Topically Applied Sunflower Seed Oil Prevents Invasive Bacterial Infections in Preterm Infants in Egypt

Darmstadt, Gary L.; Badrawi, F. Nadia; Law, Paul A.; Ahmed, Saifuddin; Bashir, Moataza; Iskander, Iman; Said, Dalia Al; El-Kholy, Amani; Husein, M H; Alam, Asif; Winch, Peter J.; Gipson, Reginald; Santosham, Muhammad

doi:10.1097/01.inf.0000133047.50836.6f

Cited by 164 publications

(154 citation statements)

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“…Although hypothermia was not a primary outcome in a study of sunflower seed oil massage in Egypt, the application improved skin condition among preterm infants. 81 In mouse models, sunflower seed oil and Aquaphor accelerated barrier recovery and prevented transepidermal water loss as compared with controls. 69 In the same study, mustard, soybean and olive oils delayed barrier recovery, and mustard oil was shown to damage epidermal cellular structure and barrier function.…”

Section: Topical Agents and Oil Massagementioning

confidence: 99%

“…Mustard oil, which is the most commonly used oil in South Asia, has been shown to damage skin barrier function, leading to increased transepidermal loss of water and heat. 68,69,80 Although massage with certain emollients may be beneficial, 5,81,82 frequent and prolonged environmental exposure during massage could result in cold stress. Thus, care needs to be taken to limit exposure during the massage process.…”

Section: Transportmentioning

confidence: 99%

“…Mustard oil, which is widely used in South Asia for newborn and infant massage, is also easily adulterated to include toxic compounds. 69 In randomized, controlled trials in hospitals in Egypt and Bangladesh, sunflower seed oil applications reduced the incidence of neonatal sepsis by about 40 to 50%, 5,81 and in Bangladesh they reduced the risk of mortality by 26%. 82 Thus, evidence exists to promote the use of this highly cost effective intervention 102 in hospitalized, preterm infants <33 weeks gestational age in low resource settings.…”

Section: Topical Agents and Oil Massagementioning

confidence: 99%

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Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Section: Topical Agents and Oil Massagementioning

confidence: 99%

Section: Transportmentioning

confidence: 99%

Section: Topical Agents and Oil Massagementioning

confidence: 99%

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Neonatal hypothermia in low resource settings: a review

et al. 2009

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“…4 In Bangladesh, massage with SSO resulted in a 41% reduction in sepsis and a 26% reduction in mortality, 5,18 while Aquaphor treatment resulted in 32% lower mortality among treated infants relative to controls. 5 The efficacy of this trial highlights the potential for lowcost, culturally acceptable alternatives to replace mustard seed oil for treating preterm, low-birth-weight infants in South Asia.…”

Section: Introductionmentioning

confidence: 99%

“…1 Infants born very preterm (i.e. gestational age < 32 weeks) and with very low birth weight (< 1500 g) have mortality rates of over 50% in many low-resource settings [2][3][4][5] and are at high risk for long-term disabilities and impairments. 6 Premature infants have compromised skin barrier function, which increases their risk of infection [7][8][9] and of hypothermia due to transepidermal water and heat loss.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of skin-barrier-enhancing emollients among preterm infants in Bangladesh

LeFevre

Shillcutt

Saha

et al. 2010

Bull. World Health Organ.

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Objective To evaluate the cost-effectiveness of topical emollients, sunflower seed oil (SSO) and synthetic Aquaphor, versus no treatment, in preventing mortality among hospitalized preterm infants (< 33 weeks gestation) at a tertiary hospital in Bangladesh. Methods Evidence from a randomized controlled efficacy trial was evaluated using standard Monte Carlo simulation. Programme costs were obtained from a retrospective review of activities. Patient costs were collected from patient records. Health outcomes were calculated as deaths averted and discounted years of life lost (YLLs) averted. Results were deemed cost-effective if they fell below a ceiling ratio based on the per capita gross national income of Bangladesh (United States dollars, US$ 470). Findings Aquaphor and SSO were both highly cost-effective relative to control, reducing neonatal mortality by 26% and 32%, respectively. SSO cost US$ 61 per death averted and US$ 2.15 per YLL averted (I$ 6.39, international dollars, per YLL averted). Aquaphor cost US$ 162 per death averted and US$ 5.74 per YLL averted (I$ 17.09 per YLL averted). Results were robust to sensitivity analysis. Aquaphor was cost-effective relative to SSO with 77% certainty: it cost an incremental US$ 26 more per patient treated, but averted 1.25 YLLs (US$ 20.74 per YLL averted). Conclusion Topical therapy with SSO or Aquaphor was highly cost-effective in reducing deaths from infection among the preterm neonates studied. The choice of emollient should be made taking into account budgetary limitations and ease of supply. Further research is warranted on additional locally available emollients, use of emollients in community-based settings and generalizability to other geographic regions.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

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Topical emollient for preventing infection in preterm infants

Conner

Soll

1998

Cochrane Database of Systematic Reviews

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Topically Applied Sunflower Seed Oil Prevents Invasive Bacterial Infections in Preterm Infants in Egypt

Cited by 164 publications

References 39 publications

Neonatal hypothermia in low resource settings: a review

Neonatal hypothermia in low resource settings: a review

Cost-effectiveness of skin-barrier-enhancing emollients among preterm infants in Bangladesh

Topical emollient for preventing infection in preterm infants

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