Browsing by Author "Mhando, Grace F."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Predictors of early neonatal mortality in public regional referral hospitals in Dar es Salaam, Tanzania: a hospital-based prospective observational study
    (Hubert Kairuki Memorial University, 2023) Mhando, Grace F.
    Background: Neonatal mortality has been prevalent in many developing countries including Tanzania. There is mounting evidence that neonatal mortality has not stalled despite palpable evidence for reduced < 5 years mortality in Tanzania. The three public Regional Referral Hospitals in Dar es Salaam have high number of neonatal mortality according to the Demographic Health Survey-2 (DHS-2). There is no available retrievable information on predictors of early neonatal mortality. Objective: To assess predictors of early neonatal mortality at the three public Regional Referral Hospitals in Dar-es–Salaam, Tanzania. Methodology: A hospital-based prospective observational study was conducted at the neonatal units of three Regional Hospitals in Dar -es- Salaam from June to August 2023. A pre-designed Case Report Form was the main tool for data collection. Early neonatal mortality was the outcome variable. Continuous data were summarized using median (with inter-quartile range) and categorical data using frequency and proportion. Multivariable logistic regression model was fitted to account for predictors of early neonatal mortality after appropriate model validation. Unless otherwise stated, an α-level of 5% was used as a limit for type 1 error. Written informed consent was sought from mothers of each baby prior to enrollment. Results: A total of 370 neonates were recruited in the study and they were in final data analysis. Their median age was 6 days (IQR: 4-7). Mortality prevalence rate was 28.1% with birth asphyxia, preterm delivery and respiratory distress syndrome the leading causes of deaths. Predictors of early neonatal mortality were elevated respiratory rate (A.O.R.:1.017 (95% CI.: 1.001 – 1.03, p-value=0.009) and gestational age (A.O.R.: 0.815, 95% CI.: 0.721 – 0.922, p-value=0.029). Conclusions: In this study early neonatal mortality rate was high. Elevated respiratory rate and increased gestational age were the significant factors associated with early neonatal mortality in this study. Recommendations: In view of high prevalence of early neonatal mortality rate, further studies should be conducted to determine the underlying causes of early neonatal mortality. Special attention should be paid on neonates admitted with birth asphyxia, preterm delivery and respiratory distress syndrome. Keywords: Early neonatal mortality, Dar es Salaam, Tanzania.
  • No Thumbnail Available
    Item
    Predictors of early newborn deaths at Dar es Salaam public regional referral hospitals: A prospective observational hospital-based study
    (PLOS one, 2025-12-11) Mhando, Grace F.; Kalabamu, Florence S.; Fataki, Maulidi R.; Galabawa, Christina C.
    Newborn deaths are still a concern to global health systems. Increased rates of documented hospital-based births are incongruent to newborn survival chances worldwide. Factors for that rather paradoxical observation are largely unknown. We aimed to assess predictors of early newborn deaths at representative metropolitan referral health facilities in Africa. Materials & methods We designed a prospective, analytical, hospital-based study in neonatal units at Dar es Salaam public regional referral hospitals, Tanzania. Neonates who died within the first 7 days of life were the target population. A pre-designed Case Report Form was the main tool for data collection. Multivariable binary logistic regression model was fitted to account for predictors of early newborn deaths after appropriate linear model validation. Proportion of early newborn deaths was the outcome variable. Results We recruited and analysed 2212 neonate-days of follow-up. Prevalence of early newborn deaths was 28.1%. Birth asphyxia (χ2 = 20.4, df = 1), preterm delivery (χ2 = 5.36, df = 1) and respiratory distress syndrome (χ2 = 30.94, df = 1) were associated with early neonatal outcomes. Predictors of early newborn deaths were neonatal respiratory rate (Tachypnoea – A.O.R.: 2.28 (95% CI.: 1.44–5.79); Bradypnoea – A.O.R.: 1.9 (95% C.I.: 1.02–12.3) and gestational age (Preterm delivery – A.O.R.: 1.48, 95% CI.: 1.11–2.09 and Post-term delivery – A.O.R.: 5.05, 95% C.I.: 4.49–32.0). Conclusions Early newborn deaths rate was relatively high in this study population. Newborns’ respiratory rates and gestational age at delivery were significant clinical factors associated with early newborn deaths in this study.