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G272 Epidemiological trends of neonatal sepsis in a county referral hospital in central Kenya
  1. J Le Geyt1,
  2. S Hauck2
  1. 1Global Links, Royal College of Paediatrics and Child Health Volunteer Scheme, London, UK
  2. 2Paediatric Epidemiology, Nanyuki Teaching and Referral Hospital, Nanyuki, Kenya

Abstract

Aims Infection remains the leading cause of neonatal mortality in developing countries. In Kenya, about 20% of neonatal deaths are attributable to sepsis. We aim to look at the epidemiological pattern of neonatal sepsis in a county referral hospital in Kenya.

Method Retrospective data was collected for all admissions to the Newborn unit between 2011 to 2014 in a county referral hospital in central Kenya. We calculated monthly rates of neonatal sepsis cases, mortalities, and case fatality rates for all admissions. We then plotted a monthly time series of sepsis cases and mortalities to determine if there was a seasonal trend over the four-year period. The epidemic time series was plotted and smoothed using a seasonal moving average estimator in Stata 12.1. The study was carried out during a Global Links RCPCH placement.

Results There were 1262 admissions to the Newborn Unit during the 4 year period. 23.9% of admissions had a diagnosis of neonatal sepsis. The overall mortality rate of admissions was 24.7%, whereas mortality attributed to sepsis was 18.2%. We observed a strong biannual peak in sepsis cases, with peaks in July 2012 and July 2014. Case fatality rates were highest in March 2012 (66.6%), July 2012 (50%), July 2014 (50%) and August 2014 (50%).

Conclusion The overall rate of neonatal mortality due to sepsis in this hospital is comparable to the national average. Our study indicates that sepsis cases correspond to a strong bi-annual pattern rather than a yearly one, with intermediate years yielding few sepsis cases. From this, we predict low sepsis rates in 2015, with a peak of cases in July 2016. This is the first time a bi-annual trend has been demonstrated for neonatal sepsis. We suggest further work should be done to analyse possible causes, including socio-political factors, for this bi-annual pattern for neonatal sepsis and mortality, and whether the same pattern can also be seen in other areas of Kenya over the same time period.

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