Neonatal hypothermia in sub-Saharan Africa: a review

Hypothermia is a major factor in neonatal morbidity and mortality in developing countries. High prevalence of hypothermia has been reported widely even from warmer tropical countries. In spite of the World Health Organization's recommendation of maintenance of warm chain in newborn care, hypothermia continues to be a common neonatal condition which has remained under-recognized, under-documented, and poorly-managed.

This review aims at providing the incidence of and risk factors for neonatal hypothermia as well as provides a pathophysiological overview and management options for neonates with the condition in sub-Saharan Africa.

All available published literature on neonatal hypothermia was searched electronically and manually. The principal electronic reference libraries and sites searched were PubMed, Embase, Ajol, Cochrane Reference Libraries and Google Scholar. The search terms used included 'neonatal hypothermia,' 'Cold stress in newborn' 'thermal care of the newborn,' 'neonatal thermogenesis,' 'neonatal cold injury,' among others. Pertinent books and monographs were accessed. Data in formats inaccessible to the reviewer were excluded.

Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities. Risk factors for neonatal hypothermia in the region include poverty, home delivery, low birthweight, early bathing of babies, delayed initiation of breastfeeding and inadequate knowledge among health workers. Low-tech facilities to prevent heat losses and provide warmth are available in sub-Saharan Africa and are thus recommended as well as continuous efforts at sensitizing caregivers on the thermal needs of newborns.