Assessment of determinants of umbilical cord infection among newborns at Pumwani Maternity Hospital
Abstract
Background: The umbilical vessels remain patent for a few days following birth which
provides direct access to the bloodstream. The cord stump can therefore be an excellent
medium for bacteria. Infections are the single most important cause of neonatal mortality
and it is estimated that 300 000 infants die annually from tetanus and 460 000 die because
of severe bacterial infections, of which umbilical cord infection is a major precursor.
Objectives: The broad objective was to assess the determinants of umbilical cord
infection among neonates aged 3 to 28 days attending Pumwani Maternity Hospital.
Methodology: This was a cross sectional descriptive design and 178 mothers with
neonates of 3-28 days were selected using systematic sampling method. The data was
collected using pre-tested semi-structured questionnaire. Descriptive analysis using
means, frequency and proportions was computed. Chi-square test (p<0.05) and odds ratio
with corresponding 95% confidence interval was used to determine the association
between dependent and independent variables. Binary logistic regression analysis was
performed to determine the independent factors associated with cord infection.
Results: The findings of the study revealed that the prevalence of umbilical cord
infection among neonates was 37.6%. Of these, 49.3% presented with redness and 37.3%
with pus discharge while13.4% presented with swelling. The stepwise logistic regression
revealed that being female was at [AOR=2.68; 95%CI=1.19-6.04; P=0.017], mothers
who had primary school education were at [AOR=7.21; 95%CI=1.62-32.13; P=0.026]
and those who had secondary school education [AOR=6.00; 95%CI=1.49-24.20;
P=0.010] than those who had college/university education respectively, households
getting water through handcart [AOR=8.19; 95%CI=1.37-48.94; P=0.021 ] compared to
those getting piped water, primipara mothers [AOR=10.38; 95%CI=2.35-45.97;
P=0.002], babies who initiated breastfeeding after one hour of delivery [AOR=2.61 ;
95%CI=1.11-6.11; P=0.027]. Babies who bathed with hand/body soap or Dettol
[AOR=3.07; 95%CI=1.24-7.58; P=0.015] were factors independently associated with
cord infection.
Conclusion: The prevalence of cord infection among neonates was high, indicating that
it is a major public health problem. Baby‟s sex, maternal level of education, parity,
source of water, breast-feeding initiation and adding hand/body or Dettol to the baby‟s
bath water were the independent predictors of umbilical cord infection.
Recommendations: More campaigning and sensitization on the contributing factors
should be tailored among mothers during ANC visits so as to avoid umbilical cord
infections.
Publisher
University of Nairobi