[Primary care of low birth weight premature infants in the rural areas of Africa]. / Cuidados basicos de los prematuros de bajo peso en las areas rurales de Africa.

PIP: The Evangelical Medical Center in Nyankunde, Zaire, has had some success in treating low birth weight premature infants despite its lack of mechanical respiratory assistance and permanent parenteral feeding. But the norms and procedures for attending to newborns have varied in recent years due to frequent changes in the hospital's administration. A retrospective study was conducted of the 46 infants weighing 1800g or less who were born at the hospital between January 1985-February 1988 to determine the correlation between feeding, antibiotic therapy, and temperature control and survival of the infants. Feeding was considered accomplished if the infant accepted at least 90 ml/kg of maternal milk through a nasogastric tube on the 1st day with a progressive increase in liquids in the 3 following days. Antibiotic therapy was considered given when gentamycin, penicillin, or ampicillin was administered. The temperature was considered controlled if it was taken at least 4 times daily during the 1st 3 days. 7 of the 46 infants were excluded from the study, 3 because their birth weight was less than 1000 g and 4 for inadequate information. The 3 remaining infants had an average birth weight of 1510 g. Gestational ages at birth ranged from 30-35 weeks. 19 were male and 20 female. 27 (69%) survived and were discharged from the hospital. 8 boys and 4 girls died. The wright of those who died ranged from 1140-1760 g. 21 of the 26 who were fed survived, vs. only 6 of the 13 who were not fed. Almost all the mothers were capable of adequately breast feeding. 19 of the 24 patients receiving antibiotics survived, vs. 8 of the 15 who did not. 25 of the 34 whose temperature was routinely taken survived, vs. 2 of 5 for whom it was not. 17 of the 21 infants receiving all 3 forms of treatment survived (81%), vs. 10 of 18 who received none (56%). More detailed prospective studies are needed to confirm the effectiveness of these simple measures and to evaluate other measures appropriate for rural and poorly equipped maternity centers in developing countries.^ieng