TY - JOUR
T1 - Disinfection of neonatal resuscitation equipment in low‐resource settings
T2 - The importance, the reality, and considerations for the future
AU - White, Anne M.
AU - Mutai, Dominic
AU - Cheruiyot, David
AU - Rule, Amy R.L.
AU - Mortensen, Joel E.
AU - Schaffzin, Joshua K.
AU - Kamath‐rayne, Beena D.
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Preventable neonatal deaths due to prematurity, perinatal events, and infections are the leading causes of under‐five mortality. The vast majority of these deaths are in resource‐limited areas. Deaths due to infection have been associated with lack of access to clean water, overcrowded nurseries, and improper disinfection (reprocessing) of equipment, including vital resuscitation equipment. Reprocessing has recently come to heightened attention, with the COVID‐19 pandemic bringing this issue to the forefront across all economic levels; however, it is particularly challenging in low‐resource settings. In 2015, Eslami et al. published a letter to the editor in Resuscitation, high-lighting concerns about the disinfection of equipment being used to resuscitate newborns in Kenya. To address the issue of improper disinfection, the global health nongovernment organization PATH gathered a group of experts and, due to lack of best‐practice evidence, published guidelines with recommendations for reprocessing of neonatal resuscitation equipment in low‐resource areas. The guidelines follow the gold‐standard principle of high‐level disinfection; however, there is ongoing concern that the complexity of the guideline would make feasibility and sustainability difficult in the settings for which it was designed. Observations from hospitals in Kenya and Malawi reinforce this concern. The purpose of this review is to discuss why proper disinfection of equipment is im-portant, why this is challenging in low‐resource settings, and suggestions for solutions to move forward.
AB - Preventable neonatal deaths due to prematurity, perinatal events, and infections are the leading causes of under‐five mortality. The vast majority of these deaths are in resource‐limited areas. Deaths due to infection have been associated with lack of access to clean water, overcrowded nurseries, and improper disinfection (reprocessing) of equipment, including vital resuscitation equipment. Reprocessing has recently come to heightened attention, with the COVID‐19 pandemic bringing this issue to the forefront across all economic levels; however, it is particularly challenging in low‐resource settings. In 2015, Eslami et al. published a letter to the editor in Resuscitation, high-lighting concerns about the disinfection of equipment being used to resuscitate newborns in Kenya. To address the issue of improper disinfection, the global health nongovernment organization PATH gathered a group of experts and, due to lack of best‐practice evidence, published guidelines with recommendations for reprocessing of neonatal resuscitation equipment in low‐resource areas. The guidelines follow the gold‐standard principle of high‐level disinfection; however, there is ongoing concern that the complexity of the guideline would make feasibility and sustainability difficult in the settings for which it was designed. Observations from hospitals in Kenya and Malawi reinforce this concern. The purpose of this review is to discuss why proper disinfection of equipment is im-portant, why this is challenging in low‐resource settings, and suggestions for solutions to move forward.
KW - Disinfection
KW - Global child health
KW - Neonatal infection
KW - Neonatal mortality
KW - Reprocessing
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U2 - 10.3390/ijerph18137065
DO - 10.3390/ijerph18137065
M3 - Article
C2 - 34281001
AN - SCOPUS:85108957436
SN - 1661-7827
VL - 18
JO - International journal of environmental research and public health
JF - International journal of environmental research and public health
IS - 13
M1 - 7065
ER -