肯尼亚新生儿眼炎的流行病学

Epidemiology of ophthalmia neonatorum in Kenya.

作者信息

Laga M, Plummer F A, Nzanze H, Namaara W, Brunham R C, Ndinya-Achola J O, Maitha G, Ronald A R, D'Costa L J, Bhullar V B

出版信息

Lancet. 1986 Nov 15;2(8516):1145-9. doi: 10.1016/s0140-6736(86)90544-1.

DOI:10.1016/s0140-6736(86)90544-1

PMID:2877285

Abstract

In a Nairobi hospital where ocular prophylaxis against ophthalmia neonatorum has been discontinued, 1,019 women were screened for Neisseria gonorrhoeae and Chlamydia trachomatis during labour and 7 and 28 days postpartum. The prevalence of gonococcal infection was 7% and that of chlamydial was 29%. 52.4% of gonococcal isolates produced penicillinase. The incidence of ophthalmia neonatorum was 23.2 per 100 live births, and incidences of gonococcal and chlamydial ophthalmia were 3.6 and 8.1 per 100 live births, respectively. Of 181 cases of neonatal conjunctivitis, 31% were caused by C trachomatis, 12% by N gonorrhoeae, and 3% by both. In 67 babies exposed to maternal gonococcal infection and 201 exposed to maternal chlamydial infection, rates of transmission to the eye were 42% and 31%, respectively, and to the throat were 7% and 2%. Gonococcal transmission rate was higher in mothers with concomitant chlamydial infection (68%; p = 0.01). Postpartum endometritis was associated with ophthalmia neonatorum (p less than 0.001). Ocular prophylaxis at birth for gonococcal ophthalmia should be reintroduced.

摘要

在内罗毕一家已停止新生儿眼炎预防性用药的医院，对1019名妇女在分娩期间以及产后7天和28天进行了淋病奈瑟菌和沙眼衣原体筛查。淋球菌感染患病率为7%，衣原体感染患病率为29%。52.4%的淋球菌分离株产生青霉素酶。新生儿眼炎发病率为每100例活产23.2例，淋菌性和衣原体性眼炎发病率分别为每100例活产3.6例和8.1例。在181例新生儿结膜炎病例中，31%由沙眼衣原体引起，12%由淋病奈瑟菌引起，3%由二者共同引起。在67名暴露于母体淋球菌感染的婴儿和201名暴露于母体衣原体感染的婴儿中，眼部传播率分别为42%和31%，咽部传播率分别为7%和2%。伴有衣原体感染的母亲的淋球菌传播率更高（68%；p=0.01）。产后子宫内膜炎与眼炎相关（p<0.001）。应重新引入针对淋菌性眼炎的出生时眼部预防性用药。