Fievre néonatale en pediatrie au niveau des centres hospitaliers universitaire et regional de Kara au Togo
Keywords:
Fever; Newborn; Neonatal infection; TogoAbstract
Introduction: Neonatal fever is a common and concerning clinical condition, posing diagnostic and prognostic challenges. The objective of this study was to investigate the epidemiological, diagnostic, therapeutic, and outcome-related aspects of fever in newborns admitted to hospitals in Kara.
Patients and Methods: This was a descriptive and analytical crosssectional study of neonatal fever conducted at the University Hospital Center and the Regional Hospital Center of Kara from February 1 to April 30, 2024. We included all neonates admitted to the neonatal unit with an axillary temperature ≥ 37.5°C, hospitalized for at least 24 hours, and who underwent at least one complete blood count and/or C-reactive protein (CRP) assay.
Results: The incidence of neonatal fever was 35.8% (153/427), with a mean age of 1.8 ± 2.6 days and a sex ratio of 1.2. Newborns were born from poorly monitored pregnancies in 18.3% of cases and to paucigravida mothers in 39.7%. Maternal history included positive hepatitis B surface antigen (HBsAg) in 14.1%, acute genital infection in 8.5%, malaria in 8%, severe preeclampsia in 5.2%, and maternal fever in 2%. Birth occurred in- hospital in 67.9% of cases, was vaginal in 78.4%, preterm in 16.3%, with neonatal asphyxia in 12.4%, and meconiumstained amniotic fluid in 26.2%. The main associated clinical signs were respiratory (26.7%) and neurological (13.7%). Dehydration was present in 13.1% of cases. A diagnosis of probable neonatal bacterial infection was retained in 81.7% of cases, with positive Creactive protein in 18.4%. Other causes of fever included dehydration and malaria. Empirical dual antibiotic therapy was initiated in 77.8% of cases. The case fatality rate was 4.6%. A significant correlation was found between age at admission and mortality (p = 0.01). Conclusion: The causes of neonatal fever are diverse and require optimization of therapeutic decision-making, as well as strengthening of technical facilities and healthcare provider capacities.
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