Prevention of omphalitis with a single application of chlorhexidine in newborns
Keywords:
efficacy, solitary chlorhexidine treatment, omphalitis, neonatesAbstract
Background: Out of the estimated 6.3 million global childhood deaths in 2013, 44% (2•761 million) occurred in the first month of life. Worldwide, seventy-five percent of all neonatal fatalities occur during the first week of life. Neonatal mortality is almost entirely a problem of low- and middle-income nations. These newborn mortality may be reduced significantly if proper health precautions are followed throughout labour and delivery, with an emphasis on cleanliness. Objective: The goal of this study is to assess whether or not a single treatment of chlorhexidine may reduce the risk of omphalitis in newborns. Methodology: The Paediatrics department at Hayatabad Medical Complex in Peshawar, Pakistan, played host to this randomised control trial between January 2019, December 2020. Sixty-four participants were studied in all, with 32 participants observing each group. Two groups, Group-A and Group-B, of newborns were each given a different plan for handling the umbilical cord. Those in Group A had their umbilical cords cleaned with a 4% chlorhexidine solution, whereas those in Group B were told to let theirs dry naturally.
Downloads
References
Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet. 2015 Jan 31;385(9966):430-40. doi.org/10.1016/S0140-6736(14)61698-6Get
Lawn JE, Cousens S, Zupan J, Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why?. The lancet. 2005 Mar 5; 365(9462):891-900. doi.org/10.1016/S0140-6736(05)71145-4
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet. 2012 Dec 15; 380(9859):2095-128. doi.org/10.1016/S0140-6736(12)61728-0
Lu MC, Highsmith K, de la Cruz D, Atrash HK. Putting the “M” back in the maternal and child health bureau: reducing maternal mortality and morbidity. Matern Child Health J. 2015 Jul 1;19(7):1435-9.
Saleem S, Rouse DJ, McClure EM, Zaidi A, Reza T, Yahya Y, et al. Chlorhexidine vaginal and infant wipes to reduce perinatal mortality and morbidity: a randomized controlled trial. Obstet Gynecol. 2010 Jun;115(6):1225-32. doi: 10.1097/AOG.0b013e3181e00ff0
Ameh EA, Nmadu PT. Major complications of omphalitis in neonates and infants. Pediatr Surg Int. 2002 Sep;18(5-6):413-6.
Feo CF, Dessanti A, Franco B, Ganau A, Iannuccelli M. Retroperitoneal abscess and omphalitis in young infants. Acta Paediatr. 2003;92(1):122-5. doi.org/10.1111/j.1651-2227.2003.tb00483.x
Lin J, Zupeng H, Zi C, Hong H, Minjie Y, Ting S, et al. Evolving practice environment for urban emergency physicians in China. Am J Emerg Med. 2011 Jun;29(5):569.doi.org/10.1016/j.ajem.2011.02.025
Mullany LC, Khatry SK, Sherchand JB, LeClerq SC, Darmstadt GL, Katz J, et al. A randomized controlled trial of the impact of chlorhexidine skin cleansing on bacterial colonization of hospital-born infants in Nepal. Pediatr Infect Dis J. 2008 Jun;27(6):505-11. doi: 10.1097/INF.0b013e31816791a2
Mullany LC, Darmstadt GL, Khatry SK, Katz J, LeClerq SC, Shrestha S, et al. doi.org/10.1016/S0140-6736(06)68381-5
Topical applications of chlorhexidine to the umbilical cord for prevention of omphalitis and neonatal mortality in southern Nepal: a community-based, cluster-randomised trial. Lancet. 2006 Mar 18;367(9514):910-8. doi.org/10.1016/S0140-6736(06)68381-5
Mullany LC, Darmstadt GL, Khatry SK, LeClerq SC, Katz J, Tielsch JM. Impact of umbilical cord cleansing with 4.0% chlorhexidine on time to cord separation among newborns in southern Nepal: a cluster-randomized, community-based trial. Pediatrics. 2006 Nov;118(5):1864-71. DOI: https://doi.org/10.1542/peds.2006-1091
Imdad A, Mullany LC, Baqui AH, El Arifeen S, Tielsch JM, Khatry SK, Shah R, Cousens S, Black RE, Bhutta ZA. The effect of umbilical cord cleansing with chlorhexidine on omphalitis and neonatal mortality in community settings in developing countries: a meta-analysis. BMC Public Health. 2013 Sep;13(3):S15.
