Pattern of morbidity and mortality in the newborn special care unit in a tertiary institution in the Niger Delta region of Nigeria: A two year prospective study

G I McGil Ugwu

Department of paediatrics Delta State University Oghara Delta State Nigeria

E-mail: gnclinic@yahoo.com; Phone: +2348026239010

Accepted 12 July, 2012

Abstract

To determine the pattern of morbidity and mortality of admitted newborns in the Neonatal Intensive Care Unit of Delta State University Teaching Hospital Oghara. Newborn morbidity and mortality are still very high in developing countriets despite significant decline in developed countries. The quality of newborn care depends among other things, the establishment of the special care baby unit, regular audit and evaluation of services rendered. All neonates admitted into the Newborn Intensive Care Unit (NICU) of Delta State University Teaching Hospital Oghara in Niger Delta of Nigeria over a two year period between January 2010 and December 2011, were prospectively studied. Information documented include the biodata of each child, the diagnosis, services rendered and outcome. A total of 646 neonates were admitted during the period of review. The male: female ratio was 1.2:1 in favour of the males.(350:296). Of these, 108 were due to prematurity (16.4% ), 24(3.9% ) due to intrauterine growth restriction,116 (18.3%) with birth asphyxia. 228 (35.5%) were due to neonatal sepsis, 8(1.5%) neonatal tetanus. 60 (9.5%) had neonatal jaundice while 102 or(14.9 %) were due to other diseases. Of the 228 with neonatal sepsis, only in 80 (35.1%) was the sepsis culture proven, with 47.4% as presumed sepsis and 17.5% of cases, the neonates had other comorbid states. The overall mortality rate was 20.3%. The ratio of male to female deaths was 2.31 with the case fatality rate also higher in males than females at 26.3% and 14.1% respectively. Sepsis accounted for 25.7% of the deaths, birth asphyxia 24.1%, prematurity 22.6%. However the case fatality rate showed neonatal tetanus to be highest at 50%, Prematurity 27.8%, birth asohyxia 27.6% and neonatal sepsis 14.9%. Though more patients seen and died had neonatal sepsis, the case fatality rate showed neonatal sepsis to be just slightly above half of that for prematurity and birth asphyxia which are almost at par. Case fatality for tetanus remains very high. Regular auditing of the services in the neonatal intensive care unit is very essential and reduction of the neonatal mortality is a must, if the dream of achieving the 4th millenium development goal of reducing under 5 mortality by 2/3rd by 2015 can be attained.

Keywords: neonate, morbidity, mortality.