Neonatal morbidity and mortality in the pediatric ward at the Ambohimiandra Antananarivo Madagascar hospital

Background: The 28 firsts days of life have high-risk of diverse aggression. To achieve the goal of ODD3 in reducing preventable neonatal death, our study was to evaluate main pathologies of newborn, newborn’s mortality.Methods: This is a retrospective descriptive and analytical cross-sectional study extending over a period of 8 months, December 2014 to July 2015.Results: We collected 132 newborn, the sex ratio was 1.13. Main newborn’s pathologies are neonatal infection (59.85%). Mortality rate was 14.39% and majority of neonatal death occurs early (73.68% of all deaths). Main causes of death are neonatal infection by septic shock. The most lethal pathology was hypoxic-ischemic encephalopathy. We have identified as a risk factor for neonatal death: admission age of 24 hours or less (OR 7; 95% CI 2.5-20.10; p = 0.00006), presence of resuscitation at birth (OR 3.48, 95% CI 1.28-9.44, p = 0.01), Apgar index less than 7 at the fifth minute (OR 4.22, 95% CI 2.25-14.87, p = 0.03) and birth weight less than 2500g (OR 3.80, 95% CI 1.39-10.36, p = 0.006).Conclusions: The mortality rate remains high. The prevention of low birth weight, asphyxia and infections has shown strategies to reduce neonatal morbidity and mortality

Psychosocial experience of mothers of children with sickle cell disease in Antananarivo and Toamasina, Madagascar

Background: Sickle cell disease in children can disrupt life of their mothers who are at the forefront of care. The objectives of this study were to describe the psychosocial experience of these mothers, to identify factors associated to maternal anxiety and depressive disorders.Methods: A cross-sectional study was conducted from December 2017 to February 2018 with mothers of children with sickle cell disease under the age of 15 in Antananarivo and Toamasina. The abbreviated Beck and Hamilton scales were used to assess respectively depression and anxiety.Results: Of 134 mothers surveyed, 61.2% had depression and 35.8% had anxiety. Depression significantly affected mothers with more than one child with sickle cell disease (aOR=4.31, CI- 1.12-16.58) and mothers of children hospitalized at least three times per year for vaso-occlusive crisis (aOR=13.55, CI- 1.56-117.5). Anxiety was associated with blood transfusion more than three times (aOR=9.06, CI- 2.05-40.00). Pity (74.6%) and fear of death (55.2%) were the main feelings reported. Negative occupational repercussions were reported by 48.5% of mothers, marital conflict by 15.6%, financial difficulties by 43.3%.Conclusions: A global approach focused on the child and his family would be optimal for success in the management of pediatric sickle cell disease

Hospitalizations in neonatal intensive care unit at Mahajanga: impacts on parents

Background: Experiencing a birth with a pathology imposes on parents a lot of frustration. Objectives of this study were to describe the general profiles of newborns and to describe the hospitalization’s psychosomatic impact on parents; in intensive care unit of the neonatalogy ward at the mother-child complex at the university Hospital Androva Mahajanga Madagascar.Methods: It was prospective descriptive study, by a survey of parents, among 3 months, from 01st May to 31th July.Results: Were included 102 newborns. Mains reasons of admission are low birth weigth (51.9%), prematurity (42.1%) and perinatal asphyxia (23.5%). One hundred mothers and 90 fathers had answered our survey. Sleep distturance (all parents), negative feelings (70% of fathers and 75% of mothers), depressed mood (52.2% of fathers and 78% of mothers) and guilt (25.5% of fathers and 58% of mothers) were the most prominent psycological manifestations among parents; then somatic manifestations as digestive, cardiovascular type; weight loss was objectified on 33% of fathers.Conclusions: Newborns’s hospitalization is a difficult situation for parents. Caregivers have an important role in enabling the family to build up

Neonatal morbidity and mortality in the pediatric ward at the Ambohimiandra Antananarivo Madagascar hospital

Background: The 28 firsts days of life have high-risk of diverse aggression. To achieve the goal of ODD3 in reducing preventable neonatal death, our study was to evaluate main pathologies of newborn, newborn’s mortality.Methods: This is a retrospective descriptive and analytical cross-sectional study extending over a period of 8 months, December 2014 to July 2015.Results: We collected 132 newborn, the sex ratio was 1.13. Main newborn’s pathologies are neonatal infection (59.85%). Mortality rate was 14.39% and majority of neonatal death occurs early (73.68% of all deaths). Main causes of death are neonatal infection by septic shock. The most lethal pathology was hypoxic-ischemic encephalopathy. We have identified as a risk factor for neonatal death: admission age of 24 hours or less (OR 7; 95% CI 2.5-20.10; p = 0.00006), presence of resuscitation at birth (OR 3.48, 95% CI 1.28-9.44, p = 0.01), Apgar index less than 7 at the fifth minute (OR 4.22, 95% CI 2.25-14.87, p = 0.03) and birth weight less than 2500g (OR 3.80, 95% CI 1.39-10.36, p = 0.006).Conclusions: The mortality rate remains high. The prevention of low birth weight, asphyxia and infections has shown strategies to reduce neonatal morbidity and mortality