Assessment of Serum Tumor Necrosis Factor-Alpha Level in Sudanese Neonates with Bacterial Sepsis at Omdurman Maternity Hospital in Khartoum State

Abstract

Worldwide, neonatal sepsis accounts for an estimated 26% of under-five deaths, with sub-Saharan Africa (SSA) having the highest mortality rates, 49.6% of all under-five deaths. TNF-α is the prime mediator of septic shock in neonates and wide spread tissue injury. The role of TNF-α as a marker for the prediction of neonatal sepsis has been suggested. Additionally, when used in combination with IL-6, TNF-α may achieve up to 98.5% sensitivity. This cross-sectional, case control study was aimed to assess the serum TNF-α level in Sudanese neonates infected with bacterial sepsis and control subjects, in Omdurman Maternity Hospital in Khartoum State during the period from December (2019) to November (2020). In which 44 septic neonates and 44 of age and sex- matched healthy control neonates were enrolled. Among the septic neonates; 27/44 (61%) had early-onset and 17 (39%) had late-onset neonatal sepsis, 25 (57%) were males and 19 (43%) were females, 20 (45%) were preterm neonates and 24 (55%) were term, while control neonates included; 23/44 (52%) males and 21(48%) females, 15 (34%) preterm neonates and 29 (66%) term neonates. TNF-α concentration was measured using Enzyme Linked Immunosorbent Assay (ELISA). The result showed that: there was significant difference in serum level of TNF-α between septic neonates and healthy one ( p. value = 0.000). Concerning onset of disease, there was no significant difference in serum levels of TNF-α in EOS and LOS (p. value = 0.621). Level of serum TNF-α in preterm neonates was differ than term in both patient and control groups but the difference was statistically insignificant (p. value = 0.285, p. value = 0.124 respectively). Regarding to gender, there was meaningless differences between males and females in both septic (p.value =0.467) and healthy neonates (p.value was 0.726). This study concluded that; serum level of TNF-α was higher in septic neonates compared with healthy neonates. There was no significant difference in serum levels of TNF-α according to onset of disease, gestational age and gender. TNF-α concentration was elevated in septic neonates and might be a useful marker for diagnosis of neonatal bacterial sepsis.