Prevalence and Outcome of Neonatal Sepsis at the Benue State University Teaching Hospital, Makurdi
Keywords:
Hospital, Neonatal, Outcomes, Risk factor, SepsisAbstract
Sepsis is a major global health threat with a high incidence and mortality, particularly in low- and middle-income countries such as Nigeria. Infections in the newborn used to be the 3rd leading cause of neonatal morbidity and
mortality in Nigeria, but recent surveys have shown that it is becoming a leading cause of mortality in newborns. Hence, this study was undertaken to determine the prevalence and outcomes of neonatal sepsis at the Benue State University Teaching Hospital, Makurdi. A cross-sectional study was conducted from November 2024 to August 2025, involving neonates presenting with symptoms suggestive of neonatal sepsis. Data was collected using an interviewer- administered questionnaire and analysed using IBM SPSS version 23. A total of 150 neonates were recruited, with a mean birth weight of 2.26±0.81kg. Of the 150 neonates, 52 (34.7%) were in-born neonates, while 98(65.3%) were out- born. The most frequently reported neonatal clinical features were: fever 81 (54.0%), fast breathing 53(35.3%), refusal to feed 34(22.7%), foetal distress 25 (16.7%), APGAR score <7, 23 (15.3%), hypothermia 21(14.0%), respectively. Seventy-four (49.3%) neonates had positive blood culture, with a prevalence of 49.3%. A total of 114 (76.0%) neonates were managed and discharged, while mortality occurred in 26 (17.3%). Neonatal sepsis remains a significant cause of
preventable mortality that requires continual surveillance to achieve a reduction in line with the SDG 3.2 goal.
References
1. United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME), 'Levels & Trends in Child Mortality: Report 2019, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation', United Nations Children's Fund, New York, 2020. https://data.unicef.org. Accessed 1st September 2020
2. WHO. Global report on the epidemiology and burden of sepsis: current evidence, identifying gaps and future directions. Geneva: World Health Organization; 2020. https//www.who.int/publications/i/item/9789240010789 Accessed 9th September, 2020
3. United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME), 'Levels & Trends in Child Mortality: Report 2023, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation', United Nations Children's Fund, New York, 2024 https://data.unicef.org Accessed 13th March 2024
4. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, MD, Bauer M, et al. Definitions for Sepsis and Septic Shock. Special Communication Clinical Review& Education. JAMA. 2016;315(8):801-810. Doi:10.1001/jama.2016.0287
5. Stoll BJ, Shane AL. Infections of the neonatal infant. In: Kleigman RM, Stanton BF, St Geme JW, Schor NF (eds). Nelson Textbook of Paediatrics, 20th ed. Philadelphia, WB Saunders Company 2015:909-920
6. Baqui AH, Saha SK, Ahmed ASMNU, Shahidullah M, Quasem I, Roth DE, et al. Safety and efficacy of alternative antibiotic regimens compared with 7-day injectable procaine benzylpenicillin and gentamicin for outpatient treatment of neonates and young infants with clinical signs of severe infection when referral is not possible: A randomised, open-label, equivalence trial. Lancet Glob Health. 2015;3: e279–87. Doi:10.1016/S2214-109X (14)70347-X
7. Ekwochi U, Onah SK, Ndu IK. Bacterial profile and antibiogram of neonatal sepsis in Nigeria: Literature review. Anatol J Family Med. 2020;3(1):2–9 Doi: 10.5505/anatoljfm.2020.37450
8. Iroh Tam PY, Bekker A, Bosede Bolaji O, Chimhini G, Dramowski A, Fitzgerald F, et al. Neonatal sepsis and antimicrobial resistance in Africa. The Lancet Child and Adolescent Health. 2023;7: 677–9. Doi:10.1016/S2352-4642(23)00167-0
9. Medugu N, Iregbu K, Tam PYI, Obaro S. Aetiology of neonatal sepsis in Nigeria, and relevance of group b streptococcus: A systematic review. PLoS ONE. 2018;13(7): e0200350. Doi: 10.1371/journal.pone.0200350
10. Federal Ministry of Health. Nigeria Every Newborn Action Plan: A plan to end preventable newborn deaths in Nigeria. Federal Ministry of Health. Abuja, Nigeria, 2016.https://www.health.gov.ng Accessed 6th September, 2020
11. Federal Ministry of Health. National Guidelines for Comprehensive Newborn Care. Federal Ministry of Health. Abuja, Nigeria, 2021.https://www.health.gov.ng Accessed 8th April, 2024
12. Odejimi A, Quinley J, Eluwa GI, Kunnuji M, Wammanda RD, Weiss W, et al. Causes of deaths in neonates and children aged 1–59 months in Nigeria: verbal autopsy findings of 2019 Verbal and Social Autopsy Study. BMC Public Health. 2022; 22:1130 Doi:10.1186/s12889-022-13507-z
13. Bech CM, Stensgaard CN, Lund S, Holm-Hansen C, Brok JS, Nygaard U, et al. Risk factors for neonatal sepsis in Sub-Saharan Africa: A systematic review with meta-analysis. BMJ Open 2022;12: e054491. Doi:10.1136/bmjopen-2021-054491
14. WHO. International Statistical Classification of Diseases and related Health problems, Tenth Revision, 4th Ed. Geneva: World Health Organization;2011: www.who.int/classifications. Accessed 21st December, 2020
15. Rosenberg RE, Ahmed ASM, Ahmed S, Saha SK, Chowdhury MAK, Black RE et al. Determining gestational age in a low-resource setting: validity of last menstrual period. J Health Popul Nutr 2009;27(3):332-338.
