First Attempt to Implement Ophthalmia Neonatorum Prophylaxis in Angola: Microorganisms, Efficacy, and Obstacles

Abstract EN

Purpose.

To determine the efficacy of povidone-iodine (P-I) prophylaxis for ophthalmia neonatorum (ON) in Angola and to document maternal prevalence and mother-to-child transmission rates.

Methods.

Endocervical samples from mothers n = 317 and newborn conjunctival smears n = 245 were analysed by multiplex polymerase chain reaction (PCR) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG).

Newborns were randomized into a noninterventional group and an interventional group that received a drop of P-I 2.5% bilaterally after conjunctival smear collection.

Mothers were trained to identify signs of ON and attend a follow-up visit.

Results.

Forty-two newborns had ocular pathology, and 11 (4.4%) had clinical signs of ON at the time of delivery.

Maternal PCR was positive for MG n = 19 , CT n = 8 , and NG n = 2 .

Six newborns were positive for CT n = 4 , MG n = 2 , and NG n = 1 .

Mother-to-child transmission rates were 50% for CT and NG and 10.5% for MG.

Only 16 newborns returned for follow-up.

Conclusions.

Lack of maternal compliance prevented successful testing of prophylactic P-I efficacy in ON prevention.

Nevertheless, we documented the prevalence and mother-to-child transmission rates for CT, NG, and MG.

These results emphasize the need to develop an effective Angolan educational and prophylactic ON program.