The Epidemiology of Respiratory Distress Syndrome in Neonates in Fiji: A Retrospective Cohort Study

Joshua Szanyi; Ilisapeci Tuibeqa; Tupou Ratu; Kate Milner; Cattram D Nguyen; Evelyn Tuivaga; Fiona M Russell

doi:10.24135/pacifichealth.v2i0.36

Joshua Szanyi Centre for International Child Health, Department of Paediatrics, The University of Melbourne
Ilisapeci Tuibeqa Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
Tupou Ratu Department of Paediatrics, Ministry of Health and Medical Services, Suva, Fiji
Kate Milner Centre for International Child Health, Department of Paediatrics, The University of Melbourne
Cattram D Nguyen Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
Evelyn Tuivaga Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
Fiona M Russell Centre for International Child Health, Department of Paediatrics, The University of Melbourne; Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Australia

DOI: https://doi.org/10.24135/pacifichealth.v2i0.36

Keywords: low and middle income, neonate, respiratory distress syndrome

Abstract

Introduction

The commonest cause of death in preterm neonates worldwide is respiratory distress syndrome (RDS). In Fiji, prematurity and RDS have been identified as important causes of neonatal mortality and surfactant was added to supportive care in 2015. This retrospective cohort study describes the RDS epidemiology in Fiji’s major neonatal centre prior to surfactant introduction.

Methods

RDS-related intensive care admissions in 2013 and 2014 were reviewed and clinical information was extracted from medical records. Subsequent readmissions of RDS cases were also retrieved.

Results

The rate of RDS was 6.7 (95% confidence interval 5.5 – 8.0) per 1,000 live births. There were 36 RDS deaths. No cases who died received more than one dose of corticosteroids, compared to 25.3% of survivors.

Conclusion

Death from RDS was high, and is consistent with that in other low- and middle-income countries prior to the uptake of surfactant therapy. Improving antenatal corticosteroid use and access to surfactant therapy is likely to improve outcomes.