Lillian Benjamin
•
1 like•343 views
The study analyzed neonatal hospitalizations and deaths at the Albert Schweitzer Hospital in Gabon from 2005-2007. It found that neonatal infections were the primary cause of hospitalizations (43%) and premature birth was the leading cause of deaths (59%). While hospitalizations decreased over this period, neonatal deaths increased, raising the proportional mortality. The recommendations include conducting a prospective study to better understand morbidity and mortality, implementing health education programs, and establishing continuum of care between the hospital and community.
![Lillian D. Benjamin, MPH, MAIS Albert Schweitzer Public Health Fellow Lambaréné Gabon Primary Causes of Neonatal Morbidity and Mortality at Hospital Albert Schweitzer The purpose of the study is to identify the primary causes of neonatal mortality and morbidity at the Albert Schweitzer Hospital in Gabon from 2005 to 2007. Objective Methods Results Recommendations Acknowledgments The study was conducted through a retrospective review of the hospitals vital records and also included interviews with the hospital staff. In total, there were a 667 neonates hospitalized from January 1, 2005 to December 31, 2007 (242 in 2005; 221 in 2006; and 204 in 2007). The statistical data was collected from the Pediatric hospitalization registry; additional death dossiers were found in the record room and were added to the study. Because of the condition of the health records, some of the demographic information for this study is questionable; however, it is believed that the results provided still provide useful information on the mortality and morbidity at the hospital. Neonatal infections are the primary cause of hospitalizations at HAS –43% compared to 20% for premature births the second leading cause. Of the infants that were hospitalized with neonatal infection, 71 percent were hospitalized within the first 10 days of life. While neonatal infections are the most common form of morbidity for neonates at HAS, the exact types of infections afflicting many of the infants are difficult to ascertain because the illness is simply recorded as “Infection Neonatal” rather than the disease itself. Of the 109 neonatal deaths from 2005-2007, the leading causes of death was premature birth, accounting for 59 percent of deaths. The second leading cause was neonatal infection and neonatal distress was the third. Even though premature births accounted for 20% of hospitalizations, they accounted for nearly 60% of all deaths. Close to 45% of all premature births at HAS ended with the infants death—therefore prematurity is a major heath risk for infant survival for the infants in this study. Of the 64 premature births, the gestational mode age was 28 weeks. Also, 15 of the 64 the deaths attributed to premature deaths were multiple births. When the hospital records are examined by year, it is interesting to note that while hospitalizations are going down, neonatal deaths are going up. This trend can be attributed to a number of factors; and while it is interesting to note, there are many factors that I was not able to confirm without further research. What is important to note from this trend is that the proportional mortality is increasing. Meaning the proportion of neonatal fatalities is increasing in spite of the fact that the number of neonatal hospitalization are decreasing. More research is needed to determine exactly what is happening. I would like to thank the founders of the Thomas Francis, Jr. Global Health Fellowship Program, the University of Washington’s Department of Global Health, and School of Public Health and Community Medicine. I would also like to express my appreciation to the Albert Schweitzer Foundation, Lachlan Farrow, Devon Reber, Mary Anne Mercer, and the Schweitzer Hospital and its staff, especially the PMI team in Lambaréné, Gabon for this amazing opportunity. ,[object Object],[object Object],[object Object],HAS Neonatal Morbidity from 2005 - 2007 Infection Neonatal 43% Premature Birth 20% Neonatal Distress 13% Fetal distress 2% other 6% Neonatal Jaundice 10% Malformation 1% Infection Neonatal Premature Birth Neonatal Distress Neonatal Jaundice Fetal distress Unknown GEA Infection Maternal fetal Malformation Prenatal distress Anal perforation Conjunctivitis Convulsions febrile Omphalitis Staphylococci Other](https://image.slidesharecdn.com/lillianb-090415132857-phpapp01/85/Lillian-Benjamin-1-320.jpg)
