Prospective observational study of the challenges in diagnosing common neonatal conditions in Nigeria and Kenya. Issue 12 (6th December 2022)

• Record Type: Journal Article
• Authors: Staunton, Aimee P; Nabwera, Helen M; Allen, Stephen J; Tongo, Olukemi O; Akindolire, Abimbola E; Abdulkadir, Isa; Ezeaka, Chinyere V; Ezenwa, Beatrice N; Fajolu, Iretiola B; Imam, Zainab O; Umoru, Dominic D; Otieno, Walter; Nalwa, Grace M; Olwala, Macrine; Talbert, Alison W; Andang'o, Pauline E A; Mwangome, Martha K; Abubakar, Ismaela; Embleton, Nicholas D
• Other Names: author non-byline.; Abdulkadir Isa author non-byline.; Abubakar Ismaela author non-byline.; Akindolire Abimbola E author non-byline.; Akinyinka Olusegun author non-byline.; Allen Stephen J author non-byline.; Andang'o Pauline EA author non-byline.; Devereux Graham author non-byline.; Ezeaka Chinyere author non-byline.; Ezenwa Beatrice N author non-byline.; Fajolu Iretiola B author non-byline.; Imam Zainab O author non-byline.; Mortimer Kevin author non-byline.; Mwangome Martha K author non-byline.; Nabwera Helen M author non-byline.; Nalwa Grace M author non-byline.; Otieno Walter author non-byline.; Talbert Alison W author non-byline.; Embleton Nicholas D author non-byline.; Tongo Olukemi O author non-byline.; Umoru Dominic D author non-byline.; Wijgert Janneke van de author non-byline.; Gladstone Melissa author non-byline.
• Is Part Of: BMJ open. Volume 12:Issue 12(2022)
• Publication Date: 2022-12-06
• Subjects: Health policy -- Public health -- NEONATOLOGY -- Paediatric gastroenterology; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2022-064575
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: Accurate and timely diagnosis of common neonatal conditions is crucial for reducing neonatal deaths. In low/middle-income countries with limited resources, there is sparse information on how neonatal diagnoses are made. The aim of this study was to describe the diagnostic criteria used for common conditions in neonatal units (NNUs) in Nigeria and Kenya. Design: Prospective observational study. Standard case report forms for suspected sepsis, respiratory disorders, birth asphyxia and abdominal conditions were co-developed by the Neonatal Nutrition Network (https://www.lstmed.ac.uk/nnu ) collaborators. Clinicians completed forms for all admissions to their NNUs. Key data were displayed using heatmaps. Setting: Five NNUs in Nigeria and two in Kenya comprising the Neonatal Nutrition Network. Participants: 2851 neonates, which included all neonates admitted to the seven NNUs over a 6-month period. Results: 1230 (43.1%) neonates had suspected sepsis, 874 (30.6%) respiratory conditions, 587 (20.6%) birth asphyxia and 71 (2.5%) abdominal conditions. For all conditions and across all NNUs, clinical criteria were used consistently with sparse use of laboratory and radiological criteria. Conclusion: Our findings highlight the reliance on clinical criteria and extremely limited use of diagnostic technologies for common conditions in NNUs in sub-Saharan Africa. This has implications for the management of neonatal conditions which often have overlapping clinical features. Strategies for implementation of diagnostic pathways and investment in affordable and sustainable diagnostics are needed to improve care for these vulnerable infants.