Prevalence of neonatal sepsis among neonates admitted to a neonatal intensive care unit in a university hospital in eastern Ethiopia: A cross-sectional study

Background: Neonatal sepsis is a leading cause of neonatal mortality, yet data on its prevalence and associated factors remain limited. This study aimed to assess the prevalence of neonatal sepsis and associated factors among neonates admitted to the neonatal intensive care unit of a university hospital in eastern Ethiopia. 

Methods: An institution-based cross-sectional study was conducted on randomly selected neonates admitted to the NICU of Hiwot Fana Comprehensive Specialized Hospital from January 1, 2016 to December 31, 2019. Sociodemographic and feto-maternal data were collected and analyzed using Epi Data 3.1 and Stata 14. Bivariate and multivariate analyses identified factors associated with neonatal sepsis through binary logistic regression, presenting results as adjusted odds ratios (AORs) with 95% confidence intervals (CIs), with statistical significance set at p < 0.05. 

Results: Of the 414 neonates included, with a mean age of 3.6 (±2.3 SD) days, 264 (63.7%) were diagnosed with neonatal sepsis. Significant factors associated with neonatal sepsis included; being under seven days old (AOR = 2.18), rural residence (AOR = 1.70), lack of antenatal care (AOR = 0.61), premature rupture of membranes (AOR = 1.66), shorter labor duration (AOR = 0.40), meconium-stained amniotic fluid (AOR = 1.92), birth asphyxia (AOR = 2.25), and neonatal comorbidity (AOR = 1.98). 

Conclusion: Nearly two-thirds of NICU-admitted neonates had sepsis, with associations such as age, rural residence, and lack of antenatal care, premature rupture of membranes, shorter labor duration, meconium-stained amniotic fluid, birth asphyxia, and neonatal comorbidity highlighting the need for targeted interventions to improve outcomes.