Time to Death and Predictors Among Neonates with Esophageal Atresia in Ethiopia

Figures & data

Figure 1 ArcMap of the study area with respect to regions of Ethiopia.

Table 1 Socio-Demographic and Neonatal Characteristics of Neonates with Esophageal Atresia Admitted to TikurAnbesa Specialized Hospital, Addis Ababa, Ethiopia; from March 2011 to February 2021 (n = 225)

Socio-Demographic and Neonatal Characteristics	Category	Frequency (%)
Region	Addis Ababa city	83(36.9)
	Amhara	27(12)
	Oromia	90(40)
	SNNPR*	25(11.1)
	Other**	5 (2.2)
Admission source	Inborn	6(2.7)
	Out born	219(97.3)
Postnatal age at admission	<1 day	68(30.2)
	1–2 day	35(15.6)
	>2 day	122(54.2)
Gestational age (GA)	28–36 week (wk.)	53(23.6)
	37–42 wk	168(74.7)
	>42 wk	4(1.8)
Sex	Male	102(45.3)
	Female	123(54.7)
Weight	2500–4000 gram (gm)	140(62.2)
	1500–2500g	77(34.2)
	1000–1500g	8(3.6)
Type of variants (n = 218)	Type A	18(8)
	Type B	3(1.3)
	Type C	193(88.5)
	Type D	4(1.8)
Feeding history	Yes	91(40.4)
	No	134(59.6)
Time of diagnosis	<48 hours (hrs)	92(40.9)
	>48 hr	133(59.1)
Associated congenital anomalies	Yes	92(40.9)
	No	133(59.1)

Notes: *Southern, Nations, Nationalities and people’s region. **Afar, Tigari, Somali, Benishangul Gumuz, Gambela, Dire Dawa city, and Harari regions.

Table 2 Maternal Related Characteristics of Neonates Diagnosed with Esophageal Atresia Admitted to TikurAnbesa Specialized Hospital, Addis Ababa, Ethiopia; from March 2011 to February 2021 (n = 225)

Maternal-Related Characteristics	Category	Frequency (%)
Maternal age	<18year (yr)	4(1.8)
	18–35 yr	191(84.9)
	>35 yr	30(13.3)
Place of delivery	Home	11(4.9)
	Health facility	214(95.1)
Mode of delivery	Vagianl delivery (SVD)	168(74.7)
	Cesarean section (C/S)	57(25.3)
History of polyhydramnios	Yes	51(22.7)
	No	174(77.3)
History of maternal chronic illness	Yes	27(12)
	No	198(88)

Figure 2 Kaplan–Meier failure curve of neonates with esophageal atresia admitted in NICU at TikurAnbesa specialized Hospital from March 2011 to February 2021(n = 225).

Figure 3 Kaplan–Meier failure curve by birth weight, dehydration, and malnutrition of neonates with esophageal atresia admitted in NICU at TikurAnbesa specialized Hospital from March 2011 to February 2021(n = 225).

Table 3 Bivariable and Multivariable Cox Regression Model for Predictors of Time to Death Among Neonates with Esophageal Atresia Admitted in NICU at TikurAnbesa Specialized Hospital from March 2011 to February 2021 (n = 225)

Covariates	Died (%)	Censored (%)	CHR and 95% CI	AHR and 95% CI	P-value
GA
28–36 wk.	54(24)	10(4.4)	1.65(1.19–2.30)	0.97(0.63–1.50)	0.883
37–42 wk.	102(45.3)	51(22.7)	1	1
>42 wk.	4(1.8)	4(1.8)	0.92(0.34–2.50)	2.00(0.68–5.90)	0.208
Birth weight
2500–4000 g	91(40.4)	49(21.8)	1	1
1500–2500 g	62(27.6)	15(6.7)	1.78(1.28–2.46)	1.49(1.02 −2.21)	0.049*
1000–1500 g	7(3.1)	1(0.4)	8.17(3.62–18.43)	3.90(1.36–11.17)	0.011*
Admission source
Inborn	2(0.9)	4(1.8)	1	1
Out born	158(70.2)	61(27.1)	3.63(0.90–14.71)	3.37(0.76–14.97)	0.110
Time of diagnosis
<48 hr	58(25.8)	34(15.1)	1	1	0.043*
>48 hr	102(45.3)	31(13.8)	1.33(0.96–1.83)	1.48(1.01–2.15)
Associated congenital anomalies
Yes	75(33.3)	17(7.6)	1.21(0.89–1.66)	0.97(0.67–1.39)	0.851
No	85(37.8)	48(21.3)	1	1
Place of delivery
Home	10(4.4)	1(0.4)	2.15(1.13–4.09)	1.78(0.87–3.62)	0.113
Health facility	150(66.7)	64(28.4)	1	1
History of maternal chronic illness
Yes	15(6.7)	3(1.3)	1.43(0.84–2.44)	1.75(0.99–3.10)	0.056
No	145(64.4)	62(27.6)	1	1
Aspiration pneumonia
Absent	9(4)	13(5.8)	1	1
Present	151(67.1)	52(23.1)	2.0(1.02–3.90)	1.03(0.49–2.19)	0.937
Malnutrition
Yes	117(52)	9(4)	2.80(1.94–4.04)	1.61(1.03 −2.58)	0.047*
No	38(16.9)	49(21.8)	1	1
Thrombocytopenia
Yes	87 (38.7)	13(5.8)	2.39(1.73–3.30)	1.27(0.87–1.84)	0.212
No	67(29.8)	52(23.1)	1	1
Sepsis
No	103(45.8)	45(20)	1	1
Yes	57(25.3)	20(8.9)	1.30(0.94–1.81)	1.67(1.15–2.44)	0.008
Dehydration
Present	88(39.1)	6(2.7)	2.69(1.96–3.69)	2.38(1.63–3.46)	0.000*
Absent	72(32)	59(26.2)	1	1
Metabolic abnormality
Yes	15(6.7)	3(1.3)	1.59(0.93–2.72)	1.40(0.77–2.53)	0.271
No	145(64.4)	62(27.6)	1	1
Time of surgery
≤72 hr	5(2.2)	18 (8)	1	1
>72 hr	59(26.)	37 (16.4)	1.76(0.71–4.40)	1.13(0.41–3.14)	0.813
No surgery	96 (42.7)	10(4.4)	7.61(3.08–18.80)	3.73(1.33–10.38)	0.012*
Type of variant
Type A	16(7.3)	2(0.9)	3.13(0.72–13.64)	2.17(0.44–10.66)	0.339
Type B	2(0.9)	1(0.5)	1.94(0.27–13.8)	1.44(0.18–11.81)	0.731
Type C	136(62.5)	57(26.1)	2.03(0.5–8.21)	1.69(0.38–7.44)	0.487
Type D	2(0.9)	2(0.9)	1	1

Notes: *A statistically significant predictor of time to death (P < 0.05). Censored: refers to neonates with esophageal atresia discharged or against for medical treatment or EA cases lost during treatment for unknown status. Event: was considered to be the death of neonates with esophageal atresia while in the hospital and whose death report was recorded. Malnutrition: neonates with EA whose serum albumin level is low to age or kept NPO for a prolonged time or edematous and documented on the chart as malnutrition. Dehydration: neonates with EA who had signs of dehydration and documented on the medical chart as dehydration. Sepsis: neonates with EA who had signs and symptoms of infection and documented on the chart as sepsis. Thrombocytopenia: is defined as a platelet count of <150 × 103/μL.