Determine the Risk Factors Associated with Neonatal Sepsis among Neonates in the Newborn Unit at Mandera County Referral Hospital, Mandera County

Abstract

Aims: Identified neonate-related factors associated with neonatal sepsis and determined knowledge gaps among healthcare providers on neonatal sepsis at Mandera County Referral Hospital. Study Design: In light of the information presented above, a retrospective study that is both descriptive and analytic in nature was employed. Place and Duration of Study: The study was carried out in the Newborn Unit of the Mandera County Referral Hospital in Mandera County between May 2022 and May 2023 with the goal of identifying risk variables associated with newborn sepsis. Methodology: Purposive sampling was used to select 199 infants aged 0 to 28 days old for inclusion in the study. These infants had been referred to the neonatal intensive care unit (NICU) with a suspicion of sepsis and/or had been discharged through the same ward following delivery. The single formula for population proportion was utilized where a sample size of 50 for the medical staff working in the pediatric unit was used in the study. Results: A total of 199 neonates were included (100% response rate); 71.9% were <7 days old, 56.8% were male, and 60% were breastfed. Overall, 79.4% (95% CI: 75.2–83.6%) of neonates had sepsis. Low birth weight (<2.5 kg, 60.8%), prematurity (<37 weeks, 54.3%), male sex (56.8%), and birth asphyxia (41.2%) were common among septic neonates, though not significantly associated with sepsis severity (all P > 0.05). Of the 50 nurses surveyed, most were aged 21–30 (72%), female (74%), held a BSc in Nursing (52%), had 2–4 years of experience (66%), and the majority (82%) had not taken specialized neonatology courses. Among healthcare providers, neonates managed by nurses knowledgeable in essential care had higher odds of sepsis (AOR = 2.69; 95% CI: 1.526–7.672). Multivariate analysis identified neonatal age <3 days (aOR = 2.77; 95% CI: 1.31–5.84; P = 0.008) and preterm birth (<37 weeks) (aOR = 4.15; 95% CI: 1.19–9.17; P ≤ 0.001) as significant predictors. Conclusion: Neonatal sepsis was highly prevalent at Mandera County Referral Hospital, affecting 79.4% of admitted neonates. Early neonatal age (<3 days) and preterm birth (<37 weeks) were significant predictors of sepsis, while other factors such as low birth weight, male sex, and birth asphyxia were common but not independently associated with severity. Targeted surveillance, early diagnosis, and improved healthcare provider knowledge are essential to reduce the burden of neonatal sepsis in this setting.