Bangladesh Abdullah Baqui MHS at the School of Public Health; Department of International Health; Global Disease Epidemiology and Control concentration
Although many developing countries have witnessed declines in both post-neonatal and 1-4 year-old child mortality, neonatal mortality has remained relatively constant, with an estimated 4 million annual neonates deaths globally. Infections account for about a third and birth asphyxia accounts for another 25% of neonatal deaths. In high mortality settings, up to 50% of neonatal deaths are attributable to infection. However, risk factors for neonatal infection and birth asphyxia in developing countries including in Bangladesh are not well characterized; most studies of risk factors have been hospital-based or conducted in developed countries. Umbilical cord care has been identified as a risk factor for omphalitis and neonatal mortality. The World Health Organization (WHO) currently recommends that nothing should be applied to the umbilical cord (“dry cord care”). However, cord cleansing with chlorhexidine, an antiseptic, has been suggested as an intervention to reduce omphalitis and neonatal mortality. In a community-based study in Nepal, application of chlorhexidine to the umbilical cord stump reduced neonatal mortality by 34%. An ongoing community-based study of 28,000 neonates in the rural Sylhet district of Bangladesh is evaluating the impact of chlorhexidine cleansing of the umbilical cord stump on the incidence of omphalitis and neonatal mortality. This analysis will examine risk factors for neonatal sepsis and omphalitis and for birth asphyxia using data from an earlier phase of the study. In addition, Ms. Munos will assist with the chlorhexidine study management and data collection.
| 
Melinda Munos
