title: Knowledge of danger signs in newborns and health seeking practices of mothers and care givers in Enugu state, South-East Nigeria.
abstract: BACKGROUND
  According to UNICEF, 40% of all under-5 deaths occur within the first month of life and half of these within the first few days of life. Many of these deaths are related to late recognition of neonatal illness, delays in decision to seek care at household level and subsequent late intervention at healthcare facilities. Knowledge of mothers about the danger signs in newborn is imperative to reduce these delays and preventable deaths.
  
  
  OBJECTIVE
  This study aimed to assess the perception of mothers and/or care givers of danger signs in newborns and their knowledge of the WHO recognized danger. A secondary aim was to explore the socio-demographic factors of mothers that influence knowledge of the WHO recognized danger signs and the health seeking behaviors of these mothers and/or care-givers.
  
  
  METHODS
  This was a community based descriptive and analytical study which used a multistage sampling technique to select 376 mothers and/or care-givers from four communities in 4 of the 17 Local Government Areas (LGA) of Enugu State. Logistic regression and chi-square was used in testing associations between variables.
  
  
  RESULTS
  Knowledge of more than three of the nine WHO recognized danger sign was poor (0.0-30.3%). Majority of the mothers had knowledge of one (i.e. fever) WHO recognized danger sign (95.2%). Knowledge of the WHO signs was not significantly associated with maternal socio-demographic variables considered in this study. Healthcare seeking behaviour was significantly determined by knowledge of at least one WHO recognized danger sign (OR 4.6 CI 1.1-18.7, P = 0.032). Cough, diarrhea and the excessive crying were the most perceived and experienced non-WHO recognized dangers signs among respondents.
  
  
  CONCLUSIONS
  There is urgent need to strengthen the teaching and training of expectant mothers across all maternal socio-demographic variables on these danger signs and the most appropriate measures to take when they occur.
authors.affiliation: Department of Paediatrics, Enugu State University of Science and Technology, Enugu, Enugu State, Nigeria. uekwochi@yahoo.co.uk.
authors.forename: Uchenna
authors.initials: U
authors.lastname: Ekwochi
authors.affiliation: Department of Paediatrics, Enugu State University of Science and Technology, Enugu, Enugu State, Nigeria. Ikennandu@gmail.com.
authors.forename: Ikenna K
authors.initials: IK
authors.lastname: Ndu
authors.affiliation: Child Survival Unit, Medical Research Council UK, The Gambia Unit, Fajara, Gambia. chidi.osuorah@yahoo.com.
authors.forename: Chidiebere D I
authors.initials: CD
authors.lastname: Osuorah
authors.affiliation: Department of Paediatrics, Enugu State University of Science and Technology, Enugu, Enugu State, Nigeria. chummmiebabe2002@yahoo.com.
authors.forename: Ogechukwu F
authors.initials: OF
authors.lastname: Amadi
authors.affiliation: Department of Paediatrics, Enugu State University of Science and Technology, Enugu, Enugu State, Nigeria. benifyokeke@gmail.com.
authors.forename: Ifeyinwa B
authors.initials: IB
authors.lastname: Okeke
authors.affiliation: Department of Paediatrics, Enugu State University of Science and Technology, Enugu, Enugu State, Nigeria. obuoha@yahoo.com.
authors.forename: Ejike
authors.initials: E
authors.lastname: Obuoha
authors.affiliation: Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. onahstan@yahoo.com.
authors.forename: Kenechi S
authors.initials: KS
authors.lastname: Onah
authors.affiliation: Department of Paediatrics, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. ikeokos@yahoo.com.
authors.forename: Ikenna
authors.initials: I
authors.lastname: Nwokoye
authors.affiliation: Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozara, Enugu State, Nigeria. odutoyintola@yahoo.co.uk.
authors.forename: Odutola I
authors.initials: OI
authors.lastname: Odetunde
authors.affiliation: Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozara, Enugu State, Nigeria. drijom@yahoo.com.
authors.forename: Nnenne I
authors.initials: NI
authors.lastname: Obumneme-Anyim
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000628:therapy; D008425:Maternal Behavior / Q000523:psychology; D009035:Mothers / Q000193:education; D009549:Nigeria; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014944:World Health Organization; D055815:Young Adult