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Chebet M, Mukunya D, Burgoine K, Kühl MJ, Wang D, Medina-Lara A, Faragher EB, Odiit A, Olupot-Olupot P, Stadskleiv Engebretsen IM, Waniaye JB, Wandabwa J, Tylleskär T, Weeks A. A cluster randomised trial to evaluate the effectiveness of household alcohol-based hand rub for the prevention of sepsis, diarrhoea, and pneumonia in Ugandan infants (the BabyGel trial): a study protocol. Trials 2023; 24:279. [PMID: 37069595 PMCID: PMC10106319 DOI: 10.1186/s13063-023-07312-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/12/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Infections are one of the leading causes of death in the neonatal period. This trial aims to evaluate if the provision of alcohol-based hand rub (ABHR) to pregnant women for postnatal household use prevents severe infections (including sepsis, diarrhoea, pneumonia, or death) among infants during the first three postnatal months. METHODS Through a cluster-randomised trial in eastern Uganda, 72 clusters are randomised in a 2-arm design with rural villages as units of randomisation. We estimate to include a total of 5932 pregnant women at 34 weeks of gestation. All women and infants in the study are receiving standard antenatal and postnatal care. Women in the intervention group additionally receive six litres of ABHR and training on its use. Research midwives conduct follow-up visits at participants' homes on days 1, 7, 28, 42, and 90 after birth and telephone calls on days 14, 48, and 60 to assess the mother and infant for study outcomes. Primary analyses will be by intention to treat. DISCUSSION This study will provide evidence on the effectiveness of a locally available and low-cost intervention in preventing neonatal sepsis and early infant infections. If ABHR is found effective, it could be implemented by adding it to birthing kits. TRIAL REGISTRATION Pan African Clinical Trial Registry, PACTR202004705649428. Registered 1 April 2020, https://pactr.samrc.ac.za/ .
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Affiliation(s)
- Martin Chebet
- Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Sanyu Africa Research Institute, Mbale, Uganda
| | - David Mukunya
- Faculty of Health Sciences, Busitema University, Mbale, Uganda.
| | | | - Melf-Jakob Kühl
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Duolao Wang
- Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - Amos Odiit
- Ngora Freda Carr Hospital, Ngora, Uganda
| | - Peter Olupot-Olupot
- Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Mbale Clinical Research Institute, Mbale, Uganda
| | | | | | - Julius Wandabwa
- Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Thorkild Tylleskär
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Andrew Weeks
- Sanyu Research Unit, Department of Women's and Children's Health, University of Liverpool, Liverpool Women's Hospital, Crown Street, Liverpool, L8 7SS, UK
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Abate BB, Kasie AM, Reta MA, Kassaw MW. Neonatal sepsis and its associated factors in East Africa: a systematic review and meta-analysis. Int J Public Health 2020; 65:1623-1633. [PMID: 32997150 DOI: 10.1007/s00038-020-01489-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to reveal the magnitude of neonatal sepsis and its associated factors in East Africa. METHODS Using PRISMA guideline, we reviewed and meta-analyzed studies from Google Scholar, Cochrane library, and PubMed; last search date: October 15, 2019. Heterogeneity across the studies was estimated. The subgroup analysis was done. Publication bias was also assessed. RESULTS A total of 26 studies with 11,239 participants are included. The pooled prevalence of neonatal sepsis in East Africa was 29.765% (95% CI 23.36-35.94). Home delivery (AOR = 2.67; 95% CI 1.15-4.00), maternal history of urinary tract infection (UTI) (AOR = 2.083; 95% CI 0.24-3.93), gestational age/(preterm) (AOR = 1.56; 95% CI 1.04-2.08), prolonged labor (AOR = 3.23; 95% CI 0.04-6.51) and PROM (AOR = 1.95; 95% CI 0.53-3.37) were identified associated factors of neonatal sepsis. CONCLUSIONS The prevalence of neonatal sepsis in East Africa remains high. The relevant stockholders should give attention for neonates delivered from women with intranatal fever to prevent neonatal sepsis. Pregnant women should be screened for UTI. Appropriate interventions should be put in place to manage PROM to decrease the chance of ascending microorganisms.
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Affiliation(s)
- Biruk Beletew Abate
- College of Health Sciences, Department of Nursing, Woldia University, P. O. Box 400, Woldia, Ethiopia.
| | - Ayelign Mengesha Kasie
- College of Health Sciences, Department of Nursing, Woldia University, P. O. Box 400, Woldia, Ethiopia
| | - Melese Abate Reta
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, P. O. Box 400, Woldia, Ethiopia.,Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Mesfin Wudu Kassaw
- College of Health Sciences, Department of Nursing, Woldia University, P. O. Box 400, Woldia, Ethiopia
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