World Health Organization , 2020. Levels and Trends in Child Mortality: Report 2020. Available at: https://www.who.int/publications/m/item/levels-and-trends-in-child-mortality-report-2020. Accessed June 21, 2022.
United Nations General Assembly, 2015. Transforming our world: the 2030 Agenda for Sustainable Development. Available at: https://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E. Accessed July 5, 2022.
Oza S , Cousens S , Lawn J , 2014. Estimation of daily risk of neonatal death, including the day of birth, in 186 countries in 2013: a vital-registration and modelling-based study. Lancet Glob Health 2: e635–e644.
World Health Organization , 2020. Newborns: Improving Survival and Well-being. Available at: https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Accessed June 21, 2022.
World Health Organization , 2015. WHO Recommendations on Interventions to Improve Preterm Birth Outcomes. Available at: https://apps.who.int/iris/bitstream/handle/10665/183037/9789241508988_eng.pdf;jsessionid=6603B6C087D8A303D166E816DD9FA52F?sequence=1. Accessed July 5, 2021.
Federal Ministry of Health , 2016. Nigeria Every Newborn Action Plan: A Plan to End Preventable Newborn Deaths in Nigeria. Available at: https://www.healthynewbornnetwork.org/hnn-content/uploads/Nigeria-Every-Newborn-Action-Plan.pdf. Accessed February 4, 2021.
World Health Organization , 2010. Essential Newborn Care Course. Trainer’s guide Available at: https://www.who.int/publications/i/item/essential-newborn-care-course. Accessed July 5, 2022.
American Academy of Pediatrics , 2014. Solidarity bolstered in new global initiative to save 100,000 babies every year. AAP News 35: 30.
Ezeaka VC , Ogunbase AO , Awogbemi OT , Grange AO , 2003. Why our children die: a review of paediatric mortality in a tertiary centre in Lagos, Nigeria. Niger Q J Hosp Med 13: 17–21.
Fajolu IB , Egri-Okwaji MTC , 2011. Childhood mortality in children emergency centre of the Lagos University Teaching Hospital. Niger J Paediatr 38: 131–135.
Ezenwa B , Akintan P , Fajolu I , Ladele J , Ezeaka C , 2016. Bubble CPAP in the management of respiratory distress syndrome in resource constrained settings: the LUTH experience. Pediatr Oncall J. 13: 9–12.
March of Dimes, Partnership for Maternal Newborn and Child Heath Children, World Health Organization , 2012. Born Too Soon: The Global Action Report on Preterm Birth Born .Geneva, Switzerland: WHO.
Engle WA et al., 2007. “Late-preterm” infants: a population at risk. Pediatrics 120: 1390–1401.
Cutland CL et al., 2017. Low birth weight: case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 35: 6492–6500.
Hug L , Alexander M , You D , Alkema L , 2019. National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis. Lancet Glob Health 7: e710–e720.
Liu L , Oza S , Hogan D , Chu Y , Perin J , Zhu J , Lawn JE , Cousens S , Mathers C , Black RE , 2016. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 388: 3027–3035.
Abdulraheem MA , Tongo OO , Orimadegun AE , Akinbami OF , 2016. Neonatal transport practices in Ibadan, Nigeria. Pan Afr Med J 24: 216.
Okonkwo IR , Abhulimhen-Iyoha BI , Okolo AA , 2020. Newborn transport practices: influence on newborn survival in Benin City, Nigeria. Am J Pediatr 6: 346–352.
Tette EMA , Nuertey BD , Akaateba D , Gandau NB , 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 (Basel) 7: 22.
Mohan KR , Kumar R , 2019. Study of indications, complications and outcomes of neonatal transport by a skilled team. Int J Contemp Pediatrics 6: 2402–2405.
Nabwera HM et al., 2021. Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya. PLoS One 16: e0244109.
Disu EA , Ferguson IC , Njokanma OF , Anga LA , Solarin AU , Olutekunbi AO , Ekure EN , Ezeaka VC , Esangbedo DO , Ogunlesi TA , 2015. National neonatal resuscitation training program in Nigeria (2008–2012): a preliminary report. Niger J Clin Pract 18: 102–109.
Fowler TT , Fairbrother G , Owens P , Garro N , Pellegrini C , Simpson L , 2014. Trends in complicated newborn hospital stays and costs, 2002–2009: implications for the future. Medicare Medicaid Res Rev 4: mmrr2014-004-04-a03.
Slusher TM , Zamora TG , Appiah D , Stanke JU , Strand MA , Lee BW , Richardson SB , Keating EM , Siddappa AM , Olusanya BO , 2017. Burden of severe neonatal jaundice: a systematic review and meta-analysis. BMJ Paediatr Open 1: e000105.
Ogunfowora OB , Ogunlesi TA , Ayeni VA , 2019. Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria. S Afr Fam Pract 61: 177–183.
Eze P , Al-Maktari F , Alshehari AH , Lawani LO , 2020. Morbidities and outcomes of a neonatal intensive care unit in a complex humanitarian conflict setting, Hajjah Yemen: 2017–2018. Confl Health 14: 53.
Jajoo M , 2019. IDDF2019-ABS-0222 Exchange transfusion in neonatal hyperbilirubinemia and bilirubin encephalopathy: a long way to go. Gut 68: A149.
