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Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019
Thesis (MMed)--Stellenbosch University, 2023.
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| Format: | Thesis |
| Language: | en_ZA en_ZA |
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Stellenbosch : Stellenbosch University
2023
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| _version_ | 1867613875793297408 |
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| access_status_str | Open Access |
| author | Read, Jo-Mari |
| author2 | Slogrove, Amy |
| author_browse | Read, Jo-Mari Slogrove, Amy |
| author_facet | Slogrove, Amy Read, Jo-Mari |
| author_sort | Read, Jo-Mari |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed)--Stellenbosch University, 2023. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/128967 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA en_ZA |
| last_indexed | 2026-06-10T12:43:06.129Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/128967 Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019 Read, Jo-Mari Slogrove, Amy Engelbrecht, Arnold Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Birth weight, Low -- Western Cape (South Africa) Respiratory distress syndrome -- Western Cape (South Africa) Pediatric respiratory diseases -- Western Cape (South Africa) Newborn infants -- Diseases -- Western Cape (South Africa) Children -- Mortality -- Western Cape (South Africa) Thesis (MMed)--Stellenbosch University, 2023. ENGLISH ABSTRACT: Background Respiratory distress in low birth weight (LBW; <2500g) neonates is associated with prolonged morbidity and high mortality. Neonatal transport to specialized facilities can lead to complications and increased mortality. Improving care for LBW neonates with respiratory distress at district and regional hospitals and avoiding transport to specialized centres, may improve South Africa's neonatal mortality rate. Objectives This study aimed to compare the respiratory care received by LBW neonates in three rural Western Cape hospitals during 2019, to assess adherence to recommendations and to describe the outcomes. Methods A retrospective cohort study was conducted including LBW neonates with signs of respiratory distress within the first 24 hours of life born in 2019 at three rural hospitals. Neonates were categorised into mutually-exclusive groups: regional (all care at regional hospital), district (all care at district hospital) and transferred (transferred from district to regional hospital). Respiratory management was assessed according to the Western Cape Provincial Peri-viability Decision Support Framework, utilising the Downe score to classify severity of respiratory distress upon admission. The proportion (95% confidence interval) receiving recommended respiratory care was compared between groups. Results Among 210 included neonates, 145 (69%) were in the regional group, 53 (25%) in the district group and 12 (6%) in the transferred group. A total of 197 (94%) neonates received respiratory support as recommended or more with no significant difference between the groups. There was a higher proportion of neonates with moderate or severe distress in the regional (61/145;42%) compared to the district group (18/53;34%). Escalation of respiratory support occurred more frequently in the district (N=8/53;15%) compared to the regional group(N=12/145;8%). Neonates at regional level received a longer period of respiratory support (median 36.5 hours; IQR 13.5-82.5 hours) compared to district level (median 21 hours; IQR 9-48 hours). Specialized interventions were more prevalent at the regional level, with surfactant administration to 35/145 (24%) neonates compared to 4/53 (8%) at district level. However, there was no meaningful difference in mortality between the regional and district groups Conclusion Reassuringly 94% of neonates in rural Western Cape received respiratory support as recommended or more. While the regional hospital cared for neonates with more severe respiratory distress, requiring longer respiratory support and more specialized interventions, no difference in mortality between the regional and district level was observed which requires further investigation. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2023-11-25T12:59:29Z 2024-01-08T17:33:53Z 2023-11-25T12:59:29Z 2024-01-08T17:33:53Z 2023-11 Thesis https://scholar.sun.ac.za/handle/10019.1/128967 en_ZA en_ZA Stellenbosch University 68 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Birth weight, Low -- Western Cape (South Africa) Respiratory distress syndrome -- Western Cape (South Africa) Pediatric respiratory diseases -- Western Cape (South Africa) Newborn infants -- Diseases -- Western Cape (South Africa) Children -- Mortality -- Western Cape (South Africa) Read, Jo-Mari Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019 |
| title | Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019 |
| title_full | Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019 |
| title_fullStr | Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019 |
| title_full_unstemmed | Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019 |
| title_short | Respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the Western Cape during 2019 |
| title_sort | respiratory management of low birth weight neonates with respiratory distress in rural district and regional hospitals in the western cape during 2019 |
| topic | Birth weight, Low -- Western Cape (South Africa) Respiratory distress syndrome -- Western Cape (South Africa) Pediatric respiratory diseases -- Western Cape (South Africa) Newborn infants -- Diseases -- Western Cape (South Africa) Children -- Mortality -- Western Cape (South Africa) |
| url | https://scholar.sun.ac.za/handle/10019.1/128967 |
| work_keys_str_mv | AT readjomari respiratorymanagementoflowbirthweightneonateswithrespiratorydistressinruraldistrictandregionalhospitalsinthewesterncapeduring2019 |