Improved Neonatal Mortality at a District Hospital in Aweil, South Sudan
Identifieur interne : 000847 ( Pmc/Checkpoint ); précédent : 000846; suivant : 000848Improved Neonatal Mortality at a District Hospital in Aweil, South Sudan
Auteurs : Johanna Thomson [France] ; Myrto Schaefer [Australie] ; Belen Caminoa [Australie] ; David Kahindi [Soudan du Sud] ; Northan Hurtado [États-Unis]Source :
- Journal of Tropical Pediatrics [ 0142-6338 ] ; 2016.
Abstract
Neonatal deaths comprise a growing proportion of global under-five mortality. However, data from the highest-burden areas is sparse. This descriptive retrospective study analyses the outcomes of all infants exiting the Médecins sans Frontières-managed neonatal unit in Aweil Hospital, rural South Sudan from 2011 to 2014. A total of 4268 patients were treated over 4 years, with annual admissions increasing from 687 to 1494. Overall mortality was 13.5% (
Url:
DOI: 10.1093/tropej/fmw071
PubMed: 27789662
PubMed Central: 5452431
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75011</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="fmw071-aff2">Department of Field Epidemiology and Training, Epicentre, Paris, 75011, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Field Epidemiology and Training, Epicentre, Paris, 75011</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Schaefer, Myrto" sort="Schaefer, Myrto" uniqKey="Schaefer M" first="Myrto" last="Schaefer">Myrto Schaefer</name><affiliation wicri:level="1"><nlm:aff id="fmw071-aff3">Médecins Sans Frontières, Sydney, 2037, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Médecins Sans Frontières, Sydney, 2037</wicri:regionArea><wicri:noRegion>2037</wicri:noRegion></affiliation></author><author><name sortKey="Caminoa, Belen" sort="Caminoa, Belen" uniqKey="Caminoa B" first="Belen" last="Caminoa">Belen Caminoa</name><affiliation wicri:level="1"><nlm:aff id="fmw071-aff3">Médecins Sans Frontières, Sydney, 2037, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Médecins Sans Frontières, Sydney, 2037</wicri:regionArea><wicri:noRegion>2037</wicri:noRegion></affiliation></author><author><name sortKey="Kahindi, David" sort="Kahindi, David" uniqKey="Kahindi D" first="David" last="Kahindi">David Kahindi</name><affiliation wicri:level="1"><nlm:aff id="fmw071-aff4">Medical Co-ordination, Médecins Sans Frontières, Juba, South Sudan</nlm:aff><country xml:lang="fr">Soudan du Sud</country><wicri:regionArea>Medical Co-ordination, Médecins Sans Frontières, Juba</wicri:regionArea><wicri:noRegion>Juba</wicri:noRegion></affiliation></author><author><name sortKey="Hurtado, Northan" sort="Hurtado, Northan" uniqKey="Hurtado N" first="Northan" last="Hurtado">Northan Hurtado</name><affiliation wicri:level="1"><nlm:aff id="fmw071-aff5">Médecins Sans Frontières, NY, 10001-5004, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Médecins Sans Frontières, NY, 10001-5004</wicri:regionArea><wicri:noRegion>10001-5004</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Tropical Pediatrics</title><idno type="ISSN">0142-6338</idno><idno type="eISSN">1465-3664</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><p>Neonatal deaths comprise a growing proportion of global under-five mortality. However, data from the highest-burden areas is sparse. This descriptive retrospective study analyses the outcomes of all infants exiting the Médecins sans Frontières-managed neonatal unit in Aweil Hospital, rural South Sudan from 2011 to 2014. A total of 4268 patients were treated over 4 years, with annual admissions increasing from 687 to 1494. Overall mortality was 13.5% (<italic>n</italic> = 576), declining from 18.7% to 11.1% (<italic>p</italic> for trend <0.001). Newborns weighing <2500 g were at significantly increased mortality risk compared with babies ≥2500 g (odds ratio = 2.27, 95% confidence interval = 1.9–2.71, <italic>p</italic> < 0.001). Leading causes of death included sepsis (49.7%), tetanus (15.8%), respiratory distress (12.8%) and asphyxia (9.2%). Tetanus had the highest case fatality rate (49.7%), followed by perinatal asphyxia (26.5%), respiratory distress (20.4%) and neonatal sepsis (10.5%). Despite increasing admissions, overall mortality declined, indicating that survival of these especially vulnerable infants can be improved even in a basic-level district hospital programme.