Outcome and Mortality Determinants of Hypernatremic Dehydration among Hospitalized Neonates in Tigray, Ethiopia

Authors

  • Hailemariam Gebrearegay Haileeyesus Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia Author
  • Amanuel Hadgu Berhe Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia Author
  • Kiros Tesfay Gebremariam Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia Author
  • Hansa Haftu Lemma Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia Author
  • Mohammed Mustefa Mohammedamin Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia Author
  • Dawit Seyoum Gebremariam Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia Author
  • Yemane Leake Gebremikael Axum University, College of Health Sciences, Department of Pediatrics and Child Health, Axum Town, Tigray, Ethiopia Author
  • Abeba Hadush Hagos Adigrat University, College of Health Sciences, Department of Midwifery, Adigrat Town, Tigray, Ethiopia Author
  • Girmatsion Fisseha Abreha Mekelle University, College of Health Sciences, School of Public Health, Mekelle Town, Tigray, Ethiopia Author

Keywords:

Hypernatremia Dehydration, Outcome, Mortality, Neonate, Tigray

Abstract

Background: Hypernatremic dehydration causes life-threatening complications, such as serious neurologic damage, acute kidney injury, and peripheral limb gangrene, and leads to death. However, there is limited data on hypernatremic dehydration among neonates in Sub-Saharan Africa in general and Ethiopia in particular. This study aimed to assess the clinical profile, outcome, and mortality determinants of hypernatremic dehydration among hospitalized neonates in Tigray, Ethiopia.

Methods: An institution-based cross-sectional study was conducted among neonates admitted with a diagnosis of hypernatremic dehydration at the Ayder Comprehensive Specialized Hospital (ACSH) between January and July 2022. All neonates admitted to the ACSH with a diagnosis of hypernatremic dehydration during the study period were included by using consecutive sampling. Data were prospectively collected using a pretested checklist. The collected data were coded, edited, cleaned, and analyzed using SPSS version 23. The results were described using tables, graphs, and charts. The chi-square test (P-value < 0.05) was used to test variables associated with mortality.

Results: The prevalence of hypernatremic dehydration among 670 consecutive hospitalized neonates was 7.8% (52/670) over seven months period. Fifty of these were included in the analysis, two cases were excluded (the outcome was unknown). Fever, failure to suck, and decrement in urine amount were the common presenting features, occurring in 78%, 54%, and 52% of them respectively. The median serum sodium level at admission was 161 mmol/l (IQR,154-169). Acute kidney injury was the common complication observed in 54% of neonates. In addition, three neonates had bilateral peripheral limb gangrene. The case fatality rate in the present study was 32% (16/50). Being lethargic at admission, the presence of acute kidney injury and hyperglycemia, and a hospital stay of less than a week were significantly associated with mortality.

Conclusion: Breastfeeding-associated hypernatremic dehydration has a high prevalence and mortality rate among neonates. Being lethargic at admission, the presence of acute kidney injury and hyperglycemia, and a hospital stay of less than a week were significantly associated with mortality. Antenatal and in-hospital screening of maternal and neonatal risk factors for lactational insufficiency combined with early post-delivery follow-up to identify excessive neonatal weight loss and inadequate elimination patterns is essential to prevent hypernatremia dehydration in neonates.

Author Biographies

  • Hailemariam Gebrearegay Haileeyesus, Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

    Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

  • Amanuel Hadgu Berhe, Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

    Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

  • Kiros Tesfay Gebremariam, Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

    Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

  • Hansa Haftu Lemma, Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

    Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

  • Mohammed Mustefa Mohammedamin, Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

    Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

  • Dawit Seyoum Gebremariam, Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

    Mekelle University, College of Health Sciences, School of Medicine, Department of Pediatrics and Child Health, Mekelle Town, Tigray, Ethiopia

  • Yemane Leake Gebremikael, Axum University, College of Health Sciences, Department of Pediatrics and Child Health, Axum Town, Tigray, Ethiopia

    Axum University, College of Health Sciences, Department of Pediatrics and Child Health, Axum Town, Tigray, Ethiopia

  • Abeba Hadush Hagos, Adigrat University, College of Health Sciences, Department of Midwifery, Adigrat Town, Tigray, Ethiopia

    Adigrat University, College of Health Sciences, Department of Midwifery, Adigrat Town, Tigray, Ethiopia

  • Girmatsion Fisseha Abreha, Mekelle University, College of Health Sciences, School of Public Health, Mekelle Town, Tigray, Ethiopia

    Mekelle University, College of Health Sciences, School of Public Health, Mekelle Town, Tigray, Ethiopia

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Published

2025-10-26

Issue

Vol. 6 No. 4 (2025): Volume 6, Issue 4

Section

Articles