Komakech Allan, Aceng Freda L, Migamba Stella M, Nakamya Petranilla, Mutumba Robert, Bulage Lilian, Kwesiga Benon, Ario Alex R
Uganda National Institute of Public Health, Kampala, Uganda.
Reproductive Health Department, Ministry of Health, Kampala, Uganda.
Afr Health Sci. 2025 Jun;25(2):274-281. doi: 10.4314/ahs.v25i2.33.
During 2018-2020, almost half of all neonatal deaths reviewed in Uganda were due to birth asphyxia. In 2015, Uganda adopted the Every Newborn Action Plan interventions to renew the focus on surveillance for birth asphyxia and other childhood-related illnesses. In 2016, the Ministry of Health implemented an evidence-based educational program for birth attendants about neonatal resuscitation techniques to improve the management of birth asphyxia. We described the trends and distribution of birth asphyxia in Uganda during 2017-2020 following these renewed efforts.
We analysed birth asphyxia surveillance data from the District Health Information System 2 from January 2017-December 2020. We calculated the incidence of birth asphyxia per 1,000 deliveries at district, regional, and national levels. We used line graphs to demonstrate the trend of birth asphyxia incidence with the corresponding reporting rates at national and regional levels. We used logistic regression to evaluate the significance of the trends. Using choropleth maps, we described the distribution of birth asphyxia incidence at district level.
The average national annual incidence of birth asphyxia in 2020 was 31 per 1,000, with an increase of 4.5% from 2017 to 2020 (OR=1.05; 95%CI=1.04-1.05, p=0.001), with national quarterly reporting rates of 70-80% over the same period. Incidence in the Northern and Eastern Regions increased by 6% (OR=1.06; 95%CI=1.05-1.07, p=0.001) and 5% (OR=1.05; 95%CI=1.03-1.05, p=0.001), respectively, over the study period. Bundibugyo, Iganga, and Mubende Districts had rates of >60/1,000 during each of the four years of the study period. The least affected district was Kazo District, with an overall incidence of 3/1,000 over the study period.
The incidence of birth asphyxia increased nationally from 2017-2020. We recommend efforts towards reducing the burden of birth asphyxia in Uganda, with emphasis on the most affected districts.
在2018 - 2020年期间，乌干达审查的所有新生儿死亡病例中，近一半是由于出生窒息。2015年，乌干达采用了《每一名新生儿行动计划》的干预措施，重新将重点放在对出生窒息和其他儿童相关疾病的监测上。2016年，卫生部为助产人员实施了一项关于新生儿复苏技术的循证教育计划，以改善对出生窒息的管理。我们描述了在这些重新努力之后，2017 - 2020年期间乌干达出生窒息的趋势和分布情况。
我们分析了2017年1月至2020年12月期间地区卫生信息系统2的出生窒息监测数据。我们计算了地区、区域和国家层面每1000例分娩中出生窒息的发生率。我们使用折线图展示出生窒息发生率的趋势以及国家和区域层面相应的报告率。我们使用逻辑回归评估趋势的显著性。通过分级统计图，我们描述了地区层面出生窒息发生率的分布情况。
2020年全国出生窒息的年平均发生率为每1000例中有31例，从2017年到2020年增加了4.5%（比值比=1.05；95%置信区间=1.04 - 1.05，p = 0.001），同期国家季度报告率为70 - 80%。在研究期间，北部和东部地区的发生率分别增加了6%（比值比=1.06；95%置信区间=1.05 - 1.07，p = 0.001）和5%（比值比=1.05；95%置信区间=1.03 - 1.05，p = 0.001）。在研究期间的四年里，本迪布焦、伊甘加和穆本德地区的发生率均>60/1000。受影响最小的地区是卡佐区，在研究期间的总发生率为3/1000。
2017 - 2020年期间，乌干达全国出生窒息的发生率有所上升。我们建议努力减轻乌干达出生窒息的负担，重点关注受影响最严重的地区。
