{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T03:13:22Z","timestamp":1787454802337,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neonatal hypothermia is a major public health concern that threatens the survival and well\u2010being of newborns, particularly those admitted to neonatal intensive care units. In Ethiopia, where the burden of neonatal hypothermia remains high, it contributes substantially to neonatal morbidity and mortality. This study aimed to model the time to recovery from neonatal hypothermia and identify its predictors using a shared frailty survival analysis among neonates admitted to the neonatal intensive care unit at Pawe General Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective follow\u2010up study was conducted among 425 neonates admitted with hypothermia to the NICU of Pawe General Hospital. Time to recovery was analyzed using survival analysis techniques. Non\u2010parametric methods were used to compare recovery experiences across demographic and clinical characteristics, and parametric accelerated failure time and shared frailty models were fitted to identify significant predictors while accounting for unobserved heterogeneity. Model selection was based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The log\u2010logistic gamma shared frailty model was identified as the best\u2010fitting model. The frailty effect at the level of place of childbirth was statistically significant (\u03b8\u2009=\u20091.228;\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2 = 84.24,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), indicating substantial unobserved heterogeneity with moderate intra\u2010cluster dependence (\u03c4\u2009=\u20090.38). Maternal age 20\u201329 years (AF\u2009=\u20090.842) and 30\u201339 years (AF\u2009=\u20090.707), urban residence (AF\u2009=\u20090.823), and above\u2010average family income (AF\u2009=\u20090.834) were associated with shorter recovery times. Female neonates had slightly prolonged recovery (AF\u2009=\u20091.110). Very low and low birth weight, as well as preterm and post\u2010term gestational ages, were associated with delayed recovery. Early initiation of breastfeeding (AF\u2009=\u20090.365) and skin\u2010to\u2010skin contact (AF\u2009=\u20090.801) accelerated recovery, whereas CPR at birth (AF\u2009=\u20090.857) and admission\u2010related complications, including prematurity, low birth weight, sepsis, respiratory distress syndrome, asphyxia, and congenital malformations, were strong predictors of prolonged recovery time from neonatal hypothermia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings indicate that recovery from neonatal hypothermia is influenced by maternal, socioeconomic, neonatal, clinical, and contextual factors. The significant frailty effect underscores the importance of accounting for clustering by place of childbirth when modeling recovery time. Interventions aimed at improving early breastfeeding practices, promoting skin\u2010to\u2010skin contact, and strengthening neonatal care, particularly for preterm and low birth weight infants, may substantially reduce recovery time and improve neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72370","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T04:47:07Z","timestamp":1776660427000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Shared Frailty Survival Analysis of Neonatal Hypothermia and Its Predictors Among Neonates Admitted to the Neonatal Intensive Care Unit at Pawe General Hospital"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8042-0727","authenticated-orcid":false,"given":"Aboma Tolessa","family":"Denta","sequence":"first","affiliation":[{"name":"Department of Statistics, College of Natural and Computational Science Oda Bultum University Chiro Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonas Shuke","family":"Kitawa","sequence":"additional","affiliation":[{"name":"Department of Statistics, College of Natural and Computational Science Hawassa University Hawassa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gezahagn Mekonnen","family":"Woldemedihn","sequence":"additional","affiliation":[{"name":"Department of Statistics, College of Natural and Computational Science Hawassa University Hawassa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0180-9669","authenticated-orcid":false,"given":"Buzuneh Tasfa","family":"Marine","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Faculty of Public Health Jimma University Jimma Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.32677\/ijch.v10i1.3830"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-052045"},{"key":"e_1_2_15_4_1","unstructured":"S.Naresh Prevalence Complications and Outcome of LBW and VLBW Babies Admitted in Tertiary Care Hospital.2018 Rajiv Gandhi University of Health Sciences (India)."},{"key":"e_1_2_15_5_1","doi-asserted-by":"crossref","unstructured":"K.Sachin Spectrum of Neonatal Surgical Problems in the Newborn\u2010Incidence Clinical Course Immediate Outcome Follow up Study in a Tertiary Care NICU.2019 Rajiv Gandhi University of Health Sciences (India).","DOI":"10.9734\/ajpr\/2019\/v2i430116"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2018.03.009"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.233"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.18203\/2320-1770.ijrcog20212175"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1179\/2046905515Y.0000000034"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1057\/jphp.2014.44"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-019-0545-0"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000369"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X241273134"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-24572-0"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-statistics-032921-021310"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2434"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.16929\/ajas\/2019.565.231"},{"key":"e_1_2_15_18_1","doi-asserted-by":"crossref","unstructured":"A.Wienke Frailty models. 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