Blood infections, a silent killer in newborn babies
Sep 12, 2011
FINELA Asiimwe, a first-time mother, had made arrangements to deliver from a main hospital, but things did not go as the 26-year-old had planned.
FINELA Asiimwe, a first-time mother, had made arrangements to deliver from a main hospital, but things did not go as the 26-year-old had planned.
“Labour began in the middle of the night and I could not find transport to the hospital. My mother called in a midwife to help,†she recalls.
A week later, the baby developed a fever, became irritable and refused to breastfeed. When Asiimwe took the baby to hospital, it was diagnosed with septicemia. Much as the baby was put on treatment, it died.
Dr. Sabrina-Bakera Kitaka, a paediatrician at Mulago Hospital, describes septicemia as an infection resulting from bacteria growing in a newborn baby’s blood stream before it is one-month-old.
According to an analysis of the 2007 newborn health report, 31% of deaths in newborn babies in Uganda are due to infections. A study conducted between June and August, 2011, revealed that the prevalence of neonatal sepsis in Mulago Hospital is 37.5%, with a mortality of 18.8%.
Signs and symptoms
Dr Jessca Nakibuka, a paediatrician in Mulago Hospital, notes that a baby with blood infection has a grossly high fever, general body weakness, rapid breathing, sleeps a lot, refuses to breastfeed, is irritable and cries uncontrollably. In addition, septicemia may be detected by symptoms of intestinal infection, for example, vomiting and diarrhoea.
Causes
According to the 2007 newborn health report, poor care practices take the lead in increasing the risk of infections.
Kitaka cites situations where a mother has an infection in the birth canal. Another cause could be the use of unsterile equipment.
Dr. Jolly Nankunda, a neonatologist at Mulago special care unit, adds that poor umbilical cord care such as mothers using cow dung and other cultural practices, for example, the use of ekyogero could expose the baby to infection. Sharing bathing material with the newborn baby also put it at risk of infection.
Who is at risk?
Nankunda explains that all newborn babies are prone to blood infections, but premature babies are at a higher risk because their defence mechanism is not fully developed.
In addition, children born with HIV are susceptible to severe blood infection. Also, if a mother is not immunised against tetanus, the chances of the baby getting neonatal tetanus are high.
Diagnosis
Kitaka notes that a sepsis screen is done to confirm the presence of neonatal septicemia. Blood culture, umbilical swab, urinalysis and sometimes a lumber puncture (removing spinal cord fluid) may also be done.
Treatment
Nakibuka says once a child is confirmed to have septicemia, it should be started on treatment immediately. The baby is admitted for a minimum of 10 days and put on intravenous antibiotic.
Prevention
Nankunda advises mothers and caretakers to minimise the number of people who come in contact with the baby. Those who do so should wash their hands with soap and water to avoid transfer of infections to the baby. There is need to observe a clean environment during childbirth and when caring for the baby.
Expectant mothers should attend antenatal care, as well as get immunised.
“Labour began in the middle of the night and I could not find transport to the hospital. My mother called in a midwife to help,†she recalls.
A week later, the baby developed a fever, became irritable and refused to breastfeed. When Asiimwe took the baby to hospital, it was diagnosed with septicemia. Much as the baby was put on treatment, it died.
Dr. Sabrina-Bakera Kitaka, a paediatrician at Mulago Hospital, describes septicemia as an infection resulting from bacteria growing in a newborn baby’s blood stream before it is one-month-old.
According to an analysis of the 2007 newborn health report, 31% of deaths in newborn babies in Uganda are due to infections. A study conducted between June and August, 2011, revealed that the prevalence of neonatal sepsis in Mulago Hospital is 37.5%, with a mortality of 18.8%.
Signs and symptoms
Dr Jessca Nakibuka, a paediatrician in Mulago Hospital, notes that a baby with blood infection has a grossly high fever, general body weakness, rapid breathing, sleeps a lot, refuses to breastfeed, is irritable and cries uncontrollably. In addition, septicemia may be detected by symptoms of intestinal infection, for example, vomiting and diarrhoea.
Causes
According to the 2007 newborn health report, poor care practices take the lead in increasing the risk of infections.
Kitaka cites situations where a mother has an infection in the birth canal. Another cause could be the use of unsterile equipment.
Dr. Jolly Nankunda, a neonatologist at Mulago special care unit, adds that poor umbilical cord care such as mothers using cow dung and other cultural practices, for example, the use of ekyogero could expose the baby to infection. Sharing bathing material with the newborn baby also put it at risk of infection.
Who is at risk?
Nankunda explains that all newborn babies are prone to blood infections, but premature babies are at a higher risk because their defence mechanism is not fully developed.
In addition, children born with HIV are susceptible to severe blood infection. Also, if a mother is not immunised against tetanus, the chances of the baby getting neonatal tetanus are high.
Diagnosis
Kitaka notes that a sepsis screen is done to confirm the presence of neonatal septicemia. Blood culture, umbilical swab, urinalysis and sometimes a lumber puncture (removing spinal cord fluid) may also be done.
Treatment
Nakibuka says once a child is confirmed to have septicemia, it should be started on treatment immediately. The baby is admitted for a minimum of 10 days and put on intravenous antibiotic.
Prevention
Nankunda advises mothers and caretakers to minimise the number of people who come in contact with the baby. Those who do so should wash their hands with soap and water to avoid transfer of infections to the baby. There is need to observe a clean environment during childbirth and when caring for the baby.
Expectant mothers should attend antenatal care, as well as get immunised.