16. Opara P. Gestational age assessment in the newborn- a review. Int J Pediatr Neonato 2009;12(2):1-9
17. Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Paediatrics. 2013; 13:59 Doi:10.1186/1471-2431-13-59.
18. Olorukooba A, Ifusemu W, Ibrahim M, Jibril M, Amadu L, Lawal B. Prevalence and factors associated with neonatal sepsis in a tertiary hospital, North West Nigeria. Niger Med J. 2020; 61:60-66. Doi: 10.4103/nmj.NMJ_31_19
19. Shobowale E, Solarin A, Elikwu C, Onyedibe K, Akinola I, Faniran A. Neonatal sepsis in a Nigerian private tertiary hospital: Bacterial isolates, risk factors, and antibiotic susceptibility patterns. Ann Afr Med. 2017;16(2): 52–58. Doi: 10.4103/aam.aam_34_16
20. Iregbu KC, Elegba OY, Babaniyi IB. Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria. African Health Sciences 2006; 6(3): 151-154
21. Onyedibe K, Bode-Thomas F, Afolaranmi T, Okolo M, Banwat E, Egah D. Bacteriologic Profile, Antibiotic Regimen and Clinical Outcome of Neonatal Sepsis in a University Teaching Hospital in North Central Nigeria. Br J Med Med Res. 2015; 7(7):567–579. Doi:10.9734/BJMMR/2015/16150
22. Arowosegbe AO, Ojo DA, Dedeke IO, Shittu OB, Akingbade OA. Neonatal sepsis in a Nigerian Tertiary Hospital: Clinical features, clinical outcome, aetiology and antibiotic susceptibility pattern. South African J Infect Dis. 2017; 32:127–31. Doi:10.1080/23120053.2017.1335962
23. Mokuolu OA, Jiya N, Adesiyun OO. Neonatal septicaemia in Ilorin: bacterial pathogens and antibiotic sensitivity pattern. Afr. J. Med. med. Sci 2002; 31:127-130
24. Ihekaike MM, Uhunmwangho-Courage A, Izugbara DC, Shehu M, Thielen BK, White AM, et al. Prevalence of Neonatal Sepsis in a Tertiary Hospital in os: A Five-Year Retrospective Study.Cureus 2025;17(5): e84416. Doi:10.7759/cureus.84416
25. Mezgebu T, Ossabo G, Zekiwos A, Mohammed H, Demisse Z, (2023). Neonatal sepsis and its associated factors among neonates admitted to the neonatal intensive care unit in Wachemo University Comprehensive Specialized Hospital, Southern Ethiopia, 2022. Frontiers in Paediatrics, 2023: 11:1184205. Doi:10.3389/fped.2023.1184205.
26. Karmila A, Barchia I, Ramandati A, Zhang L. Clinical and bacteriological profile of culture-negative and culture-proven neonatal sepsis in Palembang, Indonesia. J Infect Dev Ctries 2022; 16:1887–1896. Doi: 10.3855/jidc.14638
27. Ahmed SA, Shah M, Ameley A, Mosuka E, Ericksen K. Culture negative sepsis in neonate in a level III NICU of a community hospital in Brooklyn New York. Int J Contemp Paediatrics. 2025; 12(2):154–8. Doi:10/18203/2349-329.ijcp20250079.
28. Klingenberg C, Kornelisse RF, Buonocore G, Maier RF, Stocker M. Culture-Negative Early-Onset Neonatal Sepsis - At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship. Front Paediatr. 2018; 9; 6:285. Doi:10.3389/fped.2018.00285.
29. Flannery DD, Green MB. Antibiotics for culture-negative neonatal early-onset sepsis: measuring the unmeasurable. Paediatr Res 2025: 97:1443–1445 Doi:10.1038/s41390-024-03761-9
30. Milton R, Gillespie D, Dyer C, Taiyari K, Carvalho MJ, Thomson K, et al. Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study. Lancet Glob Health 2022;10: e661-72. www.thelancet.com/lancetgh
31. Uwe NO, Ezenwa BN, Fajolu IB, Oshun P, Chukwuma ST, Ezeaka VC. Antimicrobial susceptibility and neonatal sepsis in a tertiary care facility in Nigeria: A changing trend? JAC Antimicrob Resist. 2022;4(5): dlac100. Doi.10.1093/jacamr/dlac100
32. Mustapha SS, Zaidu AM, Azaria NT, Aliyu S, Abdulkadir I. Neonatal sepsis-a peek into our findings in Northwest Nigeria: a prospective study. Egyptian Paediatric Association Gazette, 2024;72(1), 1-9. Doi:10.1186/s43054-024-00294-y
33. Traoré FB, Sidibé CS, Diallo EHM, Camara BS, Sidibé S, Diallo A, et al. Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis. Front Public Health. 2024; 12:1272193. Doi:10.3389/fpubh.2024.1272193
34. Ekwochi U, Ifediora C, Osuorah CI. A 4-Year prospective study of clinico-bacterial profile and antibiogram of neonatal bacterial sepsis at a tertiary health facility in a resource-limited setting. J Clin Neonatol. 2018; 7:80-88. Doi: 10.4103/jcn.JCN_6_18.
