Data analyzed in STATA software.

Background
Neonatal sepsis remains a leading cause of morbidity and mortality in neonates across all regions, including Africa. Compared to developed and some developing countries, there are relatively few epidemiological trends for neonatal sepsis and associated patterns with COVID-19 in Ethiopia. We modeled an epidemiological trend and pattern to aid in the monitoring of changes in neonatal sepsis.
Methods
Retrospective data were collected from all admissions to the Neonatal Intensive Care Unit (NICU) in Ethiopia at Jimma Medical Center between May 2019 and April 2022. We analyzed the monthly neonatal sepsis incidence, mortality, and case-fatality rates using STATA software. Finally, we modeled a monthly time series of neonatal sepsis incidence trends and patterns associated with the COVID-19-impacted period using Joinpoint software. For all analyses, a P value of 0.05 was considered statistically significant at the 95% confidence interval (CI).
Results
In the 36 months, 6796 cases were admitted to the NICU, with a 9.5% (95% CI: 9.1, 10.0) incidence rate of neonatal sepsis. The overall admission mortality rate was 16.5% (95% CI: 13.6, 19.8), while sepsis-attributed mortality was 7.1% (95% CI: 5.8, 8.5). The data showed an unstable decreasing trend for three Joinpoints (August 2020, December 2020, and August 2021). Notably, a decrease in the incidence trend was observed from May 2019 to August 2020 (MPC, -4.1; 95% CI: -7.6, -0.5; P = 0.03), followed by a sharp increase (MPC, 23.7; 95% CI: -13.8, 77.7; P = 0.24) from August 2020 to December 2020. From December 2020 to August 2021, there was again a decreasing trend (MPC, -13.8; 95% CI: -23.3, -3.5; P = 0.01), followed by a slight increase from August 2021 to April 2022 (MPC, 4.2; 95% CI: -8.4, 18.6; P = 0.52). Finally, the study revealed an association between patterns of neonatal sepsis incidence trends and COVID-19, with a Joinpoint jump model comparability ratio (CR = 0.43) between pre- and COVID-19-impacted periods.
Conclusions
Neonatal sepsis was prevalent at Jimma Medical Center, but it was on an unstably declining trend. The current results suggest a potential temporal association between the intensity of COVID-19 containment measures and a change in the incidence trend and patterns of neonatal sepsis. However, the quantified contribution of a particular containment measure requires further investigation.

背景
新生儿败血症（Neonatal Sepsis）仍是全球各区域新生儿发病与死亡的首要诱因之一，非洲区域亦不例外。相较于发达国家与部分发展中国家，埃塞俄比亚针对新生儿败血症及其与新型冠状病毒感染（COVID-19）相关流行特征的研究相对匮乏。本研究通过构建流行趋势与特征模型，助力新生儿败血症的变化监测工作。
方法
本研究回顾性收集了2019年5月至2022年4月期间，埃塞俄比亚吉马医疗中心新生儿重症监护室（Neonatal Intensive Care Unit, NICU）的全部入院病例数据。采用Stata统计软件分析新生儿败血症的月度发病率、病死率与死亡率。最终使用Joinpoint软件，构建了与新冠疫情影响阶段相关的新生儿败血症发病率月度时间序列趋势及特征模型。所有分析均以P<0.05为具有统计学显著性的判定标准，对应95%置信区间（Confidence Interval, CI）。
结果
在36个月的研究周期内，吉马医疗中心NICU共收治6796例新生儿，新生儿败血症发病率为9.5%（95%CI：9.1，10.0）。总入院死亡率为16.5%（95%CI：13.6，19.8），败血症归因死亡率为7.1%（95%CI：5.8，8.5）。数据显示，存在3个连接点（2020年8月、2020年12月及2021年8月），呈现不稳定的下降趋势。具体而言，2019年5月至2020年8月期间，败血症发病率呈下降趋势（月度百分比变化MPC：-4.1；95%CI：-7.6，-0.5；P=0.03）；随后2020年8月至2020年12月，发病率出现急剧上升（MPC：23.7；95%CI：-13.8，77.7；P=0.24）。2020年12月至2021年8月，发病率再次呈现下降趋势（MPC：-13.8；95%CI：-23.3，-3.5；P=0.01）；2021年8月至2022年4月则出现小幅回升（MPC：4.2；95%CI：-8.4，18.6；P=0.52）。本研究最终证实，新生儿败血症发病率趋势与新型冠状病毒感染存在关联，新冠疫情影响前期与影响期的连接点跳跃模型可比率（CR=0.43）。
结论
吉马医疗中心的新生儿败血症患病率较高，但整体呈不稳定的下降趋势。本研究结果提示，新冠疫情防控措施的强度与新生儿败血症发病率趋势及特征的变化可能存在时间相关性。不过，特定防控措施的量化贡献仍需进一步研究探明。