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Original Research



Role of cultural practices in neonatal sepsis

Anil Goel, SK Murmu, S Shah, GS Chawla.




Abstract

Background: Delivery of a child at home by a relative or a dhai and other associated health hazards are still a challenge to the medical fraternity. Traditional harmful practices are equally responsible for neonatal mortality and morbidity. The commonly practicing events such as prelacteal feeding, early bath, artificial feeding, throwing out of colostrum, branding, circumcision, cow dung application, and so on make the neonates more vulnerable.

Objective: To find the prevalence of traditional harmful routine care practices and other social customs and believes prevalent in the community, which are directly or indirectly associated with sepsis in newborn period.

Materials and Methods: This is a prospective cross-sectional study conducted at NICU and postpartum center of V.S.S. Medical College, Burla, Orissa, India, from September 2007 to October 2009. Mothers having term and appropriate for gestational age neonate of either sex practicing the traditional harmful practices were taken for the study. The study subjects were 167 mothers whose babies showed features of clinically suspected sepsis included as cases and 150 mothers with neonates without any features suggestive of sepsis included as controls. Information was collected using an open-ended in-depth questionnaire and an oral interview. After data collection, statistical analyses were done using 2 test, and p < 0.05 was taken as significant.

Result: The incidence of neonatal septicemia was 28.3%. Almost two-third of the babies in either group belongs to low socioeconomic status and unbooked. Unhygienic cord care (63.4%), prelacteal feeding (73.6%), and early bath (52%) of neonates were observed. The common method for feeding was through bottle (61%). Feeding intolerance and lethargy was present in all the cases of sepsis, whereas approximately three-fourth newborns with sepsis were having hypothermia and hypoglycemia. Septic screen was positive for 52.9% babies, whereas 47.2% and 66.6% babies were positive for blood culture and umbilical swab culture, respectively. Seventeen newborns died because of severe sepsis and multiorgan dysfunction.

Conclusion: This study clearly shows that certain cultural practices that are harmful to the newborn are still being widely practiced in this part of the country. The importance of traditional beliefs and cultural practices cannot be ignored as they are far deeply entrenched in daily life and more difficult to change.

Key words: Branding, neonatal sepsis, prelacteal feeding, traditional harmful practices






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