Luke C. Mullany|Gary L. Darmstadt|Subarna K. Khatry|Joanne Katz|Steven C. LeClerq|Shardaram Shrestha|Ramesh Adhikari|James M. Tielsch
Topical applications of chlorhexidine to the umbilical cord for prevention of omphalitis and neonatal mortality in southern Nepal: a community-based, cluster-randomised trial
Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Tribhuvan University|Johns Hopkins University
omphalitis contributes neonatal morbidity mortality developing countries umbilical cord cleansing antiseptics might reduce infection mortality risk rigorously investigatedin communitybased clusterrandomised trial 413 communities sarlahi nepal randomly assigned one three cordcare regimens 4934 infants assigned 40 chlorhexidine 5107 cleansing soap water 5082 dry cord care intervention clusters newborn cord cleansed home days 14 6 8 10 clusters cord examined signs infection pus redness swelling visits followup visits days 12 14 21 28 incidence omphalitis defined three signbased algorithms increasing severity infant vital status recorded 28 completed days primary outcomes incidence neonatal omphalitis neonatal mortality analysis intentiontotreat trial registered number nct00109616frequency omphalitis three definitions reduced significantly chlorhexidine group severe omphalitis chlorhexidine clusters reduced 75 incidence rate ratio 025 95 ci 012053 13 infections4839 neonatal periods compared dry cordcare clusters 524930 neonatal mortality 24 lower chlorhexidine group relative risk 076 95 ci 055104 dry cord care group infants enrolled within first 24 h mortality significantly reduced 34 chlorhexidine group 066 046095 soap water reduce infection mortality riskrecommendations dry cord care reconsidered basis findings early antisepsis chlorhexidine umbilical cord reduces local cord infections overall neonatal mortality