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1 Epidemiological Aspects of Gonorrhoeal and Chlamydial Infection. Local Effects of Silver Nitrate and Hexarginum
Author(s) -
WAHLBERG V.,
KALLINGS I. MOBERG,
WINBERG J.
Publication year - 1982
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1982.tb09580.x
Subject(s) - medicine , chlamydia , asymptomatic , placebo , irritation , silver nitrate , epidemiology , incidence (geometry) , dermatology , immunology , pathology , physics , alternative medicine , optics , chemical engineering , engineering
Since the Credé method was introduced for prophylaxis against gonococcal ophthalmia, there have been great changes with regard to prevention, diagnosis and treatment of this potentially dangerous disease, which warrants a reconsideration of its general application. In this study we report firstly on the incidence of maternal gonorrhoeal and Chlamydial infection at the time of delivery as a basis for evaluating the risk of neonatal infection. Secondly we report on pain reactions as well as on the frequency of conjunctivitis following different kinds of prophylaxis or placebo. The investigation included more than 1 000 mother‐infant pairs delivered in 1978. Eye prophylaxis was given with 1 % silver nitrate, 10 % Hexarginum (a less irritating silver compound), or physiological saline as placebo, in a randomized double‐blind fashion. Cultures for gonorrhoea were made on 1 027 women and for Chlamydia on a sub sample of 165 women. Observations for pain reactions and for irritation/conjunctivitis were made on 627 infants. Conjunctival samples for cultures were taken from 156 infants with conjunctivitis. Conjunctival samples for Chlamydia cultures were taken from 250 healthy infants and from 15 infants with long‐lasting conjunctivitis. Maternal gonococcal infections were observed in 111 027 women and maternal Chlamydia infections in 1/165 women in the sub sample; in both instances the infections were asymptomatic. There were no cases of gonococcal ophthalmia, but among 15 infants who showed a long‐lasting conjunctival irritation, Chlamydia was isolated in two. The observation of pain reaction showed that silver nitrate induced significantly more violent reactions than Hexarginum and saline. Almost 40 % of the silver nitrate infants had a heavy purulent secretion during days 1–3 post partum, but only 2 % of the other two groups. The generally applied prophylaxis against gonococcal ophthalmia with silver nitrate does not fulfil the requirements for general prophylaxis. It is suggested that the Credé method should be abandoned but that there should be compulsory notification of diagnosed cases of gonococcal ophthalmia.