ANALYSIS OF DETERMINANTS OF MORTALITY AMONG NEWBORNS WITH BACTERIAL INFECTION ADMITTED TO THE MOTHER AND CHILD UNIVERSITY HOSPITAL CENTER (CHU-ME) OF N’DJAMENA, CHAD

Ngaringuem Adrienne*, Ildjima Ousman K., Aché Danama K., Djidita Hagré Y., Hassan Adam A., Damtheo Sajoli

ABSTRACT

Introduction: Neonatal bacterial infections are a major cause of mortality in low-resource countries. In Chad, recent data to guide clinical management remain scarce. This study aimed to identify factors associated with mortality among infected newborns admitted to the Mother and Child University Hospital Center (CHU-ME) of N’Djamena. Methods: A retrospective descriptive and analytical study was conducted from January 2023 to April 2024. All newborns hospitalized for confirmed or suspected bacterial infection were included. Clinical, biological, and microbiological data were analyzed. Factors associated with mortality were identified using multivariate logistic regression. Statistical significance was set at p < 0.05. Results: Of the 2,400 newborns hospitalized during the study period, 720 had bacterial infections, yielding a prevalence of 30%. The overall mortality rate was 16.7%. The most frequently isolated pathogens were Escherichia coli (36%) and Streptococcus agalactiae (28%). High resistance rates to ampicillin (65%) and gentamicin (42%) were observed. In multivariate analysis, prematurity (adjusted OR = 2.6; p = 0.004), low birth weight (adjusted OR = 3.1; p = 0.001), and respiratory distress at admission (adjusted OR = 2.4; p = 0.02) were independently associated with mortality. Conclusion: Infectious neonatal mortality at CHU-ME remains high and is mainly related to neonatal immaturity and initial disease severity. Revising antibiotic protocols, strengthening perinatal screening, and improving neonatal intensive care are priorities to enhance survival.

Keywords: determinants, mortality, infection, newborns, Chad.