PAPERSwww.jogh.org • doi: 10.7189/jogh.14.04009 1 2024 • Vol. 14 • 04009 Incidence of possible serious bacterial infection in young infants in the three high-burden countries of the Democratic Republic of the Congo, Kenya, and Nigeria: A secondary analysis of a large, multi- country, multi-centre clinical trial

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