Characteristics, interventions, and status of infants discharged from 14 hospitals in the African Neonatal Network, 2024
Keywords:
Infant, Newborn; Premature; Neonatal mortality; Registries; Hospitals, Pediatric/statistics and numerical data; Outcome Assessment, Health Care; Africa South of the Sahara; Global HealthAbstract
Background: Sub- Saharan Africa has the world’s highest neonatal mortality rate; however, availability of high quality patient-level data remains limited. To address this gap, the African Neonatal Network (ANN) was established in 2023 through a partnership between the African Neonatal Association and Vermont Oxford Network. This study presents baseline data from the first year of ANN activity.
Methods: Infants admitted to a neonatal unit within the first 28 days and discharged between January 1 and December 31, 2024, in 14 hospitals located in Ethiopia, Nigeria, Rwanda, Uganda, and Zimbabwe were included. All analyses use descriptive statistics.
Results: A total of 11,791 infants were discharged in 2024. Median gestational age was 38 weeks (IQR 35–40), median birth weight was 2,880 grams (IQR 2,140– 3,370) and 26% were small for gestational age. Antibiotics were administered to 65% of infants, 33% received CPAP, and 47% achieved normothermia on admission. The most common diagnoses included early-onset sepsis (33%), hyperbilirubinemia (25%), and respiratory distress (24%). Among infants born <32 weeks, 59% were exposed to antenatal steroids, 52% received methylxanthines, 20% had a cranial ultrasound and 12% received a retinal examination. Of 169 infants screened, 53% had retinopathy of prematurity. Overall survival to discharge was 85%. Among survivors, 95% were discharged on human milk alone, and 41% had discharge weights < 10th percentile.
Conclusion: These data provide a valuable snapshot of neonatal care across diverse African hospitals and highlight several areas for improvement, including thermal care, antimicrobial stewardship, and specialized care and screening for preterm infants.
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