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How do low‐birthweight neonates fare 2 years after discharge from a low‐technology neonatal care unit in a rural district hospital in Burundi?
Author(s) -
van den Boogaard W.,
Zuniga I.,
Manzi M.,
Van den Bergh R.,
Lefevre A.,
NananN'zeth K.,
Duchenne B.,
Etienne W.,
Juma N.,
Ndelema B.,
Zachariah R.,
Reid A.
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12845
Subject(s) - medicine , low birth weight , pediatrics , malnutrition , psychological intervention , neonatal intensive care unit , thriving , pregnancy , psychology , nursing , genetics , pathology , psychotherapist , biology
Objectives As neonatal care is being scaled up in economically poor settings, there is a need to know more on post‐hospital discharge and longer‐term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in low‐birthweight neonates ( LBW , <2500 g). Getting a better handle on these parameters might justify and guide support interventions. Two years after hospital discharge, we thus assessed: mortality, developmental impairments and nutritional status of LBW children. Methods Household survey of LBW neonates discharged from a neonatal special care unit in Rural Burundi between January and December 2012. Results Of 146 LBW neonates, 23% could not be traced and 4% had died. Of the remaining 107 children (median age = 27 months), at least one developmental impairment was found in 27%, with 8% having at least five impairments. Main impairments included delays in motor development (17%) and in learning and speech (12%). Compared to LBW children ( n = 100), very‐low‐birthweight ( VLBW , <1500 g, n = 7) children had a significantly higher risk of impairments (intellectual – P = 0.001), needing constant supervision and creating a household burden ( P = 0.009). Of all children ( n ‐107), 18% were acutely malnourished, with a 3½ times higher risk in VLBW s ( P = 0.02). Conclusions Reassuringly, most children were thriving 2 years after discharge. However, malnutrition was prevalent and one in three manifested developmental impairments (particularly VLBW s) echoing the need for support programmes. A considerable proportion of children could not be traced, and this emphasises the need for follow‐up systems post‐discharge.