Association of umbilical cord care practices with neonatal infection in Katsina, northwest Nigeria Association des pratiques de soins du cordon ombilical avec l'infection néonatale à Katsina, dans le nord-ouest du Nigéria

Abstract

Background: Significant numbers of neonatal deaths occurring each year are caused by infections that can be directly associated with improper and unhygienic umbilical cord care practices. The objectives of this study were to describe the umbilical cord care practices among mothers whose babies were admitted for suspected sepsis at the Federal Teaching Hospital and Turai Umaru Yar’adua Maternal and Children Hospital Katsina, Nigeria, assess the relationship between umbilical cord care practices and neonatal sepsis, and the influence of home delivery on this relationship.
Methodology: This was a hospital-based descriptive observational study of 60 selected neonates with clinical features of sepsis admitted into the special care baby unit (SCBU) of the two hospitals between July and December 2022. The study involved the collection and microbiological analysis of blood samples using the BacT/Alert microbial detection system, and the administration of a structured questionnaire on the mother of each enrollee to collect relevant information about cord care practices. Data were analyzed using SPSS version 22.0. The Chisquare (x²) test and Odds ratio (with 95% confidence interval) were used to determine the association of risk factors with culture-confirmed sepsis, and a p value less than 0.05 was considered statistically significant.
Results: Of the 60 neonates blood samples, 31 (51.7%) were culture-positive for neonatal sepsis while 29 (48.3%) were culture-negative. There was no statistically significant association between risk factors such as application of traditional materials for cord care and place of delivery, and culture-confirmed neonatal sepsis (p>0.05). However, neonates whose mothers use traditional materials for cord care were more likely to develop sepsis than those who do not (OR=2.027, 95% CI=0.716-5.736). Concerning place of delivery, which is an important determinant of umbilical cord hygiene, babies delivered at home were almost 3 times more likely to have culture-confirmed sepsis than those delivered in the hospital (OR=2.975, 95% CI=1.040-8.510). A total of 26 out of the 60 (45.3%) mothers of the neonates agreed to have used unhygienic and traditional materials for cord care, with charcoal (39.0%), local herbs (27.0%), cow dung/urine concoction (19.0%), and others (15.0%), such as lubricants, ash, and balm, being the most commonly used materials for cord care.
Conclusion: Neonatal infection is common among newborns in Federal Teaching Hospital and Turai Umaru Yar’adua Maternal and Children Hospital (TUYMCH), Katsina, northwest Nigeria, with a prevalence of culture confirmed neonatal sepsis of 51.7%. Although there was no statistically significant association between unhygienic cord practices and neonatal sepsis in this study, babies whose mothers use traditional materials for cord care were more likely to develop sepsis. There is a high rate of use of harmful and unhygienic traditional materials for cord care in our environment. This habit can be discouraged through health education using the mass media and health talks in health facilities. The use of chlorhexidine, the recommended antiseptic for cord care by the World Health Organization and the Nigeria Federal Ministry of Health, should be encouraged.