title: Improved Neonatal Mortality at a District Hospital in Aweil, South Sudan.
abstract: Neonatal deaths comprise a growing proportion of global under-five mortality. However, data from the highest-burden areas is sparse. This descriptive retrospective study analyses the outcomes of all infants exiting the Médecins sans Frontières-managed neonatal unit in Aweil Hospital, rural South Sudan from 2011 to 2014. A total of 4268 patients were treated over 4 years, with annual admissions increasing from 687 to 1494. Overall mortality was 13.5% (n = 576), declining from 18.7% to 11.1% (p for trend <0.001). Newborns weighing <2500 g were at significantly increased mortality risk compared with babies ≥2500 g (odds ratio = 2.27, 95% confidence interval = 1.9-2.71, p < 0.001). Leading causes of death included sepsis (49.7%), tetanus (15.8%), respiratory distress (12.8%) and asphyxia (9.2%). Tetanus had the highest case fatality rate (49.7%), followed by perinatal asphyxia (26.5%), respiratory distress (20.4%) and neonatal sepsis (10.5%). Despite increasing admissions, overall mortality declined, indicating that survival of these especially vulnerable infants can be improved even in a basic-level district hospital programme.
authors: Médecins Sans Frontières, Paris, 75011, France.|Department of Field Epidemiology and Training, Epicentre, Paris, 75011, France.
authors: Johanna
authors: J
authors: Thomson
authors: Médecins Sans Frontières, Sydney, 2037, Australia.
authors: Myrto
authors: M
authors: Schaefer
authors: Médecins Sans Frontières, Sydney, 2037, Australia.
authors: Belen
authors: B
authors: Caminoa
authors: Medical Co-ordination, Médecins Sans Frontières, Juba, South Sudan.
authors: David
authors: D
authors: Kahindi
authors: Médecins Sans Frontières, NY, 10001-5004, USA.
authors: Northan
authors: N
authors: Hurtado
mesh_terms: D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data*; D006767:Hospitals, District / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology* / Q000639:trends; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D000068037:South Sudan / Q000453:epidemiology
keywords: South Sudan.; developing countries; neonatal mortality; newborn