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Disease Profile and Hospital Outcome of Newborn Admitted to Neonatal Intermediate Care Unit at Tertiary Care Center in Nepal
Chapagain RH, Basaula YN, Kayatha M, Adhikari K, Shrestha SM


Abstract:
Background Neonatal mortality rate (NMR) is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, Care of sick children can be done better so as to aid in reducing neonatal mortality rate. Objective The objective was to identify pattern of diseases and outcome admitted to Neonatal Intermediate care Unit (NIMCU). Method A retrospective study was conducted at Neonatal Intermediate care Unit of Kanti Children’s hospital from Bhadra 2071 to Shravan 2073 (August 2014 to July 2016). Result Total 1286 neonates were admitted in Neonatal Intermediate care Unit with the highest admission in the months of Bhadra (August-September) 12.52% and the lowest in Push (December-January) 4.82%. Among the admitted cases, 1,028 (80.0%) were full term while 256 (20.0%) were preterm. Among the total admission, 43.6% were less than 7 days old which is the most vulnerable period during the newborn phase. Admission due to neonatal sepsis was 892 (69.36%). Among them, 628 (70.40%) were late onset neonatal sepsis while 264 (29.60%) were early onset. Neonatal jaundice accounted for 12.36% (159) of the cases while Hypoxic Ischemic Encephalopathy accounted for 4.80% (62) of cases. Congenital Heart Disease were 53 (4.12%) and neonatal pustulosis were 27 (2.20%). Meningitis accounted for 45 (3.49%) of cases and UTI 29 (2.22). Death during treatment were 18 (1.39%). 7% of cases deteriorated and referred to NICU while, 3.2 % of cases were referred to other centers and 5.1% of cases were either discharged on request or left against medical advice. Conclusion Neonatal sepsis including both early and late onset, Congenital Heart disease, birth asphyxia and neonatal Jaundice accounted for majority of admission in NICU. Three of four these etiologies are preventable up to some extent.
Keyword : Morbidity, mortality neonate, sepsis, outcome