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Chlorhexidine Digluconate in Northern Nigeria

       12th August 2015 was heralded with a disturbing but crucial information of public health importance brought to the notice of Maternal Newborn and Child Health Stakeholders at the Extraordinary Core Technical Committee meeting (ad-hoc meeting for ICCM guideline review). It was at this meeting that the Nigerian Federal Ministry of Health (FMOH) red flagged the distribution of a liquid formulation of Chlorhexidine in drops is some parts of northern Nigeria and promised to find out its origin and other details with the plan to stop its distribution and use in Nigeria.The implicated drug; Chlorhexidine digluconate 7.1% solution packaged in a white plastic bottle.(more details below)
        2 years ago, the Nigeria government adopted the use of Gel formulation of 4% Chlorhexidine for Umbilical Cord Care both at the health facility and the community (for home deliveries) for the prevention of neonatal infections as part of life saving commodities for newborn health .The use of Chlorhexidine for Umbilical Cord Care is being integrated across the health system structure, e.g. the essential medicine list, procurement and supply systems, training manuals, policy and guidelines etc. The local production started last year and the distribution of the 4% Chlorhexidine Gel for cord care began with THSIP in Sokoto and Bauchi states in northern Nigeria for some years now especially at the community level and is registered in Nigeria as an Over the counter (OTC) drug.

Trajectory of Current Predicament (Chlorhexidine Chemical Keratoconjunctivitis).
        2nd of September 2015 - 3 cases of newborn iatrogenic blindness from corneal ulceration and melting due to instillation of chlorhexidine drops in the eyes of the affected children by the care givers published. The 3 initial suspected cases of unfortunate newborns are located in Yobe State, north eastern part of Nigeria.

        4th of September 2015, - 2 additional cases of this iatrogenic blindness was report in Adamawa state, a state very near to Yobe state.

        Another case has been reported in Kaduna state even though this state is NOT part of the distribution network of the MNCH Project which is responsible for this Chlorhexidine liquid drops importation and use. In this same Kaduna state some women have surrendered same drugs to the authorities. This implies the use of the chlorhexidine solution has spread beyond the supposed project sites.

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