How do low‐birthweight neonates fare 2 years after discharge from a low‐technology neonatal care unit in a rural district hospital in Burundi?

Objectives As neonatal care is being scaled up in economically poor settings, there is a need to know more on post-hospital discharge and longer-term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in low-birth-weight neonates (LBW, <2500 grams). Getting a better handle on these parameters might justify and guide support interventions. Two years after hospital discharge, we thus assessed: mortality, developmental impairments, and nutritional status of LBW children. Methods Household survey of LBW neonates discharged from a neonatal special care unit in Rural Burundi between January and December 2012. Results Of 146 LBW neonates, 23% could not be traced and 4% had died. Of the remaining 107 children (median age=27 months), at least one developmental-impairment was found in 27%, with 8% having at least five impairments. Main impairments included delays in motor development (17%) and in learning and speech (12%). Compared to LBW children (n=100), very-low-birth-weight (VLBW, < 1500 grams, n=7) children had a significantly higher risk of impairments (intellectual - P=0.001), needing constant supervision and creating a household burden (P= 0.009). Of all children (n-107), 18% were acutely malnourished, with a 3½ times higher risk in VLBWs (P=0.02). Conclusions Reassuringly, most children were thriving two years after discharge. However, malnutrition was prevalent and one-in-three manifested developmental-impairments (particularly VLBWs) echoing the need for support programs. A considerable proportion of children could not be traced, and this emphasises the need for follow-up systems post-discharge. This article is protected by copyright. All rights reserved.