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lawn, Je" uniqKey="Lawn J">JE Lawn</name></author><author><name sortKey="Blencowe, H" uniqKey="Blencowe H">H Blencowe</name></author><author><name sortKey="Oza, S" uniqKey="Oza S">S Oza</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mason, E" uniqKey="Mason E">E Mason</name></author><author><name sortKey="Mcdougall, L" uniqKey="Mcdougall L">L McDougall</name></author><author><name sortKey="Lawn, Je" uniqKey="Lawn J">JE Lawn</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Von Elm, E" uniqKey="Von Elm E">E Von Elm</name></author><author><name sortKey="Altman, Dg" uniqKey="Altman D">DG Altman</name></author><author><name sortKey="Egger, M" uniqKey="Egger M">M Egger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mukhtar Yola, M" uniqKey="Mukhtar Yola M">M Mukhtar-Yola</name></author><author><name sortKey="Iliyasu, Z" uniqKey="Iliyasu Z">Z. Iliyasu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Omoigberal, A" uniqKey="Omoigberal A">A Omoigberal</name></author><author><name sortKey="Sadoh, W" uniqKey="Sadoh W">W Sadoh</name></author><author><name sortKey="Nwaneri, D" uniqKey="Nwaneri D">D. Nwaneri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hedstrom, A" uniqKey="Hedstrom A">A Hedstrom</name></author><author><name sortKey="Ryman, T" uniqKey="Ryman T">T Ryman</name></author><author><name sortKey="Otai, C" uniqKey="Otai C">C Otai</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Okechukwu, A" uniqKey="Okechukwu A">A Okechukwu</name></author><author><name sortKey="Achonwa, A" uniqKey="Achonwa A">A. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Trop Pediatr</journal-id><journal-id journal-id-type="iso-abbrev">J. Trop. Pediatr</journal-id><journal-id journal-id-type="publisher-id">tropej</journal-id><journal-title-group><journal-title>Journal of Tropical Pediatrics</journal-title></journal-title-group><issn pub-type="ppub">0142-6338</issn><issn pub-type="epub">1465-3664</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27789662</article-id><article-id pub-id-type="pmc">5452431</article-id><article-id pub-id-type="doi">10.1093/tropej/fmw071</article-id><article-id pub-id-type="publisher-id">fmw071</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Papers</subject></subj-group></article-categories><title-group><article-title>Improved Neonatal Mortality at a District Hospital in Aweil, South Sudan</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Thomson</surname><given-names>Johanna</given-names><prefix>by</prefix></name><xref ref-type="aff" rid="fmw071-aff1">1</xref><xref ref-type="aff" rid="fmw071-aff2">2</xref><pmc-comment>johannathomson@hotmail.com </pmc-comment>
</contrib><contrib contrib-type="author"><name><surname>Schaefer</surname><given-names>Myrto</given-names></name><xref ref-type="aff" rid="fmw071-aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Caminoa</surname><given-names>Belen</given-names></name><xref ref-type="aff" rid="fmw071-aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Kahindi</surname><given-names>David</given-names></name><xref ref-type="aff" rid="fmw071-aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Hurtado</surname><given-names>Northan</given-names></name><xref ref-type="aff" rid="fmw071-aff5">5</xref></contrib></contrib-group><aff id="fmw071-aff1"><label>1</label>Médecins Sans Frontières, Paris, 75011, France</aff><aff id="fmw071-aff2"><label>2</label>Department of Field Epidemiology and Training, Epicentre, Paris, 75011, France</aff><aff id="fmw071-aff3"><label>3</label>Médecins Sans Frontières, Sydney, 2037, Australia</aff><aff id="fmw071-aff4"><label>4</label>Medical Co-ordination, Médecins Sans Frontières, Juba, South Sudan</aff><aff id="fmw071-aff5"><label>5</label>Médecins Sans Frontières, NY, 10001-5004, USA</aff><author-notes><corresp id="fmw071-cor1">Correspondence: Johanna Thomson, Médecins Sans Frontières, Operational Centre Paris, France. E-mail <<email>johannathomson@hotmail.com</email>>.</corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2017</year></pub-date><pub-date pub-type="epub" iso-8601-date="2016-10-20"><day>20</day><month>10</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>20</day><month>10</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
<volume>63</volume><issue>3</issue><fpage>189</fpage><lpage>195</lpage><permissions><copyright-statement>© The Author [2016]. Published by Oxford University Press.</copyright-statement><copyright-year>2016</copyright-year><license license-type="cc-by-nc" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com</license-p></license></permissions><self-uri xlink:href="fmw071.pdf"></self-uri><abstract><title>Abstract</title><p>Neonatal deaths comprise a growing proportion of global under-five mortality. However, data from the highest-burden areas is sparse. This descriptive retrospective study analyses the outcomes of all infants exiting the Médecins sans Frontières-managed neonatal unit in Aweil Hospital, rural South Sudan from 2011 to 2014. A total of 4268 patients were treated over 4 years, with annual admissions increasing from 687 to 1494. Overall mortality was 13.5% (<italic>n</italic> = 576), declining from 18.7% to 11.1% (<italic>p</italic> for trend <0.001). Newborns weighing <2500 g were at significantly increased mortality risk compared with babies ≥2500 g (odds ratio = 2.27, 95% confidence interval = 1.9–2.71, <italic>p</italic> < 0.001). Leading causes of death included sepsis (49.7%), tetanus (15.8%), respiratory distress (12.8%) and asphyxia (9.2%). Tetanus had the highest case fatality rate (49.7%), followed by perinatal asphyxia (26.5%), respiratory distress (20.4%) and neonatal sepsis (10.5%). Despite increasing admissions, overall mortality declined, indicating that survival of these especially vulnerable infants can be improved even in a basic-level district hospital programme.</p></abstract><kwd-group kwd-group-type="author"><kwd>newborn</kwd><kwd>neonatal mortality</kwd><kwd>developing countries</kwd><kwd>South Sudan.</kwd></kwd-group><counts><page-count count="7"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>Australie</li><li>France</li><li>Soudan du Sud</li><li>États-Unis</li></country><region><li>Île-de-France</li></region></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Thomson, Johanna" sort="Thomson, Johanna" uniqKey="Thomson J" first="Johanna" last="Thomson">Johanna Thomson</name></region><name sortKey="Thomson, Johanna" sort="Thomson, Johanna" uniqKey="Thomson J" first="Johanna" last="Thomson">Johanna Thomson</name></country><country name="Australie"><noRegion><name sortKey="Schaefer, Myrto" sort="Schaefer, Myrto" uniqKey="Schaefer M" first="Myrto" last="Schaefer">Myrto Schaefer</name></noRegion><name sortKey="Caminoa, Belen" sort="Caminoa, Belen" uniqKey="Caminoa B" first="Belen" last="Caminoa">Belen Caminoa</name></country><country name="Soudan du Sud"><noRegion><name sortKey="Kahindi, David" sort="Kahindi, David" uniqKey="Kahindi D" first="David" last="Kahindi">David Kahindi</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Hurtado, Northan" sort="Hurtado, Northan" uniqKey="Hurtado N" first="Northan" last="Hurtado">Northan Hurtado</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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