Risk Factors for Neonatal Sepsis in Public Hospitals of Mekelle City, North Ethiopia, 2015: Unmatched Case Control Study

OBJECTIVES: Neonatal sepsis is a leading cause of neonatal morbidity and mortality, particularly in the developing countries. Delays in the identification and treatment of neonatal sepsis are among the main contributors to the high mortality. The aim of this study was to determine the risk factors of neonatal sepsis in public hospitals of Mekelle City, Tigray Region, North Ethiopia, 2015. METHODS: A hospital based case control study was done in public hospitals of Mekelle City, Tigray region. Cases were neonates who had sepsis with their index mothers and controls were neonates who hadn't had sepsis with their index mothers. Hematologic findings were used to diagnose sepsis once the neonates were being clinically suspected. Cases and controls were selected using the systematic sampling technique. Data were entered using Epi info version 7 and then analyzed using SPSS window 20. The binary logistic regression model was used to test the association between dependent and independent variables and multivariable logistic regression was used to identify the associated risk factors to neonatal sepsis. FINDINGS: A total of 78 cases and 156 controls were included in this study. More than three quarters (76.8%) of cases had early onset sepsis. The multivariable logistic regression analysis showed that the possible risk factors of neonatal sepsis in this study were; history of maternal urinary tract infection or sexually transmitted infection AOR = 5. 23; 95% CI (1.82, 15.04), prolonged rupture of membrane AOR = 7. 43; 95% CI (2.04, 27.1), Place of delivery; health center delivery AOR = 5. 7; 95% CI (1.71, 19.03), intrapartum fever AOR = 6. 1 95% CI (1.29, 28.31), APGAR score <7 at 5th minute AOR = 68. 9; 95% CI (3.63, 1308) and not crying immediately at birth AOR = 124. 0; 95% CI (6.5, 2379). CONCLUSION: Both maternal and neonatal factors had contributed to the risk of neonatal sepsis. Strengthening of the existing risk based prevention strategies as well as improvement of institutional delivery practices are crucial.