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Abstract
Purpose. To estimate the incidence rate of neonatal conjunctivitis in Togo and identify the main etiologies. Patients and Methods. This was a cross-sectional survey from March 19th to May 13th 2011, in seven health centers in Togo (4 in the south and 3 in the north). All newborns in these centers were examined to identify clinical signs of conjunctivitis. Cytological and bacteriological examination (CBE) of conjunctival secretions was carried out on suspect newborns children. Results. During the study period, 507 newborns babies were examined including 265 boys and 242 girls. The mean age at examination was 3.7 days. Thirty-five newborns babies had conjunctivitis (6.9%). 11 (37.1%) of these cases of conjunctivitis were diagnosed in the first four days of life. Twenty-five of these newborns children were delivered vaginally (71.4%) against 10 by caesarean section (28.6%). All mothers of newborns patients reported signs and symptoms of sexually transmitted infections (STIs) during the third trimester of pregnancy. On CBE, Staphylococcus aureus was found in 25.7% of cases. Conclusion. Despite the extension of neonatal conjunctivitis prophylaxis by the method of Crede, this disease is still endemic in our region. Neonatal conjunctivitis’ eradication requires treatment of STIs among pregnant women followed by information on the prevention of infections inside the neonatal care centers and at home by applying simple rules of hygiene.
Résumé
But. Le but de ce travail était de d’évaluer la prévalence des conjonctivites néonatales au Togo et d’identifier les germes en cause. Patients et Méthodes. Il s’agit d’une étude transversale dans 7 formations sanitaires du Togo dont 4 au sud et 3 au nord. Tous les nouveau-nés (NNés) suivis dans ces centres ont été examinés à la recherche de signes de conjonctivite. Un examen cytologique et bactériologique (ECB) des sécrétions conjonctivales a été réalisé chez les NNés suspects afin d’isoler un germe. Résultats. Durant la période d’étude, 507 NNés ont été examinés dont 265 garçons et 242 filles. L’âge moyen était de 3,7 jours. Trente cinq NNés présentaient une conjonctivite (6,9 %). 11 ( 37,1 %) de ces cas de conjonctivites ont été observés au cours des quatre premiers jours de vie. Vingt cinq de ces NNés étaient nés par voie basse (71,4 %) contre 10 par voie haute (28,6 %). Toutes les mères des NNés malades ont eu un syndrome d’infection sexuellement transmissible (IST) au cours du troisième trimestre de grossesse. À l’ECB des sécrétions, le Staphylococcus aureus a été le seul germe, retrouvé dans 25,7 % des cas. Conclusion. Malgré la vulgarisation de la prophylaxie de la conjonctivite néonatale par la méthode de Crédé, elle persiste encore dans notre région. Éradiquer la conjonctivite néonatale nécessite le traitement des IST chez les gestantes associé à une éducation sur la prévention des infections en milieu de soins néonataux et à domicile par l’application des règles d’hygiène simples.
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References
- OMS. Conjonctivite du nouveau-né : prévention et traitement au niveau des soins de santé primaire. Geneve. 1986 ; pp 35.
- Nataf R, Coscas G. Conjonctivites purulentes. Editions techniques.
- Encycl Med Chir Ophtalmologie. Paris 1965 ; 21130, C10 : 1-5.
- Liotet S. Diagnostic biologique des conjonctivites. Encyl Med Chir Ophtalmologie. Paris 1982; 21130 B10 : 3.
- Cohen R. Les infections oculaires courantes de l’enfant. Med Enfance. 2000 ; 20 : 409-11.
- Zuppa AA, D'Andrea V, Catenazzi P, Scorrano A, Romagnoli C. Ophthalmia neonatorum : what kind of prophylaxis? J Matern Fetal Neonatal Med. 2011; 24(6) : 769-73.
- Gul SS, Jamal M, Khan NJ. Ophthalmia neonatorum. Coll Physicians Surg Pak. 2010; 20(9) : 595-8.
- Sarvikivi E, Kärki T, Lyytikäinen O, Finnish NICU Prevalence Study Group. Repeated prevalence surveys of healthcare-associated infections in Finnish neonatal intensive care units. J Hosp Infect. 2010; 76(2) :156-60.
