online、Web of Science 和 Google Scholar 数据库进行了全面检索。使用 JBI 评估检查表对研究进行评估。使用 STATA 17 进行分析。使用 I2 检验和 Eggers 和 Beggs 检验分别对研究异质性和发表偏倚进行测量。使用 Der Simonian 和 Laird 随机效应模型计算早期新生儿死亡率的综合幅度。此外，进行了亚组分析、敏感性分析和元回归，以确定异质性的来源。
从总共 311 篇文章中检索到 14 项研究，共纳入 278173 名参与者。撒哈拉以南非洲的早期新生儿死亡率总和为每 1000 例活产 80.3（95%置信区间 66 至 94.6）。埃塞俄比亚的早期新生儿死亡率最高，为 20.1%，而喀麦隆的死亡率最低，为 0.5%。在纳入的研究中，Cochrane Q 检验统计量（χ2 = 6432.46，P <0.001）和 I2 检验统计量（I2 = 99.80%，p <0.001）均显示出统计学显著的异质性。Egger 的加权回归（p <0.001）和漏斗图显示，本荟萃分析存在发表偏倚。
本综述表明，撒哈拉以南非洲的早期新生儿死亡率总和相当高。因此，政府和非政府机构、国际组织、医疗保健提供者和机构以及学术和研究机构应予以重视，并制定策略，以降低撒哈拉以南非洲的早期新生儿死亡率。
