Abstract: Background: Neonatal hospital-acquired infections (HAIs) kill tens of thousands of children in sub-Saharan Africa annually, yet district-level burden data from Rwanda remain unpublished. This study determined the period prevalence and independent predictors of neonatal HAI at Kabaya District Hospital, Ngororero District, Western Province, Rwanda.
Methods: Retrospective cross-sectional study of systematically sampled neonatal admission records (January 2022–December 2024). Of 1,704 admissions, every 4th record was selected (n=380); nine were excluded (analytic n=371). Primary outcome: clinician-ascertained HAI per CDC/NHSN criteria. Bivariate and multivariable logistic regression analysis at p<.05. Prevalence estimated with Wilson score 95% confidence intervals.
Results: Period prevalence was 13.7% (52/380; 95% CI [10.5%, 17.4%]). Sepsis predominated (55.8% of HAI cases). Case-fatality was 11.3%. Three independent predictors: maternal UTI history (aOR = 23.81, 95% CI [5.49, 103.31], p < .001), prolonged labour (aOR = 7.69, 95% CI [1.52, 38.92], p = .013), and perinatal asphyxia (aOR = 6.84, 95% CI [1.97, 23.72], p = .002). Hosmer–Lemeshow test confirmed model fit (χ² = 6.84, p = .554).
Cionclusion: Intrapartum complications account for the bulk of this facility’s neonatal HAI burden. Antenatal UTI screening, intrapartum care improvement at health centres, and post-asphyxia infection prevention protocols are the highest-yield actionable targets.
Funding: None. Ethical clearance: Mount Kigali University IRB and Kabaya District Hospital administration.
Keywords: neonatal sepsis; hospital-acquired infection; Rwanda; district hospital; perinatal asphyxia; maternal UTI; infection prevention; sub-Saharan Africa.
Title: Prevalence and Associated Factors of Neonatal Hospital Acquired Infection in Kabaya District Hospital, Rwanda
Author: Jean D’Amour Nyirimpuhwe, Amos Habimana, Amanuel A. Kidane
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
Vol. 14, Issue 1, April 2026 - September 2026
Page No: 259-265
Research Publish Journals
Website: www.researchpublish.com
Published Date: 22-June-2026
