TIME TO RECOVERY AND PREDICTORS OF NEONATAL SEPSIS AMONG NEONATES ADMITTED TO NEONATAL INTENSIVE CARE UNIT AT HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, EASTERN ETHIOPIA

Abstract

Background: Neonatal death in Ethiopia accounted for more than half (56%) of all deaths of children under five years in 2020. The proportion of causes of neonatal deaths in Ethiopia due to neonatal infection is estimated to be 23%.Despite high mortality rate and health burden the duration time that the neonates take to recover from neonatal sepsis and predictors of recovery are not well studied and documented in Ethiopia. Objective: To assess the time to recovery of neonatal sepsis and predictors among neonates admitted in neonatal intensive care unit (NICU) at Hiwot Fana Comprehensive Specialized University hospital (HFCSH), eastern Ethiopia, from February 28/2021 to February 28/2023. Methods: An institution based retrospective cohort study was conducted among randomly selected 650 patient records neonates admitted to NICU at Hiwot Fana Comprehensive Specialized University hospital HFSCH spanning a period between February 28/2021 to February 28/2023. Crude hazard ratio and adjusted hazard ratio were used with 95% CI. The backward stepwise selection method was used for multivariable cox regression analysis p<0.2 and Finally, Cox Snell residual test was used for checking final model adequacy. Result: Of the total 650 neonates with sepsis in this study, with a total of 40557 observation/follow-up days, 333 (51.23%) were recovered. The median time to recovery was 8 days (IQR=6-13days). Respiratory failure (AHR=0.25, 95% CI; 0.07,0.81), abnormal radiologic findings (AHR=0.43, 95% CI; 0.26,0.70), diagnosed meningitis (AHR=0.45, 95% CI; 0.31,0.65), and being in critical condition (AHR=0.64, 95% CI; 0.51,0.81) were predictors that delay the time to recovery of neonatal sepsis and late onset neonatal sepsis (AHR=1.34, 95% CI; 1.01,2.87), normal platelet count (AHR=1.30, 95% CI; 1.01,1.68) were predictors that fastened the time to recovery of neonatal sepsis. Conclusion: Neonates who were admitted due to sepsis typically recovered within a median timeframe of one week. Time to recovery was longer among neonates with abnormal radiologic findings, respiratory failure, meningitis, and critical condition and time to recovery of neonatal sepsis were decreased by late onset neonatal sepsis and normal platelet count. Health sectors should anticipate high-risk newborns and should intensively follow, practice timely decision and interventions to decrease recovery time and neonatal mortality.