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马里新生儿败血症的患病率及相关因素:一项横断面研究。

Prevalence and factors associated with neonatal sepsis in Mali: a cross-sectional study.

作者信息

Traoré Fatoumata Bintou, Camara Bienvenu Salim, Diallo Elhadj Marouf, Sidibé Cheick Sidya, Diallo Alhassane, Sidibé Sidikiba, Ly Birama Apho, Yaro Fatimata, Traoré Mariam, Dembelé Haoua, Touré Abdoulaye, Camara Alioune, Delamou Alexandre, Sangho Hamadoun

机构信息

Gamal Abdel Nasser University of Conakry, Conakry, Guinea

Research, National Institute of Public Health, Bamako, Mali.

出版信息

BMJ Open. 2025 Jan 7;15(1):e082066. doi: 10.1136/bmjopen-2023-082066.

Abstract

OBJECTIVE

This study aimed to assess the prevalence and risk factors for neonatal sepsis among neonates admitted to selected health facilities in the Bamako district and Koulikoro region in Mali.

DESIGN

This is a prospective cross-sectional study. Data were analyses using bivariate and multivariate logistic regression.

SETTING

This facility-based study was conducted in four health facilities consisting of two hospitals and two reference health centres in Mali.

PARTICIPANTS

The study participants comprised 795 randomly selected neonates and their indexed mother.

OUTCOME MEASURES

The primary outcome of the study was the prevalence of sepsis in the considered health facilities. The other variables of interest were risk factors for sepsis.

RESULTS

The prevalence of neonatal sepsis among the study population was 21.00%. More than 74% of sepsis cases were early onset (<72 hours). Neonatal age <7 days (AOR=2.79, 95% CI 1.59 to 4.89, p=0.000), low birth weight <2500 g (AOR=2.88, 95% CI 1.41 to 5.86, p=0.003), Apgar score <7 (AOR=4.03, 95% CI 3.09 to 5.24, p=0.000), mother with no education (AOR=2.24, 95% CI 1.15 to 4.33, p=0.02), maternal fever (AOR=2.31, 95% CI 1.53 to 3.53, p=0.000), prolonged rupture of membranes (AOR=1.87, 95% CI 1.01 to 3.54, p=0.04) and prolonged labour (AOR=2, 95% CI 1.03 to 3.88, p=0.04) were significantly associated with neonatal sepsis.

CONCLUSION

The prevalence of sepsis in Mali is still high. Given the country's current security context, the findings in this study can support prevention activities, particularly given the limited resources available. It is essential to facilitate antenatal and postnatal visits, to promote in-facility births and rigorous monitoring of neonates at high risk of sepsis. Furthermore, it would be beneficial for future research on neonatal sepsis to include neonates born at home.

摘要

目的

本研究旨在评估马里巴马科地区和库利科罗地区选定医疗机构收治的新生儿败血症的患病率及危险因素。

设计

这是一项前瞻性横断面研究。数据采用双变量和多变量逻辑回归进行分析。

背景

这项基于机构的研究在马里的四家医疗机构开展,包括两家医院和两家参考健康中心。

参与者

研究参与者包括795名随机选取的新生儿及其索引母亲。

观察指标

本研究的主要观察指标是所考虑医疗机构中败血症的患病率。其他感兴趣的变量是败血症的危险因素。

结果

研究人群中新生儿败血症的患病率为21.00%。超过74%的败血症病例为早发型(<72小时)。新生儿年龄<7天(比值比=2.79,95%置信区间1.59至4.89,p=0.000)、低出生体重<2500克(比值比=2.88,95%置信区间1.41至5.86,p=0.003)、阿氏评分<7(比值比=4.03,95%置信区间3.09至5.24,p=0.000)、母亲未受过教育(比值比=2.24,95%置信区间1.15至4.33,p=0.02)、母亲发热(比值比=2.31,95%置信区间1.53至3.53,p=0.000)、胎膜早破(比值比=1.87,95%置信区间1.01至3.54,p=0.04)和产程延长(比值比=2,95%置信区间1.03至3.88,p=0.04)与新生儿败血症显著相关。

结论

马里败血症的患病率仍然很高。鉴于该国目前的安全状况,本研究结果可为预防活动提供支持,尤其是考虑到可用资源有限的情况下。促进产前和产后检查、推广机构内分娩以及对败血症高危新生儿进行严格监测至关重要。此外,未来关于新生儿败血症的研究纳入在家出生的新生儿将是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bf3/11749796/86df315fc523/bmjopen-15-1-g001.jpg

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