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Perinatal infections--problems in developing countries
Authors:NK Ho
Affiliation:Division of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
Abstract:
The transmission of infections from the biologic mother to her offspring is popularly known as perinatal infection (PI). It is not synonymous to infections during the perinatal or neonatal period. Physicians should avoid focusing attention only on the TORCH agents in the evaluation of suspected PI. Perinatal period begins from 28 weeks of gestation. Would one consider in utero infections in the first or second trimester of pregnancy as PIs? Developing countries have difficulty in collecting reliable and accurate data of PIs. These data are useful to define the magnitude of the problems, to monitor the trends, to recognise the mode of spread, and to find a solution of PIs. Most PIs are asymptomatic and diagnosis is extremely difficult. Developing countries need rapid, easy-to-operate, simple, and cheap diagnostic tools urgently. Access to health care in the remote city is limited. Newer drugs are too expensive and very few patients can benefit from these. Each developing country should prioritize its PI problems and tackle those that have serious public health problems and socio-economic impact. Most developing countries should focus on HIV (human immunodeficiency virus) and HBV (hepatitis B virus) infections. Other countries where ophthalmia, malaria or tuberculosis are prevalent or endemic, should focus on these. Developing countries are more willing to allocate the budget for prevention of diseases than for treatment. There may be problem of promulgating the information on prevention of diseases because of illiteracy, multi-lingual community. Vaccines where available, should be affordable. Other effective prevention guidelines should be workable in poorer nations. The government should play an important role in enforcing immunisation program by intensive promotion program or by legislation.
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