The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Method
2.1. Study Location
2.2. Study Design
2.3. Sampling and Sample Size
2.4. Study Population
2.5. Data Collection
2.6. Data Analysis
2.7. Ethical Clearance
3. Results
3.1. Patient Characteristics
3.2. Distance Travelled
3.3. Mode of Transport
3.4. Travel Time
3.5. Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
IQR | Inter-quartile range |
NICU | Neonatal intensive care unit |
SD | Standard deviation |
SDG | Sustainable development goals |
SJH | St Joseph’s Hospital |
UK | United Kingdom |
UWRH | Upper West Regional Hospital |
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Demographic Characteristics | Outcome | ||
---|---|---|---|
Survived | Died | ||
n (%) | n (%) | χ2 (p-value) | |
All participants | 141 (92.2) | 12 (7.8) | |
Sex of neonate | |||
Female | 56 (39.7) | 9 (75.0) | 5.634 (0.018) |
Male | 85 (60.3) | 3 (25.0) | |
Birth weight in grams | |||
<2500 g | 15 (10.6) | 6 (50.0) | 14.468 (0.001) |
≥2500 g | 126 (89.4) | 6 (50.0) | |
Gestational age at birth | |||
<37 completed weeks | 20 (14.2) | 6 (50.0) | 10.057 (0.002) |
≥37 completed weeks | 121 (85.8) | 6 (50.5) | |
Mother in attendance at NICU | |||
Mother in attendance | 134 (95.0) | 11 (91.7) | 0.253 (0.615) |
Mother did not attend * | 7 (5.0) | 1 (8.3) | |
Accompanied to NICU by | |||
child’s father | 66 (57.4) | 2 (22.2) | 5.721 (0.221) |
Other family member | 34 (29.6) | 6 (66.7) | |
Friend | 13 (11.3.) | 1 (11.1) | |
Not indicated | 2 (1.7) | - | |
Time from onset of symptoms to arrival at hospital | |||
Within 24 h | 37 (26.2) | 2 (16.7) | 0.534 (0.465) |
More than 24 h | 104 (73.8) | 10 (83.3) |
Survived | Died | |
---|---|---|
Transport Characteristics | N = 141 | N = 12 |
n (%) | n (%) | |
Mode of Transport | ||
Walked | 6 (4.3) | 2 (16.7) |
Taxi | 50 (36.0) | 2 (16.7) |
Public transport (Bus) | 40 (28.8) | 5 (41.7) |
Motor bike | 39 (28.1) | 2 (16.7) |
Motor king (Tricycle) | 2 (1.4) | 1 (8.3) |
Ambulance | 1 (0.7) | - |
* Unspecified | 2 (1.4) | - |
Self-reported experienced delay in reaching NICU | ||
Yes | 29 (20.9) | 2 (16.7) |
No | 110 (79.1) | 10 (83.3) |
Sources of delay among those reporting delay | ||
Bad road | 19 (54.3) | |
No available vehicle | 8 (22.9) | 2 (100.0) |
The place was far | 1 (2.9) | |
Financial problem | 5 (14.3) | |
Other | 2 (5.7) | |
Time taken to be seen by doctor on arrival | ||
Less than 30 min | 35 (24.8) | 7 (58.3) |
30–60 min | 101 (71.6) | 5 (41.6) |
More than 60 min | 5 (3.5) | - |
Outcome | |||
---|---|---|---|
Survived | Died | ||
Clinical Characteristics | N = 141 | N = 12 | |
n, % | n, % | ||
Temperature ranges (°C) | |||
Moderate to severe hypothermia | 34.0–35.5 | 18 (12.8) | 2 (16.7) |
Mild hypothermia | 35.6–36.4 | 49 (34.8) | 6 (50.0) |
Normal | 36.5–37.5 | 15 (10.6) | 3 (25.0) |
High (low grade to moderate fever) | 37.6–38.4 | 45 (31.9) | 1 (8.3) |
High (moderate fever to hyperpyrexia) | ≥38.5 | 14 (9.9) | - |
Heart rate (beats per min) | |||
Low | <110 | 36 (25.5) | 5 (41.7) |
Normal | 111–160 | 99 (70.2) | 5 (41.7) |
High | >160 | 6 (4.3) | 2 (16.7) |
Respiratory rate (breaths/min) | |||
Low | <30 | 10 (7.1) | - |
Normal | 30–60 | 51 (36.4) | 6 (50.0) |
High | >60 | 79 (56.4) | 6 (50.0) |
General condition | |||
Stable | 35 (24.8) | 1 (8.3) | |
* Unstable | 106 (75.2) | 11 (91.7) | |
Main diagnosis | |||
** Neonatal sepsis | 26 (17.0) | 2 (1.3) | |
Asphyxia | 14 (9.1) | 2 (1.3) | |
*** Malaria | 13 (8.5) | ||
Neonatal jaundice | 13 (8.5) | ||
Congenital malformation **** | 13 (8.5) | ||
Abdominal distension | 11 (7.2) | 1 (0.7) | |
Prematurity | 9 (5.9) | 3 (1.9) | |
Impetigo | 9 (5.9) | ||
Circumcision bleeding | 8 (5.2) | 1 (0.7) | |
Ophthalmia neonatorum | 8 (5.2) | ||
Pneumonia | 5 (3.2) | ||
Low birth weight | 4 (2.6) | 2 (1.3) | |
Birth injury | 3 (1.9) | ||
Gastroenteritis | 3 (1.9) | ||
Meconium aspiration | 3 (1.9) | 1 (0.7) | |
Other ***** | 11 (7.5) |
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Tette, E.M.A.; Nuertey, B.D.; Akaateba, D.; Gandau, N.B. The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study. Children 2020, 7, 22. https://doi.org/10.3390/children7030022
Tette EMA, Nuertey BD, Akaateba D, Gandau NB. The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study. Children. 2020; 7(3):22. https://doi.org/10.3390/children7030022
Chicago/Turabian StyleTette, Edem M. A., Benjamin D. Nuertey, Dominic Akaateba, and Naa Barnabas Gandau. 2020. "The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study" Children 7, no. 3: 22. https://doi.org/10.3390/children7030022