review · Heliyon
Neonatal sepsis accounts for over one-third of neonatal deaths in Ethiopia, representing a major public health challenge. A systematic review and meta-analysis assessed the burden of the condition alongside its links to common maternal morbidities. Analysis by region showed the highest prevalence of neonatal sepsis occurred in the Oromiya region. The findings demonstrate that maternal infections during pregnancy and delivery substantially increase risk for newborns. Specifically, neonates born to mothers with antenatal urinary tract infections were over three and a half times more likely to develop neonatal sepsis than unexposed infants. In addition, maternal fever during delivery increased the risk of neonatal sepsis by more than three and a half times. Preventing maternal urinary infections and optimising intra-partum care are critical steps recommended to reduce the overall burden of neonatal sepsis.
Neonatal sepsis is a leading cause of infant mortality in Ethiopia. Establishing clear statistical links between maternal complications, including antenatal urinary tract infections and intra-partum fever, and infant sepsis enables healthcare systems to prioritise targeted maternal care. Implementing better screening and care protocols during pregnancy and labour offers an effective route to lowering preventable newborn infections and deaths.
The findings can inform healthcare providers, clinical diagnostic developers, and public health organisations seeking to design targeted point-of-care maternal screening tools and clinical protocols. Because the research consists of epidemiological meta-analysis rather than product testing, practical commercial applications, such as integrated rapid testing kits for antenatal care, remain at an early exploratory stage.
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BACKGROUND: More than one-third of the neonatal death in Ethiopia has been attributed to neonatal sepsis. However, there is no recent national evidence about the burden of neonatal sepsis and its association with antenatal urinary tract infection and intra-partum fever, which are commonly reported maternal morbidities in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to assess the pooled burden of neonatal sepsis and its association with antenatal urinary tract infection as well as intra-partum fever in the country. METHODS: = 99.2%). Subgroup analysis was performed for evidence of heterogeneity. Sensitivity analyses were performed. Absence of publication bias was declared from symmetry of funnel plot and Egger's test (p = 0.244). RESULTS: = 99.2%]. From regional subgroup analysis, the highest prevalence was observed in the Oromiya region. Neonates born to mothers who had antenatal urinary tract infection were at 3.55 times (95% CI: 2.04, 5.06) higher risk of developing neonatal sepsis as compared to those neonates born to mothers who didn't have antenatal urinary tract infection. Moreover, neonates born to mothers having intra-partum fever were 3.63 times (95% CI: 1.64, 5.62) more likely to develop neonatal sepsis as compared to those born to mothers who were nonfebrile during intrapartum. CONCLUSION: Neonatal sepsis has remained a problem of public health importance in Ethiopia. Both antenatal urinary tract infection and intra-partum fever were positively associated with neonatal sepsis. Therefore, preventing maternal urinary tract infection during pregnancy and optimizing the intra-partum care are recommended to mitigate the burden of neonatal sepsis in Ethiopia.
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DOI: 10.1016/j.heliyon.2021.e06121
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