scholarly journals The effect of umbilical cord cleansing with chlorhexidine on omphalitis and neonatal mortality in community settings in developing countries: a meta-analysis

2013 ◽  
Vol 13 (Suppl 3) ◽  
pp. S15 ◽  
Author(s):  
Aamer Imdad ◽  
Luke C Mullany ◽  
Abdullah H Baqui ◽  
Shams El Arifeen ◽  
James M Tielsch ◽  
...  
Keyword(s):  
Developing Countries ◽  
Neonatal Mortality ◽  
Umbilical Cord ◽  
Meta Analysis ◽  
Community Settings

scholarly journals Association between place of delivery for pregnant mothers and neonatal mortality: a systematic review and meta-analysis

2019 ◽  
Vol 30 (4) ◽  
pp. 743-748 ◽  
Author(s):  
Eshetu E Chaka ◽  
Mulugeta Mekurie ◽  
Ahmed Abdulahi Abdurahman ◽  
Mahboubeh Parsaeian ◽  
Reza Majdzadeh
Keyword(s):  
Developing Countries ◽  
Neonatal Mortality ◽  
Publication Bias ◽  
Health Facility ◽  
Meta Analysis ◽  
Facility Delivery ◽  
Inverse Association ◽  
Health Facility Delivery ◽  
Test Statistic ◽  
Major Health Problem

Abstract Background Neonatal mortality is a major health problem mainly in the developing countries and its reduction was remain stagnant during the era of Millennium Development Goal. Current global health policies emphasize institutional deliveries as a pathway to achieving reductions in neonatal mortality in developing countries. There are inconsistent conclusions of evidence about this fact, mainly in developing countries. Therefore, this study was conducted to assess the association between health facility delivery and neonatal mortality. Methods We systematically searched EMBASE, PubMed, ISI Web of Science and Scopus through 18 March 2018 and then updated on 14 February 2019. I2 test statistic was used to assess heterogeneity. Publication bias was checked using a funnel plot and meta-bias test. Random-effects model was used to determine the pooled effect size. Results Nineteen articles were included in the meta-analysis. The pooled odds ratios (ORs) indicated that health facility delivery was significantly associated with the odds of neonatal mortality (OR = 0.48; 95% CI: 0.38, 0.58). This significant inverse association was consistently found regardless of study design, geographical region and quality of the study. There is evidence of publication bias with high heterogeneity between studies (I2 = 84.5%). Conclusion The odds of neonatal mortality were much likely lower among those delivered at a health facility than those delivery at home. Therefore, encouraging delivery in a health facility and minimizing any barrier to health facility are important. Further longitudinal studies based on larger, more representative samples are therefore needed to further assess the underlying relationships.

scholarly journals RETRACTED ARTICLE: Application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries: a systematic review and meta-analysis

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Aklilu Abrham Roba ◽  
Maleda Tefera ◽  
Teshager Worku ◽  
Tamirat Tesfaye Dasa ◽  
Abiy Seifu Estifanos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neonatal Mortality ◽  
Umbilical Cord ◽  
Topical Application ◽  
Meta Analysis ◽  
Newborn Infants ◽  
Lower Income ◽  
Cord Care ◽  
Separation Time ◽  
Lower Income Countries

Abstract There are conflicting results from large randomized controlled trials in different populations regarding the effectiveness of topical application of 4% chlorhexidine to the umbilical stump of newborn infants at reducing neonatal mortality. Meta-analysis and systematic review of trials performed in South Asia and Europe support 4% chlorhexidine application to reduce neonatal mortality, whereas trials performed in Sub-Saharan Africa do not. The aim of this review is to determine the effectiveness of 4% chlorhexidine application to the umbilical stump of newborn infants born in lower income countries in order to reduce neonatal mortality when compared with usual cord care. Our search strategy included randomized trials published between January1st 2000 and September 4th, 2018, that compared 4% chlorhexidine with usual cord care (“dry cord care”). The outcome variable of interest was neonatal mortality. Pooled relative risks (RR) with 95% confidence intervals (CIs) using a random-effects model were calculated. Nine trials were included, from six countries: Zambia, Tanzania, Bangladesh, Nepal, India and Pakistan, with a total of 257,153 participants. Five studies (N = 119,833) reported neonatal mortality. There was a 21% reduction in neonatal mortality among with 4% chlorhexidine application: pooled RR (95% CI) 0.79 (0.69–0.90), P = 0.0005. The incidence of omphalitis was decreased by 35% with 4% chlorhexidine (6 studies, N = 108,263): pooled RR (95% CI) 0.65 (0.56–0.75), P = 0.00001. Chlorhexidine application delayed the umbilical cord separation time (4 studies, N = 28,917): mean difference (95% CI) 2.71 (2.63–2.78) days. In conclusion, this systematic review found that topical application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries significantly reduces the incidence of neonatal mortality. Chlorhexidine also reduces the incidence of omphalitis, but prolongs umbilical cord separation time. Trial registration Systematic Review Registration: CRD42018109280.

