Neonatal Near-Misses in Ghana: A Prospective, Observational, Multi-Center Study
| العنوان: | Neonatal Near-Misses in Ghana: A Prospective, Observational, Multi-Center Study |
|---|---|
| المؤلفون: | Gyikua Plange-Rhule, Richard Adanu, Samuel A. Oppong, Cyril Engmann, Yemah Bockarie, Ashura Bakari, Priscilla Wobil, Cheryl A. Moyer, April J. Bell, Bamenla Q. Goka |
| المصدر: | BMC Pediatrics, Vol 19, Iss 1, Pp 1-10 (2019) BMC Pediatrics |
| بيانات النشر: | Research Square Platform LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Pediatrics, medicine.medical_specialty, Neonatal morbidity, Near Miss, Healthcare, Neonatal near-miss indicators, Near miss, Ghana, Infant, Newborn, Diseases, Odds, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Neonatal mortality, 030505 public health, business.industry, Incidence (epidemiology), Infant, Newborn, lcsh:RJ1-570, lcsh:Pediatrics, 3. Good health, Standardized mortality ratio, Multi center study, Pediatrics, Perinatology and Child Health, Gestation, Observational study, 0305 other medical science, business, Research Article |
| الوصف: | Background For every newborn who dies within the first month, as many as eight more suffer life-threatening complications but survive (termed ‘neonatal near-misses’ (NNM)). However, there is no universally agreed-upon definition or assessment tool for NNM. This study sought to describe the development of the Neonatal Near-Miss Assessment Tool (NNMAT) for low-resource settings, as well as findings when implemented in Ghana. Methods This prospective, observational study was conducted at two tertiary care hospitals in southern Ghana from April – July 2015. Newborns with evidence of complications and those admitted to the NICUs were screened for inclusion using the NNMAT. Incidence of suspected NNM at enrollment and confirmed near-miss (surviving to 28 days) was determined and compared against institutional neonatal mortality rates. Suspected NNM cases were compared with newborns not classified as a suspected near-miss, and all were followed to 28 days to determine odds of survival. Confirmed near-misses were those identified as suspected near-misses at enrollment who survived to 28 days. The main outcome measures were incidence of NNM, NNM:mortality ratio, and factors associated with NNM classification. Results Out of 394 newborns with complications, 341 (86.5%) were initially classified as suspected near-misses at enrollment using the NNMAT, with 53 (13.4%) being classified as a non-near-miss. At 28-day follow-up, 68 (17%) had died, 52 (13%) were classified as a non-near-miss, and 274 were considered confirmed near-misses. Those newborns with complications who were classified as suspected near-misses using the NNMAT at enrollment had 12 times the odds of dying before 28 days than those classified as non-near-misses. While most confirmed near-misses qualified as NNM via intervention-based criteria, nearly two-thirds qualified based on two or more of the four NNMAT categories. When disaggregated, the most predictive elements of the NNMAT were gestational age Conclusions This research suggests that the NNMAT is an effective tool for assessing neonatal near-misses in low-resource settings. We believe this approach has significant systems-level, continuous quality improvement, clinical and policy-level implications. |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7ab23c057c91092bb2d583ea403d97deTest https://doi.org/10.21203/rs.2.12768/v3Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....7ab23c057c91092bb2d583ea403d97de |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |