Ophthalmia Neonatorum in Nairobi Kenya: The Roles of Neisseria gonorrhoeae and Chlamydia trachomatis

Fransen, L; Nsanze, H; Klauß, Volker; Stuyft, Patrick Van der; D'Costa, L J; Brunham, Robert C.; Piot, Peter

doi:10.1093/infdis/153.5.862

Cited by 71 publications

(28 citation statements)

References 27 publications

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“…539 In developing countries such as Kenya, where rates of maternal STDs are high, rates of gonococcal ophthalmia range from 15% to 34%. 540,541 A variety of interventions have been evaluated for prevention of ophthalmia neonatorum in developed countries, mostly in hospital settings, and have largely focused on the prevention of gonococcal infections. [542][543][544][545] These studies have suggested that silver-nitrate, tetracycline, or erythromycin ointments given prophylactically are equivalent in efficacy.…”

Section: Prevention and Treatment Of Ophthalmia Neonatorummentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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Section: Prevention and Treatment Of Ophthalmia Neonatorummentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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“…The sexually transmitted agents Neisseria gonorrhoeae and Chlamydia trachomatis are well known causes of microbial neonatal conjunctivitis, but in the majority of cases the aetiology is unknown [5,7,13]. The incidence of gonococcal ophthalmia in Europe is estimated to be lower than 1% with AgNO~ still being used at birth [6,12].…”

Section: Introductionmentioning

confidence: 99%

Incidence and bacterial aetiology of neonatal conjunctivitis

et al. 1987

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Two hundred and twenty-nine infants born consecutively at the maternity ward of the Middelheim Hospital in Antwerp, over a period of 5 months, and an additional 55 randomly selected infants born at the same hospital were clinically and microbiologically investigated before leaving the maternity ward. All infants born at this maternity ward received argyrol eye drops immediately after birth. Twenty-six (11%) of the infants consecutively investigated had neonatal conjunctivitis diagnosed before leaving the maternity ward, where they stayed from 7-10 days. Another 29 infants were reported to have developed sticky eyes and/or red eyes after leaving the maternity hospital and before 1 month of age. The instantaneous risk of developing, a conjunctivitis was equal for each day of the first month of life. Chlamydia trachomatis was isolated from the eyes of 11 of the 229 (4.8%) consecutively born infants but only one had conjunctivitis symptoms before leaving the maternity ward. Overall one or more bacterial species could be isolated from the eyes of 143 (48%) of the infants, but only viridans streptococci and Staphylococcus aureus were cultured significantly more often from the eyes of cases with conjunctivitis than from the eyes of the infants without conjunctivitis (P less than 0.001).

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“…In a study in the Gambia the incidence was estimated at about 5% [8], but the location of the study was an area in which trachoma is hyperendemic. In Nairobi cases of ophthalmia neonatorum were described in which the causative agent was Chlamydia with a trachoma serotype (A-C) [4]. The absence of clinical trachoma in Ndoungue, with the resultant reduced occurrence of trachoma serotypes, may be partly responsible for the lower incidence of Chlamydia ophthalmia neonatorum.…”

Section: Discussionmentioning

confidence: 99%

“…The Gram specimen. The presence of Gram-negative intracellular diplococci was taken to indicate a presumable diagnosis of gonorrhoeal ophthalmia neonatorum [4]. Other micro-organisms were not identified.…”

Section: Methodsmentioning

confidence: 99%

Chlamydia ophthalmia neonatorum in Cameroon

et al. 1988

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In the Ndoungué Hospital in Cameroon 449 new-born babies were examined for a month to check on the occurrence of ophthalmia neonatorum. Silver nitrate eyedrops 1% were applied at birth. The incidence of ophthalmia neonatorum was 19.4%; Chlamydia was found in 8 cases (incidence 1.8%) and gonococci in 4 cases (0.9%). Chemical conjunctivitis was suspected in 13 cases (2.9%). Slight conjunctivitis was seen in 68 cases and severe conjunctivitis in 19 cases (4.2%). A sexually transmitted agent was demonstrated in 6% of the slight cases and in 42% of the severe cases. Ophthalmia neonatorum due to Chlamydia was significantly more frequently severe and without specific features than those due to other agents. Although silver nitrate is still considered to be one of the most effective prophylactic measures for gonococcal ophthalmia neonatorum, in 4 cases this disease still developed. Silver nitrate is ineffective against Chlamydia and is also often the cause of a chemical conjunctivitis. The search is advocated for more efficient medicines in Africa which are effective against both Chlamydia and resistant gonoccoci.

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Ophthalmia Neonatorum in Nairobi Kenya: The Roles of Neisseria gonorrhoeae and Chlamydia trachomatis

Cited by 71 publications

References 27 publications

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Incidence and bacterial aetiology of neonatal conjunctivitis

Chlamydia ophthalmia neonatorum in Cameroon

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