ARBAMINCH UNIVERSITY COLLEGE OF MEDICINE AND HEALTH SCIENCES. SCHOOL OF NURSING

Abstract

Background: Neonatal sepsis is a leading cause of neonatal deaths worldwide, accounting for approximately 15% of all neonatal fatalities. In Ethiopia, the mortality rate associated with neonatal sepsis ranges from 20% to 45 %. Despite its significant impact, limited studies have been conducted on the recovery time of neonatal sepsis. This study, therefore, aims to identify the median recovery time and the predictors influencing recovery. Understanding these factors help healt hcare providers set realistic expectations for treatment duration and improve patient outcomes among neonates with sepsis in the North Shoa Zone. Objective: The objective of this study was to determine the median time to recover of neonatal sepsis and its predictors among neonate s admitted to neonatal intensive care unit in selected public hospitals of Amhara Regional State, North Shoa Zone, Ethiopia, 2024. Method: A prospective cohort study was conducted on 351 neonates diagnosed with neonatal sepsis and admitted to neonatal intensive care units in selected public hospitals in the North Shoa Zone. The participants were selected using simple random sampling, and the study was carried out from July 12, 2024, to October 12, 2024. Data were collected using a pre tested, structured questionnaire and entered into Epidata version 4. 6 before being exported to Stata version 17 for analysis. The neonates' survival time was est imated using the log rank test, life table, and Kaplan Meier curve. In multivariable analysis, the Cox proportional hazards model was applied, with variables having a p value < 0.05 considered statistically significant predictors of mortality. The overall model fitness was assessed using the Schoenfeld residual test, with the global test result yielding a p value of 0.0851. Result: Of the 351 neonates diagnosed with sepsis, 255 (72.65%) recovered. A total of 2,663 neonate-days were observed, with the duration of individual observation ranging from a minimum of one day to a maximum of 25 days. The median recovery period was 8 (IQR 5-12 days), and the overall incidence density rate of survival was 9.57 per 100 neonate-days of observation. Significant factors associated with recovery time included respiratory failure (AHR: 6.50 [1.553–27.248]), frequency of antibiotic changes one and above (AHR: 3.12 [1.847–5.269]), and the type of medication used vancomycin +ceftazidime (AHR: 0.49 [0.283–0.859]). Conclusions The median recovery time for neonates with neonatal sepsis was higher compared to previous studies. Statistically significant predictors of recovery included respiratory failure, frequency of antibiotic changes, and the type of medication prescribed. It is crucial to provide additional care to neonates experiencing respiratory failure and ensure that any changes to antibiotic reg imens strictly adhere to treatment guidelines for effective management.