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BACKGROUND: Surgical site infections after cesarean delivery are a cause of maternal morbidity and are typically caused by skin microbial flora. Preadmission application of chlorhexidine gluconate using impregnated cloths may decrease surgical site infections by decreasing the abundance of microbial flora. OBJECTIVE: To determine whether the application of chlorhexidine gluconate cloths the night before and the morning of scheduled cesarean delivery decreases the risk of surgical site infections by 6 weeks postoperatively compared with placebo. STUDY DESIGN: In this single-center, double-blind, placebocontrolled trial, patients were randomized (1:1) to receive either Sage 2% chlorhexidine cloths or Sage Comfort Bath fragrance-free cloths (placebo) to apply to 6 skin sites on the body (neck, shoulders and chest, armpits, arm and hands, abdomen and groin, left leg and foot, right leg and foot, back and buttocks) the night before and after a shower the morning of scheduled cesarean delivery. Routine clinical and operative procedures were followed. The primary outcome was surgical site infections (superficial or deep incisional with or without organ space endometritis) by 6 weeks after cesarean delivery. The secondary outcomes were surgical site infections by 2 weeks and other wound-related complications by 2 and 6 weeks after cesarean delivery.

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Introduction: Anemia affects more than one billion people worldwide, with pregnant women and children under five years of age comprising the vast majority of those afflicted. The development of anemia is multifactorial and could stem from a variety of factors. Nutritional deficiencies especially iron, but also folate, vitamin B12, vitamin A, and protein appear to be the biggest factor. Diagnosing anemia in children under five years of age is of utmost importance because these nutrients are essential for their rapid phase of growth and development.Objective: The purpose of this study was to determine the prevalence of anemia in children under six years of age living in Dominica.Methods: This was a retrospective, descriptive study, examining the prevalence of anemia in preschool children, aged two to six years, living in Dominica from January 1, 2012 to December 31, 2015. All available medical records of the children were collected and analyzed using Stata version 14. There were no exclusion criteria. Results and discussion:A sample population of 635 children was included in our study. The majority of children was females (54.7%), at least 3.5 years old (60.6%), and attended preschool in the parish of Saint George (58.7%). Our study determined that the prevalence of anemia was 19.3%. Additionally, we found that 22% of anemic children had a mean corpuscular volume below 75 fL, and 78% of anemic children had a mean corpuscular volume between 76 fL and 99 fL. Conclusion:The data in this study demonstrated that childhood anemia in Dominica is widely prevalent, and represents a public health issue that needs to be addressed. According to our data, 22% of anemic children had a mean corpuscular volume below 75 fL indicating a microcytic anemia. Microcytic anemia could suggest diseases such as iron deficiency and thalassemia among many other causes. Additionally, 78% of anemic children had a mean corpuscular volume between 76 fL and 99 fL indicating a normocytic anemia. Normocytic anemia could suggest chronic disease and sickle cell anemia among many others. Due to limited resources, we were unable to determine the specific cause of anemia; however, future studies should be conducted so that strategies could be developed, on a national level, to resolve this childhood burden.

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