Circumcision and neonatal tetanus : disclosure of risk and its reduction by topical antibiotics.
Background Previous case-control studies have paradoxically suggested that circumcisions protect against neonatal tetanus (NNT), but these observations have not been adjusted for differences in the length of survival of cases and controls.
Methods Boy cases (n=133) and their sex-matched controls (n=399) were extracted from a population-based study of NNT undertaken in Punjab Province, Pakistan.
In the resulting file, circumcisions were censored such that analysis was restricted to only those that occurred before onset in cases or before age of onset in the matched case for controls.
The effect of topical antibiotics in circumcision wounds was then evaluated.
Results After adjusting for confounders, circumcision before onset posed a significant risk for NNT (matched odds ratio [OR]=3.1,95% Cl : 1.2-8.0).
The risk of NNT in those circumcised before onset and treated with topical antibiotics did not differ significantly from the referent group who had not been circumcised before onset (matched OR=1.1,95% CI : 0.2-6.8), whereas the lack of topical use was associated with significant risk (matched OR=4.2,95% CI : 1.4-12.6).
This suggests that topical antibiotics are likely to be highly effective in preventing NNT from circumcision wounds. (...)
Mots-clés Pascal : Tétanos, Bactériose, Infection, Néonatal, Circoncision, Antibiotique, Chimiothérapie, Traitement, Epidémiologie, Facteur risque, Nouveau né, Homme, Prévention, Pakistan, Asie, Etude cas témoin, Appareil génital mâle, Prépuce
Mots-clés Pascal anglais : Tetanus, Bacteriosis, Infection, Neonatal, Circumcision, Antibiotic, Chemotherapy, Treatment, Epidemiology, Risk factor, Newborn, Human, Prevention, Pakistan, Asia, Case control study, Male genital system, Prepuce
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0222658
Code Inist : 002B05B02I. Création : 16/11/1999.