Goldenberg RL, McClure EM, Saleem S. A review of studies with chlorhexidine applied directly to the umbilical cord. Am J Perinatol. 2013 Sep;30(8). DOI: 10.1055/s-0032-1329695
Mullany LC, Darmstadt GL, Khatry SK, LeClerq SC, Katz J, Tielsch JM. Impact of umbilical cord cleansing with 4.0% chlorhexidine on time to cord separation among newborns in southern Nepal: a cluster-randomized, community-based trial. Pediatrics. 2006 Nov;118(5):1864-71. doi.org/10.1542/peds.2006-1091
Imdad A, Mullany LC, Baqui AH, El Arifeen S, Tielsch JM, Khatry SK, Shah R, Cousens S, Black RE, Bhutta ZA. The effect of umbilical cord cleansing with chlorhexidine on omphalitis and neonatal mortality in community settings in developing countries: a meta-analysis. BMC Public Health. 2013 Sep;13(3):S15.
Goldenberg RL, McClure EM, Saleem S. A review of studies with chlorhexidine applied directly to the umbilical cord. Am J Perinatol. 2013 Sep;30(8). DOI: 10.1055/s-0032-1329695
Sazawal S, Dhingra U, Ali SM, Dutta A, Deb S, Ame SM, Mkasha MH. Efficacy of chlorhexidine application to umbilical cord on neonatal mortality in Pemba, Tanzania: a community-based randomised controlled trial. Lancet Glob Health 2016;4:e837–44. doi.org/10.1016/S2214-109X(16)30223-6
Semrau KEA, Herlihy J, Grogan C, et al. Effectiveness of 4% chlorhexidine umbilical cord care on neonatal mortality in Southern Province, Zambia (ZamCAT): a cluster-randomised controlled trial. Lancet Glob Health 2016; published online Sept 29. http://dx.doi.org/10.1016/S2214-109X(16)30215-7.
National Bureau of Statistics and ICF Macro. Tanzania Demographic and Health Survey 2010. Dar es Salaam: NBS and ICF Macro, 2011.
Dhingra U, Sazawal S, Dhingra P, et al. Trial of improved practices approach to explore the acceptability and feasibility of different modes of chlorhexidine application for neonatal cord care in Pemba, Tanzania. BMC Pregnancy Childbirth 2015; 15: 354.
Mullany LC, Darmstadt GL, Tielsch JM. Safety and impact of chlorhexidine antisepsis interventions for improving neonatal health in developing countries. Pediatr Infect Dis J 2006; 25: 665–75. doi: 10.1097/01.inf.0000223489.02791.70
Mullany LC, Darmstadt GL, Katz J, et al. Risk factors for umbilical cord infection among newborns of southern Nepal. Am J Epidemiol 2007; 165: 203–11. doi.org/10.1093/aje/kwj356
Alam MA, Ali NA, Sultana N, et al. Newborn umbilical cord and skin care in Sylhet District, Bangladesh: implications for the promotion of umbilical cord cleansing with topical chlorhexidine. J Perinatol 2008; 28: S61–68.
Mullany LC, Darmstadt GL, Khatry SK, LeClerq SC, Katz J, Tielsch JM. Impact of umbilical cord cleansing with 4•0% chlorhexidine on time to cord separation among newborns in southern Nepal: a cluster-randomized, community-based trial. Pediatrics 2006; 118: 1864–71. DOI: https://doi.org/10.1542/peds.2006-1091
Dhingra U, Gittelsohn J, Moh A, et al. Delivery, immediate newborn and cord care practices in Pemba Tanzania: a qualitative study of community, hospital stay and community level care providers for knowledge, attitudes, belief systems and practices. BMC Pregnancy Childbirth 2014; 14: 173.
Imdad A, Mullany LC, Baqui AH. The effect of umbilical cord cleansing with chlorhexidine on omphalitis and neonatal mortality in community settings in developing countries: a meta-analysis. BMC Public Health 2013; 13 (suppl 3): S15
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
