title: Maternal and neonatal risk factors associated with vertical transmission of ophthalmia neonatorum in neonates receiving health care in Blantyre, Malawi.
abstract: BACKGROUND
  Neonatal conjunctivitis is associated with poor prenatal care worldwide.
  
  
  OBJECTIVE
  Data on neonatal conjunctivitis is scarce in Malawi. This study describes risk factors associated with conjunctivitis in neonates born in a large tertiary care hospital in Blantyre, Malawi.
  
  
  METHODS
  Medical records of a retrospective cohort of 231 neonates diagnosed with conjunctivitis from January 2006 to December 2009 at a large tertiary hospital in Malawi were reviewed. All subjects were clinically diagnosed with ophthalmia neonatorum. Data were collected on patient demographics and clinical features. The frequencies were calculated of various risk factors in neonates with ophthalmia neonatorum and their mothers as well as the treatments administered.
  
  
  RESULTS
  Mean age of the mother was 23.45 years (range, 15-40 years), and the mean number of previous deliveries was 2.3 (range, 1-7) children. Nearly, 80% of mothers delivered preterm infants via spontaneous vaginal delivery. The mean birth weight of neonates was 2869.6 grams (1100-5000 grams). Among mothers, premature rupture of membranes was the leading risk factor (24%) followed by sepsis during labor (9%), and history of sexually transmitted infections (STI) (7%). Neonates presented with low Apgar scores (19%), fever (8%), and/or meconium aspiration (5%). Providers treated patients empirically with a varied combination of benzyl penicillin, gentamicin, tetracycline eye ointment, and saline eye wash. Tetracycline with a saline eyewash was used frequently (34%) compared with combinations of benzyl penicillin and gentamicin.
  
  
  CONCLUSIONS
  Improving prenatal care to reduce sepsis, traumatic deliveries, and early diagnosis of STI with appropriate treatment may potentially reduce vertical transmission of neonatal conjunctivitis in this understudied population.
authors.affiliation: Department of Ophthalmology, University of Malawi College of Medicine, Lilongwe, Malawi.
authors.forename: Gerald
authors.initials: G
authors.lastname: Msukwa
authors.affiliation: Department of Ophthalmology, University of Malawi College of Medicine, Lilongwe, Malawi.
authors.forename: Nkume
authors.initials: N
authors.lastname: Batumba
authors.affiliation: Department of Ophthalmology, University of South Florida Eye Institute, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, Florida 33612, USA.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Drucker
authors.affiliation: Department of International Medicine, University of South Florida Eye Institute, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, Florida 33612, USA.
authors.forename: Lynette
authors.initials: L
authors.lastname: Menezes
authors.affiliation: Department of Ophthalmology, University of South Florida Eye Institute, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, Florida 33612, USA.
authors.forename: Roshni
authors.initials: R
authors.lastname: Ranjit
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D007743:Labor, Obstetric; D008295:Malawi / Q000453:epidemiology; D009878:Ophthalmia Neonatorum / Q000635:transmission*; D011247:Pregnancy; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors; D012749:Sexually Transmitted Diseases; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Neonatal Conjunctivitis; Ophthalmia Neonatorum; Prenatal Care; Risk Factors; Vertical Transmission
references.citation: J Matern Fetal Neonatal Med. 2011 Jun;24(6):769-73
references.pmid: 21534852
references.citation: Br J Ophthalmol. 2003 Dec;87(12):1449-52
references.pmid: 14660449
references.citation: Middle East Afr J Ophthalmol. 2011 Apr;18(2):109-14
references.pmid: 21731320
references.citation: Indian J Med Microbiol. 2010 Jan-Mar;28(1):45-7
references.pmid: 20061763
references.citation: J Infect. 1994 Sep;29(2):165-9
references.pmid: 7806879
references.citation: Semin Perinatol. 2001 Oct;25(5):295-309
references.pmid: 11707017
references.citation: J Nutr. 2003 May;133(5 Suppl 2):1656S-1660S
references.pmid: 12730481