Impact of respiratory distress syndrome and birth asphyxia exposure on the survival of preterm neonates in East Africa continent: systematic review and meta-analysis

Ermias Sisay Chanie; Abebew Yeshambel Alemu; Demewoze Kefale Mekonen; Biruk Demissie Melese; Binyam Minuye; Habtamu Shimels Hailemeskel; Worku Necho Asferie; Wubet Alebachew Bayih; Tigabu Munye; Tekalign Amera Birlie; Abraham Tsedalu Amare; Nigusie Selomon Tibebu; Chalie Marew Tiruneh; Getasew Legas; Fisha Alebel Gebre Eyesus; Demeke Mesfin Belay

doi:10.1016/j.heliyon.2021.e07256

Impact of respiratory distress syndrome and birth asphyxia exposure on the survival of preterm neonates in East Africa continent: systematic review and meta-analysis

Heliyon. 2021 Jun 8;7(6):e07256. doi: 10.1016/j.heliyon.2021.e07256. eCollection 2021 Jun.

Authors

Ermias Sisay Chanie¹, Abebew Yeshambel Alemu¹, Demewoze Kefale Mekonen¹, Biruk Demissie Melese², Binyam Minuye³, Habtamu Shimels Hailemeskel³, Worku Necho Asferie³, Wubet Alebachew Bayih³, Tigabu Munye⁴, Tekalign Amera Birlie⁴, Abraham Tsedalu Amare⁴, Nigusie Selomon Tibebu¹, Chalie Marew Tiruneh¹, Getasew Legas⁵, Fisha Alebel Gebre Eyesus⁶, Demeke Mesfin Belay¹

Affiliations

¹ Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
² Department of Environmental Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
³ Department of Maternity and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
⁴ Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
⁵ Department of Psychiatric, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
⁶ Department of Nursing, College of Health Sciences, Wolkitie University, Wolkitie, Ethiopia.

Abstract

Introduction: Several kinds of researches are available on preterm mortality in the East Africa continent; however, it is inconsistent and inconclusive, which requires the pooled evidence to recognize the burden in general.

Purpose: To collect and synthesis evidence on preterm mortality and identify factors in the East Africa continent.

Methods: PubMed, Google Scholar, Hinary, Cochrane library, research gate, and institutional repositories were retrieved to identity eligible articles through Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The articles were selected if the publication period is between 2010-2021 G.C. Data were extracted by a standardized JBI data extraction format for mortality rate and stratified the associated factors. Then exported to STATA 14 for further analysis. I² and Egger's tests were employed to estimate the heterogeneity and publication bias respectively. Subgroup analysis based on country, study design, year of publication, and the sample size was also examined.

Result: This meta-analysis included 32 articles with a total of 21,405 study participants. The pooled mortality rate among preterm in the East Africa continent was found to be 19.2% (95% CI (confidence interval (16.0-22.4)). Regarding the study design, the mortality rate was found to be 18.1%, 19.4%, and 19.7% concerning the prospective cohort, retrospective cohort, and cross-sectional studies. The pooled odds of mortality among preterm with respiratory distress syndrome decreased survival by nearly three folds [AOR (Adjusted odds ratio = 3.2; 95% CI: 22, 4.6)] as compared to their counterparts. Similarly, preterm neonates presented with birth asphyxia were nearly three times higher in death as compared with preterm without birth asphyxia [AOR = 2.6; 95% CI: 1.9, 3.4].

Conclusion: Preterm mortality was found to be unacceptably high in Eastern Africa continent.Fortunately, the main causes of death were found to be respiratory distress syndrome and birth asphyxia which are preventable and treatable hence early detection and timely management of this problem are highly recommended to improve preterm survival.

Keywords: Asphyxia; East Africa; Impact; Meta-analysis; Preterm; Respiratory distress syndrome; Systematic review.