Neonatal Umbilical Cord Infections: Incidence, Associated Factors and Cord Care Practices by Nursing Mothers at a Tertiary Hospital in Western Uganda

Munanura Turyasiima^1*, Martin Nduwimana¹, Silva Manuel Andres¹, Gloria Kiconco¹, Walufu Ivan Egesa¹, Bernis Melvis Maren¹, Robinson Ssebuufu²

¹Department of Paediatrics and Child Health, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Bushenyi, Uganda.
²Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Bushenyi, Uganda.

DOI: 10.4236/ojped.2020.102030                

Abstract

Background: Umbilical cord infections complicate to neonatal sepsis that significantly contributes to neonatal mortality worldwide. There is paucity of data on the incidence, factors associated with neonatal umbilical cord infections in western Uganda, yet nursing mothers continue to practice potentially dangerous cord care practices. We described the incidence, factors associated with umbilical cord infections and cord care practices by nursing mothers at a tertiary hospital in western Uganda. Methods: This was a hospital based cross sectional study at a tertiary hospital in western Uganda between the months of March and June 2019. Two hundred and forty (240) neonates aged between 2 to 14 days attending the neonatal unit were recruited in the study. Umbilical cord infection was assessed based on the World Health Organisation (WHO) clinical definition: finding of any of discharge, redness and swelling on the umbilical stump. Data on sociodemographic characteristics, maternal and neonatal perinatal factors and cord care practices of the nursing mothers were analysed by bivariate and multivariate logistic regression using STATA 13.0 to determine factors associated with umbilical cord infection. Results: Sixty-five, 65 (27.1%) neonates had at least one sign of cord infection. Majority of the nursing mothers, 168 (70%) do not use the recommended umbilical cord care practices. Among these, 73 (30.4%) do not cleanse the cord while 95 (39.6%) cleanse with application of a dangerous substance. Application of dangerous substance to the cord (aOR: 3.0, 95% CI: 1.37 - 6.37, p = 0.006) and maternal secondary education level (aOR = 2.1, CI = 1.01 - 4.18, p = 0.046) were significantly associated with umbilical cord infection. Conclusions: The incidence of neonatal umbilical cord infection is high in this setting. Application of a dangerous substance to the umbilical stump and maternal secondary education level were significantly associated with umbilical cord infection. Clinicians should routinely examine the umbilical stump of every neonate for the signs of infection and encourage mothers to avoid application of dangerous substances to the cord. Maternal education on the recommended cord care practices during antenatal and postnatal period could reduce the incidence of umbilical cord infection among neonates in low resource setting.

Keywords

Umbilical Cord Infection, Cord Care Practices, Associated Factors, Western Uganda

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

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