Contributory factors to early neonatal deaths in the Upper East Regional Hospital in Ghana

Objective: This study examined factors identified during early neonatal death audits contributing to preventable newborn deaths at the Upper East Regional Hospital. Method: Data for this study was collected retrospectively from perinatal death audit forms using three data collectors. Data collection lasted two weeks, from 18th June to 2nd July 2021. The data collectors submitted 113 filled hard copy data collection forms. This was then entered into a designed Excel sheet and exported to STATA software version 15.0 for analysis. The analysis was descriptive statistics with cross-tabulation. The results were presented in charts and tables focusing on percentages. Results: Most of the 113 neonatal deaths were from birth asphyxia (63%). Forty-six (40.7%) of the deaths occurred within 24 hrs after birth. There were 38 factors reported 254 times in the audits as contributory to all the newborn deaths; 17 health personnel-related factors stated 141 (55.5%) times, four transportation and communication-related factors stated 43 (16.9%) times, seven health facility factors stated 31 (12.2%) times. Inappropriate care during transportation to the regional hospital was reported most - 21 times, followed by delay in referral - 18 times. Conclusion: The study identified many factors, such as medical personnel-related factors, transportation and communication factors, family-related factors, and health facility administration factors, contributing to early neonatal deaths. Effective implementation of neonatal death audit-based recommendations arising from these contributory factors is critical to preventing avoidable newborn deaths.

Incidence of blood culture-related sepsis in neonates and antibiotics sensitivity of implicated organisms in a secondary healthcare facility in Ghana

Objective: We determined the incidence of blood culture-related sepsis, causative bacteria, and antibiotics sensitivity among newborn babies with suggestive signs of sepsis admitted at the Upper East Regional Hospital in Bolgatanga, Ghana. Design: Prospective cross-sectional study Setting: Newborn Care Unit of the Upper East Regional Hospital, Bolgatanga Participants: Neonates admitted to the Newborn Care Unit from August 2019 to August 2020 with signs of sepsis Main outcome measures: Organisms isolated from blood cultures and sensitivity of isolated organisms to antibiotics. Results: The study included two hundred and seventy-six (276) patients. Laboratory confirmed sepsis was 13.4% (37/276). Early onset sepsis was 3.3% (9/276), while late-onset sepsis was 10.1% (28/276). The most common clinical signs associated with positive culture cases were temperature instability (35.5%), poor feeding (14.5%), neonatal jaundice (11.3%), vomiting (9.7%), and respiratory distress (8.1%). Staphylococcus aureus and Staphylococcus epidermidis were the most common bacterial isolates (46% and 32%, respectively). There was no relationship between independent variables and blood culture confirmed sepsis. Antibiotics to which isolates were most resistant included flucloxacillin 4/4, penicillin 14/15, ampicillin 16/18, and tetracycline 23/28. Bacterial isolates were most sensitive to amikacin 16/16, levofloxacin 5/5, erythromycin 8/8, cefazolin 7/8, and ciprofloxacin 18/24. Conclusion: Late-onset sepsis is a common sepsis category, and the implicated microorganisms are resistant to commonly prescribed antibiotics.