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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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LETTER TO THE EDITOR
Year : 2015  |  Volume : 22  |  Issue : 2  |  Page : 261  

Maternal and neonatal risk factors associated with vertical transmission of ophthalmia neonatorum in neonates receiving health care in Blantyre, Malawi


Department of Paediatrics, Al Kindy College of Medicine, Baghdad University, Baghdad, Iraq

Date of Web Publication1-Apr-2015

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
P. O. Box 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-9233.154412

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How to cite this article:
Al-Mendalawi MD. Maternal and neonatal risk factors associated with vertical transmission of ophthalmia neonatorum in neonates receiving health care in Blantyre, Malawi. Middle East Afr J Ophthalmol 2015;22:261

How to cite this URL:
Al-Mendalawi MD. Maternal and neonatal risk factors associated with vertical transmission of ophthalmia neonatorum in neonates receiving health care in Blantyre, Malawi. Middle East Afr J Ophthalmol [serial online] 2015 [cited 2019 Jun 26];22:261. Available from: http://www.meajo.org/text.asp?2015/22/2/261/154412

Sir,

I have two comments on the interesting study by Ranjit et al. [1] First, Msukwa et al. [1] addressed the frequency distribution of various maternal risk factors (premature rupture of membranes [24%], sepsis during labor [9%], and history of sexually transmitted infections [STIs] [7%]) and neonatal risk factors (low Apgar scores [19%], fever [8%], and/or meconium aspiration [5%]) associated with ophthalmia neonatorum (ON) among their study of neonates.

I believe that applying descriptive statistics to determine this association is questionable. A case-control study is likely more suitable to determine statistical significant associations of the aforementioned risk factors with ON. A group of neonates with ON (cases) could be compared with a control group of neonates without ON. The two groups should be matched for age, gender, and other demographic data and statistical analysis can be performed to determine neonatal and maternal risk factors that account for increased incidence of ON in the case group.

Second, I believe that among the recommendations addressed by Msukwa et al., [1] prevention and treatment of STIs should be a priority to control the sizable problem of ON in Malawi. This is based on the following three points: (1) Although Msukwa et al. [1] did not address the exact pathogens causing ON, in developing countries, Chlamydia trachomatis, and  Neisseria More Details gonorrhea represent, the most prominent and serious sexually transmitted pathogens that newborns can acquire through passage in the infected birth canals; (2) although recent data on the prevalence of STIs among pregnant women in Malawi remains unknown, the available data indicate the considerable prevalence of STIs among pregnant women attending antenatal care facilities in sub-Saharan Africa; [2] (3) despite various attempts to control STIs, the spread of STIs is significant and continues to increase in Africa (including Malawi). An important reason for the failure to control STIs is that a large percentage of infected individuals are untreated because they are asymptomatic, or the infections are not recognized. Clearly maternal STI can result in infertility, ectopic pregnancy, pelvic inflammatory disease, chorioamnionitis, premature rupture of membranes, preterm birth, and puerperal sepsis. In addition, STIs may facilitate the acquisition and transmission of human immunodeficiency virus. Complications to the fetus or neonate include abnormalities of the major organ systems and infections such as pneumonia or conjunctivitis. [3] Many of the maternal and neonatal risk factors in Msukwa et al.'s study [1] could be related to STIs. Hence, I believe that implementation of programs to control STIs in the community tailored by health personnel and organizations and screening pregnant females for STIs in Malawi are crucial.

 
   References Top

1.
Msukwa G, Batumba N, Drucker M, Menezes L, Ranjit R. Maternal and neonatal risk factors associated with vertical transmission of ophthalmia neonatorum in neonates receiving health care in Blantyre, Malawi. Middle East Afr J Ophthalmol 2014;21:240-3.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Chico RM, Mayaud P, Ariti C, Mabey D, Ronsmans C, Chandramohan D. Prevalence of malaria and sexually transmitted and reproductive tract infections in pregnancy in sub-Saharan Africa: A systematic review. JAMA 2012;307:2079-86.  Back to cited text no. 2
    
3.
Moodley P, Sturm AW. Sexually transmitted infections, adverse pregnancy outcome and neonatal infection. Semin Neonatol 2000;5:255-69.  Back to cited text no. 3
    




 

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