Abstract:
Background Neonatal infections are a major
public health concern worldwide, particular-
ly in low- and middle-income countries, where
most of the infection-related deaths in un-
der-five children occur. Sub-Saharan Africa has
the highest mortality rates, but there is a lack of
data on the incidence of sepsis from this region,
hindering efforts to improve child survival. We
aimed to determine the incidence of possible se-
rious bacterial infection (PSBI) in young infants
in three high-burden countries in Africa.
Methods This is a secondary analysis of data
from the African Neonatal Sepsis (AFRINEST)
trial, conducted in the Democratic Republic of
the Congo (DRC), Kenya, and Nigeria between
15 March 2012 and 15 July 2013. We recorded
baseline characteristics, the incidence of PSBI
(as defined by the World Health Organization),
and the incidence of local infections among in-
fants from 0–59 days after birth. We report de-
scriptive statistics.
Results The incidence of PSBI among 0–59-day-
old infants across all three countries was 11.2%
(95% confidence interval (CI) = 11.0–11.4). The
DRC had the highest incidence of PSBI (19.0%;
95% CI = 18.2–19.8). Likewise, PSBI rates were
higher in low birth weight infants (24.5%; 95%
CI = 23.1–26.0) and infants born to mothers
aged <20 years (14.1%; 95% CI = 13.4–14.8). The
incidence of PSBI was higher among infants de-
livered at home (11.7%; 95% CI = 11.4–12.0).
Conclusions The high burden of PSBI among
young infants in DRC, Kenya, and Nigeria
demonstrates the importance of addressing
PSBI in improving child survival in sub-Saha-
ran Africa to reach the Sustainable Development
