A study to investigate neonatal sepsis at Mpilo Central Hospital. · Electronic Theses and Dissertations

Author

Nkomo, Nokuthula

Title

A study to investigate neonatal sepsis at Mpilo Central Hospital.

Abstract

Neonatal sepsis is a major global public health concern and remains a leading cause of illness and death during the neonatal period (Mezgebu, T. et.al, 2023). Mpilo Central Hospital is not spared. It is also struggling with neonatal sepsis, contributing a large percentage to the high neonatal mortality rates in Zimbabwe. This study aimed to determine the factors associated with neonatal sepsis at Mpilo Central Hospital in Bulawayo, Zimbabwe. A hospital-based case-control study was performed, comparing neonates with confirmed sepsis (cases) with matched controls with no sepsis at a ratio of 1:1. Using 12 months of already existing data (January 2024-December 2024), this study investigated maternal, obstetric, and hospital-risk factors through medical record review of 143 neonates without a lab confirmed diagnosis of neonatal sepsis (cases) and 143 neonates with no sepsis (controls). The study sample was selected using the matched case control sampling method. The study aimed to determine risk factors in a bid to guide targeted interventions and improve neonatal outcomes under this limited resource environment. Controls were individually matched to cases based on chronological age at admission (±3 days) and gestational age at birth (±1 week). These variables were selected as matching criteria because they are important predictors of neonatal sepsis risk. Chronological age influences both the timing and nature of sepsis onset, as early-onset and late-onset sepsis often have different etiologies and risk factors. Gestational age, on the other hand, is a well-established determinant of neonatal vulnerability, with preterm infants being at significantly higher risk due to their underdeveloped immune systems and the likelihood of extended hospital stays. Matching on these variables helped control for potential confounding effects related to age and maturity, ensuring a more accurate assessment of other risk factors under investigation. The results quantified significant associations among risk exposures and found out that maternal underlying infections such as HIV status (95% CI (1.52-3.89), low both weight (95% CI: (2.14- 5.81), poor access to antenatal care, delayed rupture of membranes, and having a caesarean section contributed to neonatal sepsis. The odds of developing neonatal sepsis being 3, 53 times higher in low birth weight babies compared to the controls. These findings provide critical evidence for Mpilo Hospital's clinical practice guidelines and infection prevention policies, as well as informing regional efforts to achieve Sustainable Development Goal targets for the reduction of preventable newborn mortality. In conclusion, this case-control study highlights maternal and neonatal factors and their association to neonatal sepsis in a low resource setting in Zimbabwe which calls for contextualized interventions to mitigate the incidence of sepsis in newborns.

Date

June 2025

Publisher

BUSE

Keywords

Neonatal Sepsis

Supervisor

Ms. A. Manwere