Epidemiology of neonatal sepsis and the associated cytokines in Nakuru county referral hospital
Neonatal infections especially sepsis and meningitis currently cause 4.9 million deaths annually in developing countries. According to World Health Organization (WHO) estimates, there are about 5 million neonatal deaths in the world per year due to sepsis, with 98% occurring in developing countries. The purpose of this study is to give an overview of the burden of bacterial sepsis in the newborn population in Nakuru County Referral Hospital (NCRH). The focus will be on the pathogens mostly implicated, their antibiotic susceptibility patterns and cytokine involvement in neonatal sepsis. A population of 60 neonates born and admitted in Nakuru County Referral Hospital with positive clinical diagnosis of neonatal sepsis will be selected for the study and grouped according to gender, birth weight and age. Samples of blood for culture and cytokine assay will be obtained from peripheral veins (2 ml per neonate). Blood culture will be done using 1 ml of blood from each infected neonate to isolate and identify pathogens responsible for sepsis. Antibiotic susceptibility testing will be performed for identified bacteria by disc diffusion method as per clinical and laboratory standards institute guideline. The remaining 1 ml of blood sample collected will be used for cytokine testing. This will be done using commercially available KIT for T helper-l and T helper-2 cytokines and Enzyme Linked Immunosorbent Assay (ELISA) to measure Interleukin-6 (IL-6) levels. Quantities of individual cytokine will be computed using standard reference curve. Data analysis and presentation will be done using tables and graphs, calculating percentages, Analysis of variance (ANOVA) and by Spearman's correlation to show the relationship between pro inflammatory and anti inflammatory cytokines responses in neonatal sepsis. The data from the study will provide necessary information for clinicians to use in diagnosis and management of neonatal sepsis. The data will also identify the population of neonates that is at risk of sepsis infection, which will aid in the diagnosis and management of the disease.