Predictors of Length of Hospitalization for Neonatal Sepsis at Kenyatta Nation Hospital, Kenya: A Prospective Cross-Sectional Study.

Abstract

Background and aims: Neonatal sepsis is a major cause of neonatal mortality worldwide. It remains a detrimental bottleneck to the WHO goal of eradicating preventable deaths for children below 5 years of age by 2030. Though the risk factors for adverse clinical outcomes for neonatal sepsis have been widely studied there is no universal consensus. Length of hospitalization is considered an indicator for adverse clinical outcome of neonatal sepsis. Markedly, literature is scarce regarding the drivers of extended hospitalization for neonatal sepsis in Kenya.

Methodology: This study determined the predictors of prolonged hospital stay for neonatal sepsis at the pediatric wards, KNH, Kenya. This was prospective cross-sectional research carried out among 314 mother/neonate pairs. The neonates were confirmed to have sepsis. Logistic regression analysis was conducted to determine maternal and neonate status predictive of duration of hospitalization.

Results: The median duration of hospital stay was 11 days and the majority (52.9%) were hospitalized for more than 11 days. The findings identified that maternal age ≥ 35 years (OR = 3.72, 95% CI: 1.61-8.59, p = 0.03), UTI during pregnancy (OR = 1.82, 95% CI: 1.07-3.11, p = 0.03), not breastfeeding (OR = 2.31, 95% CI: 1.29-4.14, p = 0.005), convulsion (OR = 2.03, 95% CI: 1.22-3.37, p = 0.01), jaundice (OR = 1.45, 95% CI: 1.10-1.91, p = 0.002), reduced movements (OR = 1.72, 95% CI: 1.08-2.72, p = 0.02), low birthweight (OR = 6.1, 95% CI: 2.48-14.99, p < 0.001) and preterm birth (OR = 3.1, 95% CI: 1.64-5.86, p < 0.001) were significant predictors of longer hospital stay.

Conclusion: The findings provide insights into the factors that can be monitored to predict the prognosis of neonatal sepsis. Besides, remedies can target these variables to mitigate prolonged hospitalization and severity of neonatal sepsis.