Epidemiology of neonatal infections: Community experience

Neonatal sepsis is one of the commonest causes of neonatal death in the developing world accounting for 30–50% of all neonatal deaths per year. The reported incidence of neonatal sepsis varies from 7.1 to 38 per thousand live births in Asia. The organisms causing neonatal sepsis in developing countries (gram-negative) are different from those seen in developed countries (gram-positive organisms). There are very few community based studies on etiology of neonatal sepsis and limited data are available from first level health facilities and home delivered babies. Antibiotic resistance in strains causing neonatal sepsis is increasingly being reported from developing countries from intensive care units as well as community. Signs of sepsis in neonates are often non-specific and high degree of suspicion is needed for early diagnosis. Most of the diagnostic tests are not available in secondary and primary level care; diagnostic approach mostly focuses on history and review of non specific signs and symptoms. This review highlights studies testing and validating clinical algorithms for diagnosis and management of sick child in the community - identifies gaps in such strategies, strategies for prevention of neonatal sepsis and future areas of research.