scholarly journals Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Vedran Stefanovic
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Meta Analysis ◽  
Perinatal Care ◽  
Substantial Improvement ◽  
Global Strategy ◽  
Perinatal Medicine ◽  
Technological Advances ◽  
Women's Role

Abstract Despite substantial improvement in reducing maternal mortality during the recent decades, we constantly face tragic fact that maternal mortality (especially preventable deaths) is still unacceptably too high, particularly in the developing countries, where 99% of all maternal deaths worldwide occur. Poverty, lack of proper statistics, gender inequality, beliefs and corruption-associated poor governmental policies are just few of the reasons why decline in maternal mortality has not been as sharp as it was wished and expected. Education has not yet been fully recognized as the way out of poverty, improvement of women’s role in the society and consequent better perinatal care and consequent lower maternal mortality. Education should be improved on all levels including girls, women and their partners, medical providers, religious and governmental authorities. Teaching the teachers should be also an essential part of global strategy to lower maternal mortality. This paper is mostly a commentary, not a systematic review nor a meta-analysis with the aim to rise attention (again) to the role of different aspects of education in lowering maternal mortality. The International Academy of Perinatal Medicine should play a crucial role in pushing the efforts on this issue as the influential instance that promotes reflection and dialog in perinatal medicine, especially in aspects such as bioethics, the appropriate use of technological advances, and the sociological and humanistic dimensions of this specific problem of huge magnitude. The five concrete steps to achieve these goals are listed and discussed.

scholarly journals Prevalence of Polypharmacy and Risks of Potentially Inappropriate Medication Use in the Older Population in a Developing Country: A Systematic Review and Meta-Analysis

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Eyob Alemayehu Gebreyohannes ◽  
Daniela Fialova
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Literature Review ◽  
Developing Country ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
Inappropriate Medication ◽  
Older Age ◽  
Potentially Inappropriate Medication ◽  
Older Population

<b><i>Background and Aim:</i></b> Polypharmacy and potentially inappropriate medication (PIM) use in older populations (65+ years) have not yet been investigated by meta-analyses in developing countries. This systematic literature review and meta-analysis aimed to investigate the prevalence of polypharmacy and PIM use and major risk factors associated with PIM prescribing in older adults in Ethiopia. <b><i>Methods:</i></b> We searched PubMed/MEDLINE, Scopus, Embase, and Google Scholar databases to identify relevant studies published between January 1990 and October 2020. Observational studies reporting the prevalence and association of risk factors with polypharmacy and PIM use in the older population were meta-analyzed. A multilevel meta-analysis was conducted to pool the prevalence estimates, and the risk of PIM use was reported as a relative risk (RR) with a 95% confidence interval (CI). <b><i>Results:</i></b> We identified by systematic literature review 404 articles. Of those, 8 studies fulfilled inclusion criteria, comprising a total sample of 2,608 participants. The overall prevalence of polypharmacy and PIM use pooled by meta-analysis in the Ethiopian older population was 33 and 37%, respectively. The risk factors of PIM use were analyzed in the meta-analysis (particularly polymorbidity, polypharmacy, gender, and older age), and only older age of 65+ (RR: 1.71, 95% CI: 1.16–2.51) was significantly associated with PIM use. <b><i>Conclusion:</i></b> This first meta-analysis from a developing country revealed a high prevalence of polypharmacy and PIM use in the Ethiopian older population. There was no awareness about the risk of PIMs in patients with polypharmacy and polymorbidity, and older age significantly predicted PIM use. Interventions ensuring rational geriatric pharmacotherapy are essential in developing countries in order to reduce the expected burden of PIM-related geriatric morbidity, higher costs, and mortality.

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