Table 2 Cord infections and sepsis definitions used in the included studies
Neonatal Outcome and Study | Definition Used |
|---|---|
Neonatal Sepsis Mortality | |
Bakr 2005 | Positive microbiological cultures or clinical and laboratory criteria very suggestive of sepsis (e.g., temperature instability, poor feeding, apnea, irregular respiration, positive C-reactive protein [CRP] and micro-erthrocyte sedimentation rate [micro-ESR]) and died in first 28 days of life. |
Taha 1997 | Paediatricians diagnosed on the basis of clinical criteria of temperature > 38.0°C, poor feeding, and apnoea or irregular respiration and died in first 28 days of life. |
Cutland 2009 | Culture-confirmed or clinical sepsis on the basis of clinical and laboratory signs and died in first 28 days of life. |
Mullany 2006 | Presence of 2 or more of the following signs or symptoms: (1) caregiver's report of fever; (2) vomiting more than half of feeds; (3) unconsciousness; (4)bulging fontanelle; (5) feeding difficulty (not able to suck before death or feeding less thannormal); (6) skin or umbilical cord infection (pus discharge from the cord stump); (7) jaundice;and (8) difficulty breathing and either rapid breathing or chest indrawing and died in first 28 days of life. |
Neonatal Sepsis Incidence | |
Cutland 2009 | Culture-confirmed or clinical sepsis on the basis of clinical and laboratory signs |
Saleem 2007 | Neonates who were severely ill according to Integrated Management of Childhood Illness AND had a clinical presentation, maternal history, and involvement of at least one organ system and laboratory findings; or a maternal history supporting infection; or had no evidence of a nonseptic condition to account for their condition |
Garner 1994 | Based on clinical assessment of study physician |
Cord Infection / Omphalitis | |
Tsu 2000 | Used colour photos of normal and infected cord stumps and questions re redness and pus; interviewer assessment and final decision by neonatologist review of this info (rating it as “definite”,“probable”, “possible”, or “unlikely”) |
Mullany 2006/7 | “Mild” redness (or swelling) was limited to the cord stump, while “moderate” or “severe” was defined as inflammation extending to the skin at the base of the stump (i.e., <2 cm extension onto the abdominal skin) or affecting an area 2 cm or more from the cord, respectively |
Winani 2007 | Inspection of umbilical stump by village health worker for signs of possible infection, including erythema, tenderness of tissues surrounding the cord, pus discharge, or smelly or moist stump. Diagnosis confirmed by physician. |
Darmstadt 2009 | Redness, oozing, or bleeding of umbilical stump |