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A study led by experts from the National Institute for Communicable Diseases (NICD) involving newborn babies has revealed a prevalence of infections caused by multi-drug resistant bacteria in South African hospitals.
According to the six-year study, almost 38 000 cases of infection were diagnosed, with the average age of babies at the time of diagnosis of infection at 7-days.
This is the first national population-level analysis of invasive newborn infections in the local public health sector and involved babies younger than 28-days admitted between January 2014 and December 2019.
Around 70% of cases were caused by three bacterial pathogens, Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus, none of which can be prevented by vaccines and a large proportion of which were resistant to antibiotics usually used to treat neonatal infections.
Two-thirds of cases were diagnosed in hospitals in Gauteng and KwaZulu-Natal provinces.
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Almost half of neonatal cases of infection were diagnosed at regional hospitals.
The incidence risk of late-onset infections (which were probably acquired in hospital) was considerably higher than reported in resource-rich countries.
The Baby GERMS-SA team, led by experts from the NICD, a division of the National Health Laboratory Service (NHLS), conducted the study to estimate the burden of culture-confirmed neonatal bloodstream infections and meningitis in South Africa.
Funded by the Bill and Melinda Gates Foundation, the study involved an analysis of blood and cerebrospinal fluid culture pathology records from newborn babies at 256 public-sector hospitals.
South Africa is ranked eighth in the world in infant mortality, with 24 306 deaths per 1000 live births, according to Macro Trends.
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According to UNICEF, in 2019, newborn babies accounted for almost half of all deaths in young children, with an estimated 6,700 newborn deaths recorded daily.
Moreover, 42% of deaths occurred in sub-Saharan Africa and infections were a major cause of these deaths.
According to World Health Organisation, children in sub-Saharan Africa continued to have the highest rates of mortality in the world, at 74 (68-86) deaths per 1000 live births, 14 times higher than the risk for children in Europe and Northern America.
Two regions, Sub-Saharan Africa and Southern Asia, account for more than 80% of the 5 million under-five deaths in 2020, while they only account for 53% of the global live births in 2020.
The proposed Sustainable Development Goals (SDG) target for child mortality aims to end, by 2030, preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 deaths per 1 000 live births and under-5 mortality to at least as low as 25 deaths per 1 000 live births.
Public health specialist, Dr Shakira Choonara, lamented that given the Covid-19 pandemic and the impact on socio-economic status for women and households, we are unlikely to see declines in infant mortality.
She said socio-economic status remains an important factor affecting mortality levels.
“Further, coupled with the disruption of healthcare services and our ailing healthcare systems it is unlikely we will see any gains on this front,” Choonara added.