- Borer A, Livshiz-Riven I, Golan A, et al. Hospital-acquired conjunctivitis in a neonatal intensive care unit : Bacterial etiology and susceptibility patterns. Am J Infect Control. 2010; 38(8) : 650-2.
- Amini E, Ghasemi M, Daneshjou K. A five-year study in Iran of ophthalmia neonatorum : prevalence and etiology. Med Sci Monit. 2008; 14(2) : 90-6.
- Yip PP, Chan WH, Yip KT, Que TL, Kwong NS, Ho CK. The use of polymerase chain reaction assay versus conventional methods in detecting neonatal chlamydial conjunctivitis. J Pediatr Ophthalmol Strabismus. 2008; 45(4) : 234-9.
- Abreu Caligaris LS, Medina NH, Durkin SR, Haro-Muñoz E, Chinen NH. Assessment of the current ocular health practices within neonatal units in the City of São Paulo, Brazil. Ophthalmic Epidemiol. 2010; 17(5) : 333-7.
- Salpietro CD, Bisignano G, Fulia F, Marino A, Barberi I. La conjonctivite à Chlamydia trachomatis du nouveau-né. Arch Pédiatr.1999; 6 : 317-20.
- Iroha E O, Kesah CN, Egri Okwaji M T, Odugbemi TO. Bacterial Eye infection in neonates, a prospective study in neonatal unit. West Africa J Med. 1998; 17 : 168-72.
- Nie WY, Wu HR, Qi YS et al. A pilot study of ocular diseases screening for neonates in China. Zhonghua Yan Ke Za Zhi. 2008; 44(6) : 497-502.
- Verma M, Chlatwal J, Varughese PV. Neonatal conjunctivitis: a profile. Indian Pediatr. 1994; 31 : 1357-61.
- Couto RC, Carvalho EA, Pedrosa TM, Pedroso ER, Neto MC, Biscione FM. A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units. Am J Infect Control. 2007; 35(3) : 183-9.
- Gichuhi S, Bosire R, Mbori-Ngacha D et al. Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers. Ophthalmic Epidemiol. 2009; 16(6) : 337-45.
- Djibo H, Amza A, Kamaye IM, Nassirou A. Annales de l'Université Abdou Moumouni. 2011; XII-A : 120-5.
- Olatunji FO, Fadeyi A, Ayanniyi AA, Akanbi AA 2nd. Non-gonococcal bacterial agents of conjunctivitis and their antibiotic susceptibility patterns in Ilorin, Nigeria. Afr J Med Sci. 2007; 36(3) : 243-7.
- Di Bartolomeo S, Higa M, Janer M, Pennisi A, Balbin G, Priore G. Neonatal conjunctivitis in a hospital at Gran Buenos Aires. Last 5 years up-date. Rev Argent Microbiol. 2005; 37(3) : 139-41.
- Wu J, Liu J, Feng ZC, Huang JJ, Wu G. Influence of premature rupture of membranes on neonatal health. Zhonghua Er Ke Za Zhi. 2009; 47(6) : 452-6.
- Chen CJ, Starr CE. Epidemiology of gram-negative conjunctivitis in neonatal intensive care unit patients. Am J Ophthalmol. 2008; 145(6) : 966-70.
- Kakar S, Bhalla P, Maria A, Rana M, Chawla R, Mathur NB. Chlamydia trachomatis causing neonatal conjunctivitis in a tertiary care center. Indian J Med Microbiol. 2010; 28(1) : 45-7.
- Rours IGIJG, Hammerschlag MR, Ott A et al. Chlamydia trachomatis as a cause of neonatal conjunctivitis in Dutch infants. Pediatrics. 2008; 121(2) : 321-6.
References
OMS. Conjonctivite du nouveau-né : prévention et traitement au niveau des soins de santé primaire. Geneve. 1986 ; pp 35.
Nataf R, Coscas G. Conjonctivites purulentes. Editions techniques.
Encycl Med Chir Ophtalmologie. Paris 1965 ; 21130, C10 : 1-5.
Liotet S. Diagnostic biologique des conjonctivites. Encyl Med Chir Ophtalmologie. Paris 1982; 21130 B10 : 3.
Cohen R. Les infections oculaires courantes de l’enfant. Med Enfance. 2000 ; 20 : 409-11.
