Neonatal hypothermia in Northern Uganda: a community- based cross- sectional study

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dc.contributor.authorMukunya , A David
dc.contributor.authorTumwine, James K.
dc.contributor.authorNankabirwa, Victoria
dc.contributor.authorOdongkara, Beatrice
dc.contributor.authorTongun, Justin B.
dc.contributor.authorArach, Agnes A
dc.contributor.authorTumuhamye, Josephine
dc.contributor.authorNapyo, Agnes
dc.contributor.authorZalwango, Vivian
dc.contributor.authorVicentina Achora,
dc.contributor.authorMusaba , Milton W
dc.contributor.authorNdeezi, Grace
dc.contributor.authorTylleskär, Thorkild
dc.date.accessioned2026-06-17T10:13:59Z
dc.date.available2026-06-17T10:13:59Z
dc.date.issued2021-01-25
dc.descriptionStrengths and limitations of this study ► This is the first purely community- based assessment of neonatal hypothermia in sub- Saharan Africa. ► Estimates obtained are generalisable to settings with a significant proportion of home births unlike previ ous estimates from health facility- based studies. ► We included a large number of neonates (1330), which increased the precision of our estimates. ► The choice of a digital thermometer placed in the axilla could have underestimated hypothermia, but this was the most socially acceptable option. ► We did not measure some predictors, such as delivery room temperature and maternal body temperature.
dc.description.abstractObjective To determine the prevalence, predictors and case fatality risk of hypothermia among neonates in Lira district, Northern Uganda. Setting Three subcounties of Lira district in Northern Uganda. Design This was a community- based cross- sectional study nested in a cluster randomised controlled trial. Participants Mother–baby pairs enrolled in a cluster randomised controlled trial. An axillary temperature was taken during a home visit using a lithium battery- operated digital thermometer. Primary and secondary outcomes The primary outcome measure was the prevalence of hypothermia. Hypothermia was defined as mild if the axillary temperature was 36.0°C to <36.5°C, moderate if the temperature was 32.0°C to <36.0°C and severe hypothermia if the temperature was <32.0°C. The secondary outcome measure was the case fatality risk of neonatal hypothermia. Predictors of moderate to severe hypothermia were determined using a generalised estimating equation model for the Poisson family. Results We recruited 1330 neonates. The prevalence of hypothermia (<36.5°C) was 678/1330 (51.0%, 95% CI 46.9 to 55.1). Overall, 32% (429/1330), 95% CI 29.5 to 35.2 had mild hypothermia, whereas 18.7% (249/1330), 95% CI 15.8 to 22.0 had moderate hypothermia. None had severe hypothermia. At multivariable analysis, predictors of neonatal hypothermia included: home birth (adjusted prevalence ratio, aPR, 1.9, 95% CI 1.4 to 2.6); low birth weight (aPR 1.7, 95% CI 1.3 to 2.3) and delayed breastfeeding initiation (aPR 1.2, 95% CI 1.0 to 1.5). The case fatality risk ratio of hypothermic compared with normothermic neonates was 2.0 (95% CI 0.60 to 6.9). Conclusion The prevalence of neonatal hypothermia was very high, demonstrating that communities in tropical climates should not ignore neonatal hypothermia. Interventions designed to address neonatal hypothermia should consider ways of reaching neonates born at home and those with low birth weight. The promotion of early breastfeeding initiation and skin- to- skin care could reduce the risk of neonatal hypothermia.
dc.description.sponsorshipFunding was obtained from the Survival Pluss project; grant number UGA-13-0030 at Makerere University. Survival Pluss project is funded by The Norwegian Programme for Capacity Development in Higher Education and Research for Development (NORHED) under The Norwegian Agency for Development Cooperation (NORAD).
dc.identifier.citationMukunya D, Tumwine JK, Nankabirwa V, et al. Neonatal hypothermia in Northern Uganda: a community- based cross- sectional study. BMJ Open 2021;11:e041723. doi:10.1136/ bmjopen-2020-041723
dc.identifier.otherhttp:// dx. doi. org/ 10. 1136/ bmjopen- 2020- 041723
dc.identifier.urihttp://hdl.handle.net/20.500.14270/846
dc.language.isoen
dc.publisherBMJ OPEN
dc.titleNeonatal hypothermia in Northern Uganda: a community- based cross- sectional study
dc.typeArticle

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