Neonatal seizures in a rural Kenyan District Hospital: aetiology, Incidence and outcome of hospitalization

BMC Medicine

Research Article

Michael Mwaniki¹  Ali Mathenge¹  Evasius Bauni¹  Samson Gwer¹  Neema Mturi¹  James Berkley²  Charles RJC Newton³  Richard Idro⁴ 

[1] Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, PO Box 230, Kilifi, Kenya;Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, PO Box 230, Kilifi, Kenya;Centre for Clinical Vaccinology, and Tropical Medicine University of Oxford Churchill Hospital Oxford, OX3 7LJ, UK;Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, PO Box 230, Kilifi, Kenya;Clinical Research Unit, London School of Hygiene and Tropical Medicine, London, UK;Neurosciences Unit, UCL-Institute of Child Health, The Wolfson Centre, Mecklenburgh Square, WC1N 2AP, London, UK;Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, PO Box 230, Kilifi, Kenya;Department of Paediatrics and Child Health, Mulago Hospital/Makerere University Medical School, Kampala, Uganda;

关键词: Bacterial Meningitis;    Neonatal Sepsis;    Neonatal Seizure;    Neonatal Resuscitation;    Neonatal Jaundice;   

DOI  :  10.1186/1741-7015-8-16

 received in 2010-03-02, accepted in 2010-03-17,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundAcute seizures are common among children admitted to hospitals in resource poor countries. However, there is little data on the burden, causes and outcome of neonatal seizures in sub-Saharan Africa. We determined the minimum incidence, aetiology and immediate outcome of seizures among neonates admitted to a rural district hospital in Kenya.MethodsFrom 1st January 2003 to 31st December 2007, we assessed for seizures all neonates (age 0-28 days) admitted to the Kilifi District Hospital, who were resident in a defined, regularly enumerated study area. The population denominator, the number of live births in the community on 1 July 2005 (the study midpoint) was modelled from the census data.ResultsSeizures were reported in 142/1572 (9.0%) of neonatal admissions. The incidence was 39.5 [95% confidence interval (CI) 26.4-56.7] per 1000 live-births and incidence increased with birth weight. The main diagnoses in neonates with seizures were sepsis in 85 (60%), neonatal encephalopathy in 30 (21%) and meningitis in 21 (15%), but only neonatal encephalopathy and bacterial meningitis were independently associated with seizures. Neonates with seizures had a longer hospitalization [median period 7 days - interquartile range (IQR) 4 to10] -compared to 5 days [IQR 3 to 8] for those without seizures, P = 0.02). Overall, there was no difference in inpatient case fatality between neonates with and without seizures but, when this outcome was stratified by birth weight, it was significantly higher in neonates ≥ 2.5 kg compared to low birth weight neonates [odds ratio 1.59 (95%CI 1.02 to 2.46), P = 0.037]. Up to 13% of the surviving newborn with seizures had neurological abnormalities at discharge.ConclusionThere is a high incidence of neonatal seizures in this area of Kenya and the most important causes are neonatal encephalopathy and meningitis. The high incidence of neonatal seizures may be a reflection of the quality of the perinatal and postnatal care available to the neonates.

【 授权许可】

CC BY   
© Mwaniki et al; licensee BioMed Central Ltd. 2010