Abstract
Purpose: :
After 30 years of civil war, Angola’s Health System has serious deficiencies. Angola created in 1990 an Eye Institute (IONA) which receives academic and technical support from the Eye Institute (IOBA) of the University of Valladolid, Spain since 1995. A large number of newborns with neonatal conjunctivitis (NC) are continuously attended at the IONA and there are not prophylactic measures for NC at the Angola's maternities. Thus, we developed this pilot study to analyze the prevalence of NC in the largest maternity of Luanda as a previous step to develop a National program to adopt NC prophylaxis, a project supported by the Spanish Agency for International Cooperation and Development (AECID)
Methods: :
After Ethical Committee approval, a transversal study at the Augusto N’Gangula maternity between July and August 2006 was performed. 194 consecutive new-borns were included . Children were explored by two medical students and one ophthalmologist, with a light-pen, direct ophthalmoscope and indirect ophthalmoscope under mydriasis. Pathologic and doubtful cases were refered to the IONA for a complete ocular examination
Results: :
44 (22,6%) children showed ocular alterations: 24 (10,3%) showed bilateral NC; 20 eyes showed retinal haemorrhages, 8 eyes conjunctival haemorrhages, one child had bilateral glaucoma and one albinism. 74% (143) of the mothers had an appropriate follow up during pregnancy; 15% (29) had poor control and 11,3% (22) had none. 36 mothers have previous history of urinary infection, 16 vulvo-vaginitis, 2 had AIDS and 1 had syphilis.132 labours were by caesarean and 62 via vaginal. 20 (50%) children with NC were born by caesarean. Only 4 mothers of children with NC referred leukorrea. No microbiological identification was available at the maternity or at the IONA for this study
Conclusions: :
Incidence of NC in Angola is ten times higher than in USA or Europe (1-2%) so prophylaxis must be started. A microbiologic identification is required and it is important to develop a prospective, randomized case-control study using 5% povidone-iodine eye-drops to demonstrate to Angola’s authorities the efficacy of this prophylaxis to reduce this potential cause of neonatal blindness
Keywords: conjunctivitis • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • clinical (human) or epidemiologic studies: health care delivery/economics/manpower