Olusanya BO , Teeple S , Kassebaum NJ , 2018. The contribution of neonatal jaundice to global child mortality: findings from the GBD 2016 study. Pediatrics 141: e20171471.
Olusanya BO , Ogunlesi TA , Slusher TM , 2014. Why is kernicterus still a major cause of death and disability in low-income and middle-income countries? Arch Dis Child Educ Pract Ed 99: 1117–1121.
Slusher TM , Day LT , Ogundele T , Woolfield N , Owa JA , 2017. Filtered sunlight, solar powered phototherapy and other strategies for managing neonatal jaundice in low-resource settings. Early Hum Dev 114: 11–15.
UNICEF , 2019. The State of the World’s Children 2019: Statistical Tables. Available at: https://data.unicef.org/resources/dataset/sowc-2019-statistical-tables/. Accessed June 21, 2022.
Olusanya BO , Osibanjo FB , Mabogunje CA , Slusher TM , Olowe SA , 2016. The burden and management of neonatal jaundice in Nigeria: a scoping review of the literature. Niger J Clin Pract 19: 1–17.
Olusanya BO , Emokpae AA , Zamora TG , Slusher TM , 2014. Addressing the burden of neonatal hyperbilirubinaemia in countries with significant glucose-6-phosphate dehydrogenase deficiency. Acta Paediatr Int J Paediatr 103: 1102–1109.
Cline BK , Vreman HJ , Faber K , Lou H , Donaldson KM , Amuabunosi E , Ofovwe G , Bhutani VK , Olusanya BO , Slusher TM , 2013. Phototherapy device effectiveness in Nigeria: irradiance assessment and potential for improvement. J Trop Pediatr 59: 321–325.
Ezeaka VC , Ekure EN , Fajolu IB , Ezenwa BN , Akintan PE , 2016. Mothers’ perception of neonatal jaundice in Lagos, Nigeria: an urgent need for greater awareness. S Afr J Child Health10: 227–230.
Wennberg RP et al., 2020. Maternal instruction about jaundice and the incidence of acute bilirubin encephalopathy in Nigeria. J Pediatr 221: 47–54.e4.
Thielemans L et al., 2018. Indirect neonatal hyperbilirubinemia in hospitalized neonates on the Thai-Myanmar border: a review of neonatal medical records from 2009 to 2014. BMC Pediatr 18: 190.
Lawn JE , Cousens S , Zupan J , 2005. 4 Million neonatal deaths: When? Where? Why? Lancet 365: 891–900.
Federal Ministry of Health , 2011. Saving Newborn Lives in Nigeria: Newborn Health in the Context of the Integrated Maternal, Newborn and Child Health Strategy. 2nd edition. Abuja: Federal Ministry of Health, Save the Children, Jhpiego.
Kirby R, Palamountain K, 2020. Target product profiles for newborn care in low-resource settings (v1..2). Consesus meeting report. Available at: https://www.unicef.org/supply/media/2556/file/TPP-newborn-care-final-report-v1-2.pdf. Accessed July 5, 2022.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||51||51||3|
Neonatal mortality is a major contributor to under-five mortality, and Nigeria has the second-highest number of neonatal deaths globally. The country has introduced evidence-based interventions to improve newborn care over the years. The aim of this study was to determine the current trends in neonatal morbidity and mortality at the Lagos University Teaching Hospital, monitor progress over time, and identify areas for improvement. The admission registers and case files of all the neonatal ward admissions were reviewed from January 2018 to April 2020; the age at admission, gestational age, sex, inborn or out-born status, diagnosis, and outcome were recorded and analyzed. Of the 2,959 admissions during the study period, 68.4% were out-born and 77.9% were term gestation infants. The most common diagnoses were neonatal jaundice (NNJ; 28.4%), infection (28.0%), prematurity with associated complications (22.1%), and hypoxic ischemic encephalopathy (HIE; 18.2%). The overall mortality rate was 17.6%. Prematurity with associated complications (39.2%), HIE (24.8%), congenital anomalies (CAs; 12.7%), and NNJ (11.5%) were the most common conditions associated with mortality. Of those who died, the most common diagnoses among term infants were HIE (40.7%), CAs (21.8%), NNJ (18.9%), and infection (15.5%); respiratory distress syndrome (52.4%), infection (31.8%), and CAs (7.8%) were the most common diagnoses in preterm infants. The high risk of mortality with HIE, jaundice, infections, and CAs in this cohort reflects the national figures and trends. Efforts to improve neonatal care, especially respiratory support and education of the populace on NNJ, should be intensified to reduce neonatal mortality in the country.
Authors’ addresses: Iretiola Bamikeolu Fajolu, Beatrice Nkolika Ezenwa, and Veronica Chinyere Ezeaka, Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria, and Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Katherine Megan Satrom and Angela Christine Kein, Department of Pediatrics, University of Minnesota, Minneapolis, MN, E-mails: firstname.lastname@example.org and email@example.com. Tina Marye Slusher, Department of Pediatrics, Global Health Program, Critical Care Division, University of Minnesota, Minneapolis, MN, and Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN, E-mail: firstname.lastname@example.org.