Abstract
Purpose:
To study the efficacy of povidone-iodine (P-I) prophylaxis for ophthalmia neonatorum (ON) in Angola and to document the maternal prevalence and mother-to-child transmission rates of three important infectious agents
Methods:
After ethical approval by Agostinho Neto University committee the study was conducted at General Augusto N'Gangula Specialized Hospital and Health Center of Samba, both in Luanda, Angola from 7-Dec-2011 to 22-Nov-2012. Inclusion criteria consisted of healthy children weighing at least 2.3 kg and a gestation period of at least 37 weeks. Endocervical samples from mothers (n=312) and newborn conjunctival smears (n=245) were analyzed by multiplex polymerase chain reaction (PCR) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG). After ophthalmological examination, the newborns were randomized into a non-interventional group (no local treatment) and an interventional group that received a drop of P-I 2.5% bilaterally after conjunctival smear collection. Mothers were trained to identify signs of ON and attend a follow-up visit 7-10 days after discharge
Results:
Forty-four (17.9%) newborns had pathologic ocular findings, and 11 (4.5%) had clinical signs consistent with ON at the time of delivery. Maternal PCR was positive for MG (n=19), CT (n=8), and NG (n=2) (one mother had two microorganisms: CT and MG).. Eight newborns were positive for CT (n=4), MG (n=3), and NG (n=1). Mother-to-child transmission rates were 50% for CT and NG and 10.5% for MG. Ten of the positive mothers had risk factors for M-C-T. No relationship could be established between external signs of acute conjunctivitis and maternal genito-urinary infections. Only 16 of the newborns were returned for a follow-up visit
Conclusions:
The lack of maternal compliance prevented the successful testing of prophylactic P-I efficacy in ON prevention. Nevertheless, we documented the prevalence and mother-to-child rates for CT, NG, and MG. These results emphasize the need to educate the Angolan public on the origins of ON and to develop an effective prophylaxis program