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INTRODUCTION: Neonatal mortality remains a significant public health burden worldwide, with about 4 million deaths per year. To provide evidence for the implementation of prevention measures aimed at the reduction of neonatal mortality, we performed a study on factors associated with neonatal mortality at the Referral Hospital in Nouakchott, Mauritania. METHODS: we conducted a cross-sectional study between January 2013 and December 2013 and included neonatal patients hospitalized at the National Referral Hospital (NRH). Data were collected by reviewing the medical charts and through questionnaires administered to the parents. RESULTS: two hundred and thirty-two (34.7%) of the 669 neonates included in the study died; 159 (71.3%) of deaths occurred during the first six days of life. Most neonates that died were born outside the hospital and admitted to NRH after birth (71.7%; 142/198). About 1/3 were transferred from other parts of the country outside of Nouakchott. Thirty (13.4%) of deaths were neonates born from teenage mothers. In bivariate analysis teenage mothers (RR=1.54; 95% CI: 1.15-2.05; p = 0.004), illiteracy of father (1.61; 1.13-23.0; p = 0.007), birth outside NRH (1.65; 1.28-2.13; p = 0.0001), low gestational age (3.28; 2.40-5.50; p = 0.0001), and low body temperature at admission (1.42; 1.11-1.83; p = 0.004) were significantly associated with neonatal death. In logistic regression analysis, low birth weight (adjusted odds ratio = 3.91; 95% confidence interval 1.69-9.05; p=0.001), hypothermia (2.40; 1.12-5.14; p = 0.025), and birth outside the NRH (2.13; 1.02-4.45; p = 0.044) were independently associated with neonatal deaths. CONCLUSION: neonatal mortality remains a significant burden in Mauritania. We identified different socioeconomic and clinical risk factors indicating the need for more intensified prenatal care and improved transport of high risk neonates, especially in the regions outside the capital.

Diarrhea and respiratory diseases are the leading causes of morbidity and mortality among

Introduction: neonatal mortality remains a significant public health burden worldwide, with about 4 million deaths per year. To provide evidence for the implementation of prevention measures aimed at the reduction of neonatal mortality, we performed a study on factors associated with neonatal mortality at the Referral Hospital in Nouakchott, Mauritania. Methods: we conducted a cross-sectional study between January 2013 and December 2013 and included neonatal patients hospitalized at the National Referral Hospital (NRH). Data were collected by reviewing the medical charts and through questionnaires administered to the parents. Results: two hundred and thirty-two (34.7%) of the 669 neonates included in the study died; 159 (71.3%) of deaths occurred during the first six days of life. Most neonates that died were born outside the hospital and admitted to NRH after birth (71.7%; 142/198). About 1/3 were transferred from other parts of the country outside of Nouakchott. Thirty (13.4%) of deaths were neonates born from teenage mothers. In bivariate analysis teenage mothers (RR=1.54; 95% CI: 1.15-2.05; p = 0.004), illiteracy of father (1.61; 1.13-23.0; p = 0.007), birth outside NRH (1.65; 1.28-2.13; p < 0.0001), low gestational age (3.28; 2.40-5.50; p < 0.0001), and low body temperature at admission (1.42; 1.11-1.83; p < 0.004) were significantly associated with neonatal death. In logistic regression analysis, low birth weight (adjusted odds ratio = 3.91; 95% confidence interval 1.69-9.05; p = 0.001), hypothermia (2.40; 1.12-5.14; p = 0.025), and birth outside the NRH (2.13; 1.02- 4.45; p = 0.044) were independently associated with neonatal deaths. Conclusion: neonatal mortality remains a significant burden in Mauritania. We identified different socioeconomic and clinical risk factors indicating the need for more intensified prenatal care and improved transport of high risk neonates, especially in the regions outside the capital. [ABSTRACT FROM AUTHOR]

Abstract Introduction Rotavirus vaccine was introduced in Mauritania in December 2014. We investigated hospitalizations with diarrhea during pre and post-vaccination periods among children aged 0–5 years in Nouakchott, the capital of Mauritania. Methods We conducted a retrospective review of hospital admission registries from November 1st 2012 through October 31th 2017 at all referral hospitals in Nouakchott. We described admissions of children aged 0–5 years by diagnosis, data of admission, age and sex, and compared the proportion of all childhood hospitalizations with diarrhea before and after rotavirus vaccine introduction. Results In total, 6552 (19%) of all 34,329 hospitalizations in 0–5 year-olds had diarrhea. Of these, 3523/16,952 (20.7%) were recorded during the pre-vaccine period, 1373/6897 (19.9%) during the transition period (November 2014-October 2015), and 1656/10,480 (15.8%) during the post-vaccination period. The proportion of all childhood hospitalizations with diarrhea during the pre-vaccine period was 22.6% among males and 18.7% among females. Approximately one third (32.3%) of hospitalizations with diarrhea occurred in children aged 6–11 months. During the post-vaccination period, the proportion of hospitalizations with diarrhea declined by 24%, and the highest reduction (74%) was observed in children aged 2 to 5 years (P < 0.001). Conclusions The proportion of childhood hospitalizations with diarrhea in Nouakchott was reduced by about one fourth after introduction of rotavirus vaccination in Mauritania, indicating a major impact for public health for children in the capital city. [ABSTRACT FROM AUTHOR]

Diarrhea and respiratory diseases are the leading causes of morbidity and mortality among <5-year-olds worldwide, but systematic data are not available from Mauritania. We conducted a hospital-based retrospective study. Data on admissions to Mauritania's National Referral Hospital (the main pediatric referral center in the country), due to diarrhea and respiratory diseases, during 2011⁻2014, were analyzed. A total of 3695 children <5 years were hospitalized during this period; 665 (18.0%) due to respiratory diseases, and 829 (22.4%) due to diarrhea. Case fatality rates in the respiratory diseases and diarrhea groups were 18.0% (120/665) and 14.1% (117/829), respectively. The highest frequency of deaths due to diarrhea occurred in the age group 2⁻5 years (16/76; 21.0%), and due to respiratory diseases in the age group 6⁻12 months (32/141; 22.6%). We conclude that case fatality rates caused by respiratory diseases and diarrhea are extremely high in children hospitalized at the National Referral Hospital. These data call for intensified efforts to reduce deaths among hospitalized Mauritanian children, and also for integrated control measures to prevent and reduce the burden of both diseases. Additional studies are needed to show the effectiveness of the introduction of vaccination programs for pneumococcal diseases and rotavirus infection in the child population, which were launched in November 2013 and December 2014, respectively.