Mortalité néonatale au centre hospitalier universitaire de Tengandogo, Ouagadougou, Burkina Faso: une étude de cohorte retrospective: Neonatal mortality at Tengandogo University Hospital, Ouagadougou, Burkina Faso: a retrospective cohort study

Introduction: Selon l’organisation mondiale de la santé, les décès néonataux représentent 41% de la mortalité infanto-juvénile. L’Afrique subsaharienne a le taux de mortalité néonatale le plus élevé à 28‰. L’objectif de l’étude était de mesurer le taux de mortalité néonatale et d’identifier les facteurs associés au décès au Centre hospitalier universitaire de Tengandogo, Ouagadougou, Burkina Faso. Méthodes: Les nouveaux nés de 0 à 28 jours, hospitalisés entre le 1er janvier 2013 et le 31 décembre 2017 ont été inclus dans cette étude de cohorte rétrospective au service de néonatologie et de pédiatrie. Les informations ont été extraites à partir des dossiers cliniques. La survie a été estimée par la méthode de Kaplan Meier. Un modèle de Cox a permis d’identifier les facteurs associés. Résultats: Au total 641 nouveau-nés ont été inclus. Les enfants admis dès le premier jour de leur naissance représentaient 80%. La durée médiane de séjour était de 6 jours avec un intervalle interquartile de 3-12 jours. Les principaux diagnostics étaient la prématurité (36,05%), les infections néonatales (33,23%) et l’asphyxie (17,86%). Le taux de mortalité néonatale était de 22,25 pour 1000 personnes jours. Après ajustement, le poids de naissance inferieur 1500gramme (HRa = 4,13 ; IC 95% (2,58-6,67)) et la notion de réanimation à la naissance (HRa2,62 ; IC 95% [1,64-4,39)) étaient les facteurs de risque. Conclusion: Le taux de mortalité néonatale reste élevé. Le suivi prénatal, la prévention des infections, le renforcement des moyens de réanimation et la compétence des acteurs sont essentiels pour réduire ce taux. Introduction: According to the World Health Organization, neonatal deaths account for 41% of infant and child mortality. Sub-Saharan Africa has the highest neonatal mortality rate at 28‰. The objective of the study was to measure the neonatal mortality rate and identify factors associated with death at the Tengandogo University Hospital, Ouagadougou, Burkina Faso. Method: New-borns aged 0 to 28 days, hospitalised between 1 January 2013 and 31 December 2017 were included in this retrospective cohort study in the neonatology and paediatrics department. Information was extracted from clinical records. Survival was estimated by the Kaplan Meier method. A Cox model was used to identify associated factors. Results: A total of 641 new-borns were included. Children admitted on the first day of birth accounted for 80%. The median length of stay was 6 days with an interquartile range of 3-12 days. The main diagnoses were prematurity (36.05%), neonatal infections (33.23%) and asphyxia (17.86%). The neonatal mortality rate was 22.25 per 1000 person days. After adjustment, birth weight below 1500 grams (HRa = 4.13; 95% CI (2.58-6.67)) and the notion of resuscitation at birth (HRa2.62; 95% CI (1.64-4.39)) were the risk factors. Conclusion: The neonatal mortality rate remains high. Prenatal follow-up, infection prevention, strengthening of resuscitation resources and competence of actors are essential to reduce this rate

Seasonal variations in the Amazon plume-related atmospheric carbon sink

The Amazon River plume is a highly seasonal feature that can reach more than 3000 km across the tropical Atlantic Ocean, and cover ∼2 million km². Ship observations show that its seasonal presence significantly reduces sea surface salinity and inorganic carbon. In the western tropical North Atlantic during April–May 2003, plume-influenced stations exhibited surface DIC concentrations lowered by as much as 563 μmol C kg⁻¹ (∼28%) and pCO₂ as low as 201 μatm. We combine our data with other data sets to understand the annual uptake and seasonal variability of the plume-related CO₂ sink. Using flux estimates from all seasons with monthly plume areas determined by satellite, we calculate the annual carbon uptake by the outer plume alone (28 < S < 35) to be 15 ± 6 TgC yr⁻¹. Diazotroph-supported net community production enhanced the air-sea CO₂ disequilibrium by 100x and reversed the typical CO₂ outgassing from the tropical North Atlantic. The carbon sink in the Amazon plume depends on climate-sensitive conditions that control river hydrology, CO₂ solubility, and gas exchange

A prospective study on neonatal mortality and its predictors in a rural area in Burkina Faso: can MDG-4 be met by 2015?

OBJECTIVE: To measure the neonatal mortality rate (NMR) and investigate its predictors in a rural area of Burkina Faso. STUDY DESIGN: A cohort of infants born in 24 villages in Banfora region was followed until the children were 6 months old. We estimated the risk of neonatal death and used logistic regression to identify its predictors. RESULT: Among 864 live births followed to day 28, there were 40 neonatal deaths, a NMR of 46.3 per 1000 live births (95% confidence intervals (CI): 22 to 70). Multivariable regression identified twin birth (OR=11.5, 95% CI: 4.5 to 29.8), having a nulliparous mother (odds ratio (OR)=4.3, 95% CI: 1.5 to 12.1), and birth into a polygynous household (OR=2.1, 95% CI: 1.0 to 4.7) as main predictors of neonatal death. CONCLUSION: The burden of neonatal mortality in rural Burkina Faso is very high and the observed NMRs in a predominantly rural country suggest that it is unlikely Burkina will meet fourth Millennium Development Goal (MDG-4) by 2015