The Prevalence of Neonatal Sepsis and Associated Factors Among Neonates Admitted to The Neonatal Intensive Care Unit of Jinja Regional Referral Hospital.

TABLE OF CONTENTS

DECLARATION ............................................................................................................................. i

APPROVAL ................................................................................................................................... ii

DEDICATION...............................................................................................................................iii

AKNOWLEDGEMENT................................................................................................................ iv

TABLE OF CONTENTS................................................................................................................ v

LIST OF TABLES....................................................................................................................... viii

LIST OF FIGURES ....................................................................................................................... ix

LIST OF ABBREVIATIONS......................................................................................................... x

OPERATIONAL DEFINITIONS.................................................................................................. xi

ABSTRACT.................................................................................................................................. xii

CHAPTER ONE ............................................................................................................................. 1

1.0 Introduction............................................................................................................................... 1

1.1 Background ............................................................................................................................... 1

1.2. Problem Statement................................................................................................................... 3

1.3 Study objective.......................................................................................................................... 3

1.3.1 General objective ................................................................................................................... 3

1.3.2 Specific objectives................................................................................................................. 3

1.4 Research Questions................................................................................................................... 4

1.5 Justification............................................................................................................................... 4

1.6 Study scope ............................................................................................................................... 4

1.6.1 Subject scope ......................................................................................................................... 4

1.6.2 Geographical scope................................................................................................................ 5

1.6.3 Time scope............................................................................................................................. 5

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1.7 Conceptual framework.............................................................................................................. 6

CHAPTER TWO: LITERATURE REVIEW................................................................................. 7

2.1 The prevalence of sepsis........................................................................................................... 7

2.2 Obstetric risk factors................................................................................................................. 8

2.3 Neonatal risk factors................................................................................................................. 9

CHAPTER THREE: METHODOLOGY ..................................................................................... 10

3.1 Site .......................................................................................................................................... 10

3.2 Research Design...................................................................................................................... 10

3.3 Study population ..................................................................................................................... 10

3.4 Sampling technique................................................................................................................. 10

3.5 Sample size ............................................................................................................................. 10

3.6 Data collection process........................................................................................................... 11

3.6.1 Data collection procedure .................................................................................................... 11

3.6.2 Data management................................................................................................................. 11

3.7. Inclusion and Exclusion Criteria............................................................................................ 11

3.7.1. Inclusion Criteria ................................................................................................................ 11

3.7.2. Exclusion criteria ................................................................................................................ 11

3.8 Study variables........................................................................................................................ 11

3.8.1 Dependent variables............................................................................................................. 11

3.8.2 Independent Variables ......................................................................................................... 11

3.9 Research instrument................................................................................................................ 12

3.10 Ethical consideration............................................................................................................. 12

3.11 Dissemination of results........................................................................................................ 12

3.12 Limitations and Delimitations............................................................................................... 12

3.12.1 Limitations......................................................................................................................... 12

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3.12.2 Delimitations...................................................................................................................... 13

CHAPTER FOUR: RESULTS PRESENTATION AND ANALYSIS........................................ 14

4.1 socio demographic characteristics.......................................................................................... 14

4.2 obstetric risk factors................................................................................................................ 15

4.3 neonatal risk factors................................................................................................................ 18

CHAPTER FIVE: DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS ............... 20

DISCUSSION............................................................................................................................... 20

5.1 Prevalence............................................................................................................................... 20

5.2 Obstetric factors...................................................................................................................... 20

5.3 Neonatal factors...................................................................................................................... 21

5.4 Conclusion .............................................................................................................................. 21

5.5 Recommendation .................................................................................................................... 21

REFERENCES ............................................................................................................................. 22

APPENDIX I: CHECKLIST ........................................................................................................ 26

APPENDIX II: BUDGET............................................................................................................. 27

APPENDIX III: WORK PLAN.................................................................................................... 28

APPENDIX IV: INTRODUCTORY LETTER............................................................................ 29

APPENDIX V: HOSPITAL LETTER ............................................................................................ 30

ABSTRACT Introduction Globally neonatal sepsis is one of the most significant causes of morbidity and mortality among neonates. In Africa, and other developing countries, a small number of data were available on risk factors associated with neonatal sepsis. The objectives this study were to determine the prevalence of neonatal sepsis, associated obstetric and neonatal risk factors among neonates admitted to the neonatal ICU of Jinja Regional Referral Hospital. Methodology A retrospective descriptive study was used to obtain data which was tallied then put in frequencies and percentages. Using Microsoft excel 2007 data was presented using tables and graphs. Results The study found out that of the 763 neonates who were admitted to neonatal Intensive care of Jinja Regional referral Hospital 298 had neonatal sepsis which is 39.1% prevalence. Of the 262 neonates in this study 58.8 %( 154) were males and 41.2%(108) were females, 78.6%(206) had EONS and (21.4%) 56 had LONS. The largest obstetric factor contributing to neonatal sepsis was PROM with 222(84.7%) while the 94.2 %( 147 out of 156) of the neonates whose mothers had a history of UTI developed EONS. 90.9% of the neonates whose mothers didn’t attend ANC developed LONS. The largest neonatal factor contributing to neonatal sepsis was prematurity 181(69.1%) which was also the largest risk factor in those who developed EONS. 59.2% of term babies developed LONS. Conclusions Majority of the neonates who suffered from EONS were of mothers who had suffered from Urinary tract infections and also had foul smelling liquor. Most of the neonates that suffered from LONS were those of mothers that didn’t attend antenatal care. Majority of the neonates with gestational age less than 37 weeks and APGAR score less than 7 suffered from EONS while those with birth weight above 2.5 suffered from LONS. Recommendations Early diagnosis and prompt treatment of urinary tract infections. Encourage Antenatal care and hospital delivery. Preventive measures should put in place to prevent premature delivery like cervical cerclage for mothers with incompetent cervix, prompt treatment of maternal genital infections, tocolysis where it’s indicated, giving fansidar and insecticide treated mosquito nets to pregnant women, regular blood pressure assessments in women with pre-ecclampsia.