TITLE:
Neonatal Umbilical Cord Infections: Incidence, Associated Factors and Cord Care Practices by Nursing Mothers at a Tertiary Hospital in Western Uganda
AUTHORS:
Munanura Turyasiima, Martin Nduwimana, Silva Manuel Andres, Gloria Kiconco, Walufu Ivan Egesa, Bernis Melvis Maren, Robinson Ssebuufu
KEYWORDS:
Umbilical Cord Infection, Cord Care Practices, Associated Factors, Western Uganda
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.2,
May
28,
2020
ABSTRACT: Background: Umbilical cord infections
complicate to neonatal sepsis that significantly contributes to neonatal
mortality worldwide. There is paucity of data on the incidence, factors
associated with neonatal umbilical cord infections in western Uganda, yet
nursing mothers continue to practice potentially dangerous cord care practices.
We described the incidence, factors associated with umbilical cord infections
and cord care practices by nursing mothers at a tertiary hospital in western
Uganda. Methods: This was a hospital based cross sectional study at a
tertiary hospital in western Uganda between the months of March and June 2019.
Two hundred and forty (240) neonates aged between 2 to 14 days attending the neonatal unit were
recruited in the study. Umbilical cord infection was assessed based on the
World Health Organisation (WHO) clinical definition: finding of any of
discharge, redness and swelling on the umbilical stump. Data on
sociodemographic characteristics, maternal and neonatal perinatal factors and
cord care practices of the nursing mothers were analysed by bivariate and
multivariate logistic regression using STATA 13.0 to determine factors
associated with umbilical cord infection. Results: Sixty-five, 65
(27.1%) neonates had at least one sign of cord infection. Majority of the
nursing mothers, 168 (70%) do not use the recommended umbilical cord care
practices. Among these, 73 (30.4%) do not cleanse the cord while 95 (39.6%)
cleanse with application of a dangerous substance. Application of dangerous
substance to the cord (aOR: 3.0, 95% CI: 1.37 - 6.37, p = 0.006) and maternal
secondary education level (aOR = 2.1, CI = 1.01 - 4.18, p = 0.046) were
significantly associated with umbilical cord infection. Conclusions: The
incidence of neonatal umbilical cord infection is high in this setting. Application of a dangerous
substance to the umbilical stump and maternal secondary education level were
significantly associated with umbilical cord infection. Clinicians should routinely
examine the umbilical stump of every neonate for the signs of infection and
encourage mothers to avoid application of dangerous substances to the cord.
Maternal education on the recommended cord care practices during antenatal and
postnatal period could reduce the incidence of umbilical cord infection among
neonates in low resource setting.