Neonatal mortalities without detected risk factors before birth at Mtendeli hospital, Tanzania: a cross-sectional study.

Introduction: neonatal mortality rate (NMR) is defined as the probability of dying during the first 28 days of life expressed per 1,000 live births. The death of neonates without risk factors at the end of pregnancy could be an indicator of sub-optimal quality care during labor and care of sick neonates. Therefore, this study aimed to determine the factors associated with neonatal deaths happening without detected risks during prenatal period. Methods: a cross-sectional study was conducted from 2017 to 2021.The recruited pregnant women were those who had a live, term, single-intrauterine pregnancy without detectable fetal abnormality at the time of starting labor. The data were collected through open data kit (ODK) forms that were customized in kobo tool in the tablets. The data analysis was performed using STATA statistical software. The factors associated with neonatal mortality were analyzed in a multiple logistic regression and considered significant if p < 0.05. Results: among the 4401 enrolled mothers, neonatal deaths were 361 (8.2%). The factors associated with death of neonates without risk factors during prenatal period were low Apgar score [AOR = 4.38: 95%CI (2.33-7.72)], male sex [AOR=2.25: 95%CI (1.12-3.81)], gestational age above 40 weeks [AOR=4.79: (2.50-7.61)] and assisted vaginal delivery [AOR = 2.55: 95%CI (1.12-4.96)]. Conclusion: the increased number of neonatal deaths are associated with sex of neonates, low Apgar score, post maturity and assisted vaginal delivery. The hospital-based studies should be done to address the preventable neonatal deaths with no detected risk factors before birth.

Assessing the utility of pregnant women as a sentinel surveillance population for malaria in Geita, Tanzania, 2019 - 2021.

OBJECTIVES: Estimates of malaria burden and intervention uptake in Africa are primarily based on household surveys. However, their expense and infrequency limit their utility. We investigated whether data collected during antenatal care (ANC) can provide relevant information for decision-makers. METHODS: Malaria test positivity rates and questionnaire data from ANC attendees at 39 health facilities were compared to questionnaire data and positivity rates among children from two cross-sectional surveys in the facilities' corresponding catchment areas. RESULTS: Trends in parasitemia among ANC attendees were predictive of trends in parasitemia among children at the council level (mean absolute error 6.0%). Primigravid ANC attendees had the lowest rates of net ownership (modeled odds ratio [OR] 0.28, 95% CI 0.19-0.40) and use (OR 0.58, 95% CI 0.42-0.79). ANC attendees reported higher levels of care-seeking (OR 1.78, 95% CI 1.48-2.14), malaria testing (OR 4.16, 95% CI 3.44-5.04), and treatment for children with fever (OR 7.66, 95% CI 4.89-11.98) compared to women surveyed in households, raising concerns about social desirability bias disproportionately impacting ANC surveys. CONCLUSION: ANC surveillance is an effective strategy for tracking trends in malaria burden. More work is required to elucidate the value of administering questionnaires to ANC attendees.