Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality
BackgroundReports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes.ObjectivesThis study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalen...
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1272104/full |
| _version_ | 1797242875281408000 |
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| author | John Wainaina Morris Ogero Livingstone Mumelo Kefa Wairoto George Mbevi Timothy Tuti Paul Mwaniki Grace Irimu Grace Irimu Mike English Mike English Jalemba Aluvaala Jalemba Aluvaala The Clinical Information Network Author Group Dolphine Mochache Juma Vitalis Nyumbile Bonface Christine Manyasi Caren Emadau Charles Nzioki Wagura Mwangi Magdalene Kuria Esther Njiru Penina Mwangi Rachel Inginia Emma Namulala Grace Ochieng Lydia Thuranira Felistus Makokha Josephine Ojigo Beth Maina Bernadette Lusweti Amilia Ngoda Dolphine Mochache Jane Mbungu Joan Baswetty Josephine Aritho Beatrice Njambi Zainab Kioni Lucy Kinyua Alice Oguda Loise N. Mwangi Nancy Mburu Celestine Muteshi Salome Okisa Muyale Faith Mueni Rosemary Mututa Joyce Oketch Orina Nyakina Faith Njeru Margaret Wanjiku Mwaura Seline Kulubi Susan Wanjala Pauline Njeru John Ollongo Samuel Soita Mary Nguri Margaret Waweru Otieno George Obop Jeska Kuya Esther Muthiani Esther Mwangi Joseph Ng’ang’a Benjamin Tanui Alfred Wanjau Judith Onsongo Peter Muigai Arnest Namayi |
| author_facet | John Wainaina Morris Ogero Livingstone Mumelo Kefa Wairoto George Mbevi Timothy Tuti Paul Mwaniki Grace Irimu Grace Irimu Mike English Mike English Jalemba Aluvaala Jalemba Aluvaala The Clinical Information Network Author Group Dolphine Mochache Juma Vitalis Nyumbile Bonface Christine Manyasi Caren Emadau Charles Nzioki Wagura Mwangi Magdalene Kuria Esther Njiru Penina Mwangi Rachel Inginia Emma Namulala Grace Ochieng Lydia Thuranira Felistus Makokha Josephine Ojigo Beth Maina Bernadette Lusweti Amilia Ngoda Dolphine Mochache Jane Mbungu Joan Baswetty Josephine Aritho Beatrice Njambi Zainab Kioni Lucy Kinyua Alice Oguda Loise N. Mwangi Nancy Mburu Celestine Muteshi Salome Okisa Muyale Faith Mueni Rosemary Mututa Joyce Oketch Orina Nyakina Faith Njeru Margaret Wanjiku Mwaura Seline Kulubi Susan Wanjala Pauline Njeru John Ollongo Samuel Soita Mary Nguri Margaret Waweru Otieno George Obop Jeska Kuya Esther Muthiani Esther Mwangi Joseph Ng’ang’a Benjamin Tanui Alfred Wanjau Judith Onsongo Peter Muigai Arnest Namayi |
| author_sort | John Wainaina |
| collection | DOAJ |
| description | BackgroundReports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes.ObjectivesThis study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality.MethodsA retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C–36.4°C) and hypothermia (<36.0°C). Factors associated with neonatal mortality, including hypothermia defined as body temperature below 36.0°C, were also explored using logistic regression.ResultsA total of 58,804 newborns from newborn units in 21 study hospitals were included in the analysis. Out of these, 47,999 (82%) had their admission temperature recorded and 8,391 (17.5%) had hypothermia. Hypothermia prevalence decreased over the study period while admission temperature documentation increased. Significant associations were found between low birthweight and very low (0–3) APGAR scores with hypothermia at admission. Odds of hypothermia reduced as ambient temperature and month of participation in the Clinical Information Network (a collaborative learning health platform for healthcare improvement) increased. Hypothermia at admission was associated with 35% (OR 1.35, 95% CI 1.22, 1.50) increase in odds of neonatal inpatient death.ConclusionsA substantial proportion of newborns are admitted with hypothermia, indicating a breakdown in warm chain protocols after birth and intra-hospital transport that increases odds of mortality. Urgent implementation of rigorous warm chain protocols, particularly for low-birth-weight babies, is crucial to protect these vulnerable newborns from the detrimental effects of hypothermia. |
| first_indexed | 2024-04-24T18:46:10Z |
| format | Article |
