{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:17:48Z","timestamp":1785341868358,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>There is limited literature available about necrotising enterocolitis (NEC) in low\u2010 and middle\u2010income countries. This study sought to determine the proportion, pattern and risk factors for mortality among very low birth weight (VLBW) neonates with NEC in a middle\u2010income setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational cohort study was conducted on all infants with birth weights less than 1501\u2009g admitted from 2018 to 2020 at Groote Schuur Hospital, Cape Town, South Africa. Data were obtained from the Vermont Oxford Network and hospital folders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 104\/1582 (6.6%) neonates were diagnosed with NEC with a median onset of 8\u2009days of life. The mortality rate was 39.0%, compared to the all\u2010cause mortality rate of 18.7% for VLBW neonates. Thirty\u2010two (32.0%) neonates with NEC were transferred for surgery of whom 10 (31.3%) died. Small for gestational age (<jats:italic>p<\/jats:italic>\u2009=\u20090.13), NEC stage 2B or above (<jats:italic>p<\/jats:italic>\u2009=\u20090,002), a positive blood culture (<jats:italic>p<\/jats:italic>\u2009=\u20090.018), a raised C\u2010reactive protein (<jats:italic>p<\/jats:italic>\u2009=\u20090.013), hyponatraemia (<jats:italic>p<\/jats:italic>\u2009=\u20090.004), anaemia requiring blood transfusion (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and thrombocytopenia requiring platelet transfusion (<jats:italic>p<\/jats:italic>\u2009=\u20090.033) were associated with mortality. A positive blood culture was found in 37.0% with a predominance of <jats:italic>Klebsiella pneumoniae<\/jats:italic> isolates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NEC has an early onset and a high mortality rate in our setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.17253","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T11:28:45Z","timestamp":1714130925000},"page":"1811-1817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Necrotising enterocolitis in a middle\u2010income country: Early onset and risk factors for mortality"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2281-2822","authenticated-orcid":false,"given":"Evelyne","family":"Assenga","sequence":"first","affiliation":[{"name":"Department of Paediatrics Groote Schuur Hospital, University of Cape Town  Cape Town South 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