Time to Death and its Predictors among Neonates Admitted in the Intensive Care Unit of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Received 9 October 2019
Accepted for publication 8 January 2020
Published 29 January 2020 Volume 2020:10 Pages 1—10
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Robert Schelonka
Temesgen Worku Gudayu,1 Ejigu Gebeye Zeleke,2 Ayenew Molla Lakew2
1Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Correspondence: Temesgen Worku Gudayu
College of Medicine and Health Sciences, School of Midwifery, University of Gondar, PO.Box 196, Gondar, Ethiopia
Introduction: Neonatal mortality is among the leading concerns globally and its burden is highest in sub-Saharan Africa. Despite all the efforts made, neonatal mortality remains high in Ethiopia in general and in the Amhara region in particular. In this study, we assessed the time to death and its predictors among neonates admitted to the intensive care unit of the University of Gondar Comprehensive Specialized Hospital.
Patients and Methods: A retrospective follow-up study was conducted among 504 randomly selected neonates admitted to the neonatal intensive care unit between January 1 and December 31, 2017. The extracted data were entered into epi-info version 7.2, exported to and analyzed using STATA version 14. Failure probability table and Kaplan–Meier failure function were computed. Gompertz proportional hazard regression model was used to identify predictors of time to neonatal death. The hazard ratio with a 95% confidence interval was reported and statistical significance was declared at a p-value of ≤ 0.05.
Results: The proportion of neonatal mortality in this study was 17.3 (95% CI: 14.2, 20.9). Out of 504 studied neonates, 87 (173 per 1000 live births) died. Neonates who did not cry at birth and those who were born before 34 weeks had a higher risk of death in both births-to-death and admission-to-death analysis. Whereas, in admission-to-death analysis, neonates who were born at home had a higher risk of death.
Conclusion: In this study, neonatal mortality is far higher than the national and sustainable development goal targets. Strengthening access to health facilities, improving the community’s awareness of giving birth at health facilities and strengthening facilities and providers’ capacity for caring for high-risk neonates prior to the referral is recommended.
Keywords: neonate, neonatal mortality, neonatal death, neonatal intensive care unit, Ethiopia