An Audit of Mortality Pattern in the Neonatology Unit of the University of Uyo Teaching Hospital, Uyo, Nigeria: A Seven-Year Review.

Main Article Content

Enobong Edet Ekpenyong
Usenobong Morgan Akpan
Iso Precious Oloyede
Ifunanya Ularinma Ebiekpi
Utibe David David

Keywords

Neonatal Mortality, Audit, UUTH, Nigeria

Abstract

Background: Most neonatal deaths occur in low and middle-income countries (LMICs). These deaths can be prevented through universal access to basic high-quality in-patient health services. Prematurity, neonatal sepsis, and perinatal asphyxia have been reported as the leading causes of in-patient neonatal deaths. This study aimed to assess the trend of neonatal mortality in our hospital, determine the pattern and causes of neonatal mortality, and evaluate the factors associated with neonatal mortality in our facility.


Methodology: This was a retrospective cross-sectional descriptive study conducted in the Special Care Babies Unit (SCBU) and Sick Babies Unit (SBU) of the University of Uyo Teaching Hospital, over seven years (2015-2021). Demographic, clinical, and mortality data was extracted from the case record files of patients into a structured proforma and analysed.


Results: There was a total of 228 deaths comprising 130 males (57.02%) and 98 (42.98%) females. The median age at demise was 4.00 (IQR = 1.00 – 12.00) days for both genders. The majority (71.50%) of deaths occurred in the Sick Babies Unit. More males died than females (57% vs 43%). The three leading causes of death were: prematurity (38.60%), neonatal sepsis (38.16%), and birth asphyxia (13.60%).


Conclusion: The leading causes of neonatal mortality in our environment are prematurity and neonatal sepsis. There is a need for increased community education on antenatal care, training of traditional birth attendants, improved newborn transportation facilities, and provision of neonatal intensive care facilities.

Abstract 30 | PDF Downloads 25 EPUB Downloads 9 HTML Downloads 3

References

1. The Inter-Agency Group for Child Mortality Estimation (IGME). Estimates of under-five mortality rates by country, the 2011 release. www.childmortality.org.

2. Sharrow D, Hug L, You D, Alkema L, Black R, Cousens S, Croft T, Gaigbe-Togbe V, Gerland P, Guillot M, Hill K. Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. The Lancet Global Health. 2022 Feb 1;10(2):e195-206.

3. UN. The millennium development goals report 2010. New York: United Nations, 2010.

4. UNICEF, WHO, World Bank, UN Population Division. Levels and trends in child mortality report 2011: estimates developed by the Inter-agency Group for Child Mortality Estimation. http://www. childinfo.org/fi les/Child_Mortality_Report_2011.pdf

5. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. The lancet 2012;379(9832):2151-61.

6. Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, Prieto-Merino D, Cousens S, Black RE, Liu L. Global, regional, and national causes of under-5 mortality in 2000–19: an updated systematic analysis with implications for the Sustainable Development Goals. The Lancet Child & Adolescent Health 2022;6(2):106-15.

7. Nannan NN, Groenewald P, Pillay-van Wyk V, Nicol E, Msemburi W, Dorrington RE, Bradshaw D. Child mortality trends and causes of death in South Africa, 1997-2012, and the importance of a national burden of disease study. South African Medical Journal 2019;109(7):480-5.

8. Adedokun ST, Yaya S. Childhood morbidity and its determinants: evidence from 31 countries in sub-Saharan Africa. BMJ Global Health. 2020;5(10): e003109.

9. George IO, Alex-Hart BA, Frank-Briggs AI. Mortality pattern in children: A hospital based study in Nigeria. International journal of biomedical science (IJBS) 2009;5(4):369.

10. Charles NC, Chuku A, Anazodo NM. Childhood mortality in Federal Medical Centre Umuahia, South eastern Nigeria. Oman Med J 201;29(5):320-4.

11. Duru C, Paul NI, Peterside O, Akinbami F. Pattern of mortality among Childhood emergencies at the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria. Nigerian Journal of Paediatrics 2019;46(2):55-60.

12. Odejimi A, Quinley J, Eluwa GI, Kunnuji M, Wammanda RD, Weiss W, James F, Bello M, Ogunlewe A, King R, Franca-Koh AC. Causes of deaths in neonates and children aged 1–59 months in Nigeria: verbal autopsy findings of 2019 Verbal and Social Autopsy study. BMC Public Health. 2022;22(1):1130.

13. Ijezie E, Okpokowuruk FS, Veeramachaneni R, Indurkar PS. Mortality audit in the paediatrics department of the University of Uyo teaching hospital, Uyo, Nigeria. Int J Res Med Sci 2016;4(2):615-20.

14. John KA, Olabisi FI, Olumuyiwa AA, Olawumi KA, Olubunmi BT, et al. The Pattern and Causes of Neonatal Mortality in a Tertiary Hospital in the Southwest of Nigeria. J Kermanshah Univ Med Sci. 2020;24(4): e107385.

15. Irimu G, Aluvaala J, Malla L, Omoke S, Ogero M, Mbevi G, Waiyego M, Mwangi C, Were F, Gathara D, Agweyu A, Akech S, English M, Clinical Information Network authors. Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study. BMJ Glob Health. 2021 May;6(5): e004475. doi: 10.1136/bmjgh-2020-004475

16. Eke CB, Ezomike UO, Chukwu BF, Chinawa J, Korie FC, Ndubuis C, Ukpabi IK. Pattern of Neonatal Mortality in a Tertiary Health Facility in Umuahia, Southeast, Nigeria. International Journal of Tropical Disease & Health 2014;4(2):136-146.

17. Oruamabo RS. Neonatal tetanus in Nigeria: does it still pose a major threat to neonatal survival. Arch Dis Child. 2007; 97:9–10.

18. Nyong EE, Udoh JJ, Inyang IJ, Oloyede IP, Udoh, PA. Cluster of neonatal tetanus: Case series from one traditional birth attendant's home in Uyo, South-South Nigeria. Journal of Public Health and Epidemiology 2020;12(4):305-9.

19. Cutland CL, Lackritz EM, Mallett-Moore T, Bardají A, Chandrasekaran R, Lahariya C, Nisar MI, Tapia MD, Pathirana J, Kochhar S, Muñoz FM; Brighton Collaboration Low Birth Weight Working Group. Low birth weight: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 2017;35(48 Pt A):6492-6500.

20. Clifton VL. Review: Sex and the human placenta: mediating differential strategies of fetal growth and survival. Placenta. 2010;31 Suppl:S33-9. doi: 10.1016/j.placenta.2009.11.010.

Most read articles by the same author(s)