COMPARISON OF OMPHALITIS WITH APPLICATION OF CHLORHEXIDINE AND DRY CORD CARE

Abstract

Background: Umbilical cord infection (omphalitis) is a risk factor for neonatal sepsis and mortality in low-resource settings where home deliveries are common. Up to half of neonatal deaths in high mortality settings are due to infections, many of which can originate through the freshly cut umbilical cord stump.

Objective: To compare the frequency of omphalitis with application of chlorhexidine on umbilical cord and dry cord care in neonates

Methods: This randomized controlled trial was conducted in the vaccination center of the Department of Pediatrics, Mayo Hospital, Lahore and Neonatal Unit of Lady Willingdon Hospital Lahore in 6 months duration. A total of 100 neonates were enrolled in this study. The neonates in case group got an application of the 7% chlorhexidine digluconate gel (delivering 4% chlorhexidine) on cord stump on their first day of life. Guardians or mother of the neonates in control group were advised to keep the cord stump of their neonates dry and clean without applying anything on it. They were called for follow up on 14^th day of life and signs of omphalitis were noted. The data were entered and analyzed by using SPSS v23.0. Data were stratified for gestational age, gender and birth weight to address the effect modifiers. Post stratification, Chi-square test was applied to check the significance with p-value ≤ 0.05 as significant.

Results: Total 100 neonates were enrolled in this study. Neonates were divided in two groups i.e. Group-A (Chlorhexidine) and Group-B (Dry care). In group-A, 6(12%) neonates had omphalitis and in group-B, 14(28%) had omphalitis. By applying Chi-Square test, it was concluded that, there was significant difference between both groups and omphalitis (p>0.046). Omphalitis was more present in Group-B as compared to Group-A.

Conclusion: Application of chlorhexidine to the umbilical cord was effective in reducing the risk of omphalitis and neonatal mortality in rural Pakistan. Provision of chlorhexidine in birth kits might be a useful strategy for the prevention of neonatal mortality in high-mortality settings.