Zuppa AA, D'Andrea V, Catenazzi P, Scorrano A, Romagnoli C. Ophthalmia neonatorum : what kind of prophylaxis? J Matern Fetal Neonatal Med. 2011; 24(6) : 769-73.
Gul SS, Jamal M, Khan NJ. Ophthalmia neonatorum. Coll Physicians Surg Pak. 2010; 20(9) : 595-8.
Sarvikivi E, Kärki T, Lyytikäinen O, Finnish NICU Prevalence Study Group. Repeated prevalence surveys of healthcare-associated infections in Finnish neonatal intensive care units. J Hosp Infect. 2010; 76(2) :156-60.
Borer A, Livshiz-Riven I, Golan A, et al. Hospital-acquired conjunctivitis in a neonatal intensive care unit : Bacterial etiology and susceptibility patterns. Am J Infect Control. 2010; 38(8) : 650-2.
Amini E, Ghasemi M, Daneshjou K. A five-year study in Iran of ophthalmia neonatorum : prevalence and etiology. Med Sci Monit. 2008; 14(2) : 90-6.
Yip PP, Chan WH, Yip KT, Que TL, Kwong NS, Ho CK. The use of polymerase chain reaction assay versus conventional methods in detecting neonatal chlamydial conjunctivitis. J Pediatr Ophthalmol Strabismus. 2008; 45(4) : 234-9.
Abreu Caligaris LS, Medina NH, Durkin SR, Haro-Muñoz E, Chinen NH. Assessment of the current ocular health practices within neonatal units in the City of São Paulo, Brazil. Ophthalmic Epidemiol. 2010; 17(5) : 333-7.
Salpietro CD, Bisignano G, Fulia F, Marino A, Barberi I. La conjonctivite à Chlamydia trachomatis du nouveau-né. Arch Pédiatr.1999; 6 : 317-20.
Iroha E O, Kesah CN, Egri Okwaji M T, Odugbemi TO. Bacterial Eye infection in neonates, a prospective study in neonatal unit. West Africa J Med. 1998; 17 : 168-72.
Nie WY, Wu HR, Qi YS et al. A pilot study of ocular diseases screening for neonates in China. Zhonghua Yan Ke Za Zhi. 2008; 44(6) : 497-502.
Verma M, Chlatwal J, Varughese PV. Neonatal conjunctivitis: a profile. Indian Pediatr. 1994; 31 : 1357-61.
Couto RC, Carvalho EA, Pedrosa TM, Pedroso ER, Neto MC, Biscione FM. A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units. Am J Infect Control. 2007; 35(3) : 183-9.
Gichuhi S, Bosire R, Mbori-Ngacha D et al. Risk factors for neonatal conjunctivitis in babies of HIV-1 infected mothers. Ophthalmic Epidemiol. 2009; 16(6) : 337-45.
Djibo H, Amza A, Kamaye IM, Nassirou A. Annales de l'Université Abdou Moumouni. 2011; XII-A : 120-5.
Olatunji FO, Fadeyi A, Ayanniyi AA, Akanbi AA 2nd. Non-gonococcal bacterial agents of conjunctivitis and their antibiotic susceptibility patterns in Ilorin, Nigeria. Afr J Med Sci. 2007; 36(3) : 243-7.
Di Bartolomeo S, Higa M, Janer M, Pennisi A, Balbin G, Priore G. Neonatal conjunctivitis in a hospital at Gran Buenos Aires. Last 5 years up-date. Rev Argent Microbiol. 2005; 37(3) : 139-41.
Wu J, Liu J, Feng ZC, Huang JJ, Wu G. Influence of premature rupture of membranes on neonatal health. Zhonghua Er Ke Za Zhi. 2009; 47(6) : 452-6.
Chen CJ, Starr CE. Epidemiology of gram-negative conjunctivitis in neonatal intensive care unit patients. Am J Ophthalmol. 2008; 145(6) : 966-70.
Kakar S, Bhalla P, Maria A, Rana M, Chawla R, Mathur NB. Chlamydia trachomatis causing neonatal conjunctivitis in a tertiary care center. Indian J Med Microbiol. 2010; 28(1) : 45-7.
Rours IGIJG, Hammerschlag MR, Ott A et al. Chlamydia trachomatis as a cause of neonatal conjunctivitis in Dutch infants. Pediatrics. 2008; 121(2) : 321-6.