Topical antimicrobials applied to the umbilical cord stump: a new intervention against neonatal tetanus
| Autor: | U. D. Parashar, Hlady Wg, J Bennett, Boring |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Epidemiology Administration Topical Population Umbilical cord medicine Odds Ratio Humans education education.field_of_study Tetanus business.industry Toxoid Infant Newborn General Medicine Odds ratio medicine.disease Delivery Obstetric Infant mortality Anti-Bacterial Agents Neonatal tetanus medicine.anatomical_structure Logistic Models Case-Control Studies Female business Disinfectants |
| Zdroj: | International journal of epidemiology. 27(5) |
| ISSN: | 0300-5771 |
| Popis: | Previous case-control studies of neonatal tetanus (NNT), a leading cause of infant mortality in developing countries, have suggested that antimicrobials applied after delivery to the umbilical cord stump may protect against this disease. However, assessment of their protective effect has been limited by the low prevalence of antimicrobial use in developing countries.We conducted a population-based, matched, case-control study to assess the use of antimicrobials and other factors potentially related to NNT in rural parts of Bangladesh. We studied 359 cases (infants who were normal at birth but who died between the 3rd and 30th day of life after an illness characterized by signs of NNT), each matched to three living controls for gender, residence, and date of birth.In univariate analyses, the application of either antibiotics or disinfectants at delivery, and the continuous or any application of disinfectants were protective against NNT. The application of antibiotics at delivery (odds ratio [OR] = 0.21, P = 0.019), hand washing by the delivery attendant (OR = 0.64, P = 0.005), and prior maternal immunization with tetanus toxoid (OR = 0.50, P0.001) remained protective in conditional logistic-regression analyses. Application of animal dung to the umbilical stump (OR = 2.31, P = 0.047) was hazardous.Effective and inexpensive topical antimicrobials provide a new prevention opportunity that could be used by traditional birth attendants and mothers to provide additional benefits to NNT control programmes based on maternal immunization with tetanus toxoid. Promotion of hygienic delivery and cord-care practices and increasing tetanus toxoid coverage remain cornerstones for the prevention of NNT deaths.Neonatal tetanus (NNT) is a leading cause of infant mortality in developing countries. Findings from previous case-control studies of NNT have suggested that antimicrobials applied following delivery to the umbilical cord stump may protect against the disease. However, assessment of their protective effect has been hampered by the low prevalence of antimicrobial use in developing countries. The authors conducted a population-based, matched, case-control study to assess the use of antimicrobials and other factors potentially related to NNT in rural parts of Bangladesh. 359 cases were studied, infants who were normal at birth but who died between the 3rd and 30th day of life after an illness characterized by signs of NNT. Each case was matched to 3 living controls for gender, residence, and date of birth. Univariate analyses found the application of either antibiotics or disinfectants at delivery, and the continuous or any application of disinfectants to protect against NNT. The application of antibiotics at delivery, hand washing by the delivery attendant, and prior maternal immunization with tetanus toxoid remained protective in conditional logistic-regression analyses. The application of animal dung to the umbilical stump was hazardous. |
| Databáze: | OpenAIRE |
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