title: Impact of clean delivery-kit use on newborn umbilical cord and maternal puerperal infections in Egypt.
abstract: This cross-sectional cohort study explored the impact of the use of clean delivery-kit (CDK) on morbidity due to newborn umbilical cord and maternal puerperal infections. Kits were distributed from primary-care facilities, and birth attendants received training on kit-use. A nurse visited 334 women during the first week postpartum to administer a structured questionnaire and conduct a physical examination of the neonate and the mother. Results of bivariate analysis showed that neonates of mothers who used a CDK were less likely to develop cord infection (p = 0.025), and mothers who used a CDK were less likely to develop puerperal sepsis (p = 0.024). Results of multiple logistic regression analysis showed an independent association between decreased cord infection and kit-use [odds ratio (OR) = 0.42, 95% confidence interval (CI) 0.18-0.97, p = 0.041)]. Mothers who used a CDK also had considerably lower rates of puerperal infection (OR = 0.11, 95% CI 0.01-1.06), although the statistical strength of the association was of borderline significance (p = 0.057). The use of CDK was associated with reductions in umbilical cord and puerperal infections.
authors.affiliation: International Center for Advancing Neonatal Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA. gary.darmstadt@gatesfoundation.org
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassan
authors.forename: Zohra P
authors.initials: ZP
authors.lastname: Balsara
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Winch
authors.forename: Reginald
authors.initials: R
authors.lastname: Gipson
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003150:Community Health Workers; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000295:instrumentation* / Q000592:standards; D004534:Egypt; D005260:Female; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008880:Midwifery; D011247:Pregnancy; D011645:Puerperal Infection / Q000517:prevention & control*; D018805:Sepsis / Q000097:blood / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014470:Umbilical Cord / Q000382:microbiology*; D014652:Vascular Diseases / Q000517:prevention & control*; D055815:Young Adult