| id | doaj.art-446caf231154448a9c65d25bf064e372 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-24T18:46:10Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-446caf231154448a9c65d25bf064e3722024-03-27T05:04:44ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-03-011210.3389/fped.2024.12721041272104Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortalityJohn Wainaina0Morris Ogero1Livingstone Mumelo2Kefa Wairoto3George Mbevi4Timothy Tuti5Paul Mwaniki6Grace Irimu7Grace Irimu8Mike English9Mike English10Jalemba Aluvaala11Jalemba Aluvaala12The Clinical Information Network Author GroupDolphine MochacheJuma VitalisNyumbile BonfaceChristine ManyasiCaren EmadauCharles NziokiWagura MwangiMagdalene KuriaEsther NjiruPenina MwangiRachel InginiaEmma NamulalaGrace OchiengLydia ThuraniraFelistus MakokhaJosephine OjigoBeth MainaBernadette LuswetiAmilia NgodaDolphine MochacheJane MbunguJoan BaswettyJosephine ArithoBeatrice NjambiZainab KioniLucy KinyuaAlice OgudaLoise N. MwangiNancy MburuCelestine MuteshiSalome Okisa MuyaleFaith MueniRosemary MututaJoyce OketchOrina NyakinaFaith NjeruMargaret Wanjiku MwauraSeline KulubiSusan WanjalaPauline NjeruJohn OllongoSamuel SoitaMary NguriMargaret WaweruOtieno George ObopJeska KuyaEsther MuthianiEsther MwangiJoseph Ng’ang’aBenjamin TanuiAlfred WanjauJudith OnsongoPeter MuigaiArnest NamayiHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaInfectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, University of London, London, United KingdomHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaDepartment of Paediatrics and Child Health, University of Nairobi, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaNuffield Department of Clinical Medicine, Oxford, United KingdomHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaDepartment of Paediatrics and Child Health, University of Nairobi, Nairobi, KenyaBackgroundReports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes.ObjectivesThis study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality.MethodsA retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C–36.4°C) and hypothermia (<36.0°C). Factors associated with neonatal mortality, including hypothermia defined as body temperature below 36.0°C, were also explored using logistic regression.ResultsA total of 58,804 newborns from newborn units in 21 study hospitals were included in the analysis. Out of these, 47,999 (82%) had their admission temperature recorded and 8,391 (17.5%) had hypothermia. Hypothermia prevalence decreased over the study period while admission temperature documentation increased. Significant associations were found between low birthweight and very low (0–3) APGAR scores with hypothermia at admission. Odds of hypothermia reduced as ambient temperature and month of participation in the Clinical Information Network (a collaborative learning health platform for healthcare improvement) increased. Hypothermia at admission was associated with 35% (OR 1.35, 95% CI 1.22, 1.50) increase in odds of neonatal inpatient death.ConclusionsA substantial proportion of newborns are admitted with hypothermia, indicating a breakdown in warm chain protocols after birth and intra-hospital transport that increases odds of mortality. Urgent implementation of rigorous warm chain protocols, particularly for low-birth-weight babies, is crucial to protect these vulnerable newborns from the detrimental effects of hypothermia.https://www.frontiersin.org/articles/10.3389/fped.2024.1272104/fullnewborninpatienthypothermiamortalitywarm chain |
| spellingShingle | John Wainaina Morris Ogero Livingstone Mumelo Kefa Wairoto George Mbevi Timothy Tuti Paul Mwaniki Grace Irimu Grace Irimu Mike English Mike English Jalemba Aluvaala Jalemba Aluvaala The Clinical Information Network Author Group Dolphine Mochache Juma Vitalis Nyumbile Bonface Christine Manyasi Caren Emadau Charles Nzioki Wagura Mwangi Magdalene Kuria Esther Njiru Penina Mwangi Rachel Inginia Emma Namulala Grace Ochieng Lydia Thuranira Felistus Makokha Josephine Ojigo Beth Maina Bernadette Lusweti Amilia Ngoda Dolphine Mochache Jane Mbungu Joan Baswetty Josephine Aritho Beatrice Njambi Zainab Kioni Lucy Kinyua Alice Oguda Loise N. Mwangi Nancy Mburu Celestine Muteshi Salome Okisa Muyale Faith Mueni Rosemary Mututa Joyce Oketch Orina Nyakina Faith Njeru Margaret Wanjiku Mwaura Seline Kulubi Susan Wanjala Pauline Njeru John Ollongo Samuel Soita Mary Nguri Margaret Waweru Otieno George Obop Jeska Kuya Esther Muthiani Esther Mwangi Joseph Ng’ang’a Benjamin Tanui Alfred Wanjau Judith Onsongo Peter Muigai Arnest Namayi Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality Frontiers in Pediatrics newborn inpatient hypothermia mortality warm chain |
| title | Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality |
| title_full | Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality |
| title_fullStr | Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality |
| title_full_unstemmed | Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality |
| title_short | Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality |
| title_sort | hypothermia amongst neonatal admissions in kenya a retrospective cohort study assessing prevalence trends associated factors and its relationship with all cause neonatal mortality |
| topic | newborn inpatient hypothermia mortality warm chain |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1272104/full |
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