Document Detail


The use of chlorhexidine to reduce maternal and neonatal mortality and morbidity in low-resource settings.
MedLine Citation:
PMID:  17399714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Of the 4 million neonatal deaths and 500,000 maternal deaths that occur annually worldwide, almost 99% are in developing countries and one-third are associated with infections. Implementation of proven interventions and targeted research on a select number of promising high-impact preventative and curative interventions are essential to achieve Millennium Development Goals for reduction of child and maternal mortality. Feasible, simple, low-cost interventions have the potential to significantly reduce the mortality and severe morbidity associated with infection in these settings. Studies of chlorhexidine in developing countries have focused on three primary uses: 1) intrapartum vaginal and neonatal wiping, 2) neonatal wiping alone, and 3) umbilical cord cleansing. A study of vaginal wiping and neonatal skin cleansing with chlorhexidine, conducted in Malawi in the 1990s suggested that chlorhexidine has potential to reduce neonatal infectious morbidity and mortality. A recent trial of cord cleansing conducted in Nepal also demonstrated benefit. Although studies have shown promise, widespread acceptance and implementation of chlorhexidine use has not yet occurred. This paper is derived in part from data presented at a conference on the use of chlorhexidine in developing countries and reviews the available evidence related to chlorhexidine use to reduce mortality and severe morbidity due to infections in mothers and neonates in low-resource settings. It also summarizes issues related to programmatic implementation.
Authors:
E M McClure; R L Goldenberg; N Brandes; G L Darmstadt; L L Wright; ; Deborah Armbruster; Robert Biggar; Joyce Carpenter; Michael J Free; Donald Mattison; Matthews Mathai; Nancy Moss; Luke C Mullany; Stephanie Schrag; James Tielsch; Jorge Tolosa; Stephen N Wall; Anne Schuchat; Abdelkrim Smine
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-03-30
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  97     ISSN:  0020-7292     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-23     Completed Date:  2007-08-20     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  89-94     Citation Subset:  IM    
Affiliation:
Department of Statistics and Epidemiology, RTI International, Durham, NC 27709, USA. mcclure@rti.org
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MeSH Terms
Descriptor/Qualifier:
Africa / epidemiology
Anti-Infective Agents, Local / therapeutic use*
Asia, Western / epidemiology
Chlorhexidine / therapeutic use*
Developing Countries
Female
Humans
Infant Mortality*
Infant, Newborn
Infection Control / methods*
Maternal Mortality*
Pregnancy
Puerperal Infection / mortality,  prevention & control*
Sepsis / prevention & control
Grant Support
ID/Acronym/Agency:
U01 HD040636-06/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Infective Agents, Local; 55-56-1/Chlorhexidine
Comments/Corrections

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