James M. Tielsch|Gary L. Darmstadt|Luke C. Mullany|Subarna K. Khatry|Joanne Katz|Steven C. LeClerq|Shardaram Shrestha|Ramesh Adhikari
Impact of Newborn Skin-Cleansing With Chlorhexidine on Neonatal Mortality in Southern Nepal: A Community-Based, Cluster-Randomized Trial
Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Tribhuvan University
hospitalbased data africa suggest newborn skincleansing chlorhexidine may reduce neonatal mortality evaluation intervention communities births occur home done objective assess efficacy 1time skincleansing newborn infants 025 chlorhexidine neonatal mortalitythe design communitybased placebocontrolled clusterrandomized trial sarlahi district southern nepal newborn infants cleansed infant wipes contained 025 chlorhexidine placebo solution soon possible delivery home median 58 hours primary outcome allcause mortality 28 days completion randomized phase newborns study clusters converted chlorhexidine treatment subsequent 9 monthsa total 17530 live births occurred enrolled sectors 8650 8880 chlorhexidine placebo groups respectively baseline characteristics similar treatment groups intentiontotreat analysis among live births showed impact intervention neonatal mortality among liveborn infants actually received assigned treatment 987 nonsignificant 11 lower neonatal mortality rate among treated chlorhexidine compared placebo low birth weight infants statistically significant 28 reduction neonatal mortality significant difference among infants born weighing 2500 g conversion active treatment placebo clusters 37 reduction mortality among low birth weight infants placebo clusters versus change chlorhexidine clustersnewborn skinwiping chlorhexidine solution soon birth reduced neonatal mortality among low birth weight infants evidence additional trials needed determine whether inexpensive simple intervention could improve survival significantly among low birth weight infants settings home delivery common hygiene practices poor