Observational studyThe Lancet. Global health2022
Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study.
Observational study in The Lancet. Global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 146 papers, 7 of them syntheses that pooled it.
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Who cites it
146 citing papers in PubMed, 7 syntheses or guidelines pooled it, 233 citations in OpenAlex.
- Neonatal sepsis in Ethiopia: unveiling the persistent burden through systematic review and meta-analysis.BMC pediatrics · 2026Pooled it
- The burden of neonatal sepsis and its risk factors in Africa. a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Incidence and predictors of mortality among neonates admitted with birth asphyxia to neonatal intensive care units in Ethiopia: a systematic review and meta-analysis.BMC pediatrics · 2025Pooled it
- Bibliometric analysis of sepsis and gut microbiota: Trends from 2014 to 2024.Frontiers in microbiology · 2025Pooled it
- Impact of neonatal sepsis on neurocognitive outcomes: a systematic review and meta-analysis.BMC pediatrics · 2024Pooled it
- Meta-analysis of the role of neutrophil to lymphocyte ratio in neonatal sepsis.BMC infectious diseases · 2023Pooled it
- Quality assessment of clinical practice guidelines for neonatal sepsis using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument: A systematic review of neonatal guidelines.Frontiers in pediatrics · 2022Pooled it
- [Application and comparative study of critical care ultrasound and noninvasive cardiac output monitoring in fluid resuscitation of neonatal septic shock: a randomized controlled trial].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Trial
- Transforming central line associated blood stream infection prevention in neonates: Results from a multimodal quality improvement initiative.World journal of clinical pediatrics · 2026Article
- Neonatal Mortality and Its Associated Factors Among Neonates in Ethiopia: A Systematic Review and Meta-Analysis.Public health challenges · 2026Article
- Reducing unnecessary antibiotic exposure among neonates evaluated for suspected early-onset sepsis through an adapted risk-stratification and antimicrobial stewardship pathway in northwest Ethiopia: a prospective quality improvement study.BMJ paediatrics open · 2026Article
- Association Between Community-Level Social Determinants of Health and Sepsis Incidence and Mortality: A Scoping Review.Critical care explorations · 2026Article
- Factors Associated with Severe Respiratory Support Requirement in Neonates with Gram-Negative Infections: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Escalating burden and mortality of carbapenem-resistant Klebsiella pneumoniae species complex infections in Bangladeshi infants.npj antimicrobials and resistance · 2026Article
- Aligning neonatal sepsis triage diagnostics with WHO target product profiles in low- and middle-income countries.BMJ global health · 2026Review
- Diagnostic challenges and Gram-negative pathogen dominance in early- and late-onset neonatal infection in Manila, Philippines.Nature communications · 2026Article
- Barriers and drivers to implementing family integrated newborn care for preterm and low birthweight infants in neonatal care units in Ethiopia: a qualitative study.BMJ paediatrics open · 2026Article
- Review
- Lactic Acid Bacteria-derived Bacteriocins: A Promising Antimicrobial Strategy against Multidrug-resistant for Neonatal Sepsis Pathogens.Probiotics and antimicrobial proteins · 2026Review
- Temporal trends and patterns in neonatal sepsis mortality across 194 countries, 2000-2021, with projections up to 2050.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
86 more citing papers are in PubMed but not listed here.
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Authors and funding
36 authors at 15 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeonatal sepsis is a primary cause of neonatal mortality and is an urgent global health concern, especially within low-income and middle-income countries (LMICs), where 99% of global neonatal mortality occurs. The aims of this study were to determine the incidence and associations with neonatal sepsis and all-cause mortality in facility-born neonates in LMICs.
methodsThe Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) study recruited mothers and their neonates into a prospective observational cohort study across 12 clinical sites from Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Data for sepsis-associated factors in the four domains of health care, maternal, birth and neonatal, and living environment were collected for all mothers and neonates enrolled. Primary outcomes were clinically suspected sepsis, laboratory-confirmed sepsis, and all-cause mortality in neonates during the first 60 days of life. Incidence proportion of livebirths for clinically suspected sepsis and laboratory-confirmed sepsis and incidence rate per 1000 neonate-days for all-cause mortality were calculated. Modified Poisson regression was used to investigate factors associated with neonatal sepsis and parametric survival models for factors associated with all-cause mortality.
findingsBetween Nov 12, 2015 and Feb 1, 2018, 29 483 mothers and 30 557 neonates were enrolled. The incidence of clinically suspected sepsis was 166·0 (95% CI 97·69-234·24) per 1000 livebirths, laboratory-confirmed sepsis was 46·9 (19·04-74·79) per 1000 livebirths, and all-cause mortality was 0·83 (0·37-2·00) per 1000 neonate-days. Maternal hypertension, previous maternal hospitalisation within 12 months, average or higher monthly household income, ward size (>11 beds), ward type (neonatal), living in a rural environment, preterm birth, perinatal asphyxia, and multiple births were associated with an increased risk of clinically suspected sepsis, laboratory-confirmed sepsis, and all-cause mortality. The majority (881 [72·5%] of 1215) of laboratory-confirmed sepsis cases occurred within the first 3 days of life.
interpretationFindings from this study highlight the substantial proportion of neonates who develop neonatal sepsis, and the high mortality rates among neonates with sepsis in LMICs. More efficient and effective identification of neonatal sepsis is needed to target interventions to reduce its incidence and subsequent mortality in LMICs.
fundingBill & Melinda Gates Foundation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.