Neonatal tetanus at the close of the 20th century in Nigeria

Abstract

The year 2000 marked another failed World Health Organization deadline for neonatal tetanus (NNT) eradication. Existing preventive strategies can be enhanced by exploring factors involved in the persistence of the scourge. Thus, records of neonates admitted between 1996 and 2000 into the Wesley Guild Hospital, Ilesa, were analysed. Of 3051 total neonatal admissions,162 (5.3%) had NNT. Eighty-nine (54.9%) mothers had clinic-based antenatal care (ANC), but only 59 (36.4%) had tetanus toxoid (TT) vaccines. The majority (66.7%) of them delivered at home or churches and others at either private clinics or primary health centres. Overall, the case fatality rate was 43.8%, though it was significantly higher among babies whose mothers had neither clinic-based ANC (odds ratio [OR] = 2.62; 95% confidence interval [CI] = 1.33-5.18) nor antenatal TT vaccination (OR = 2.41; 95% CI = 1.17-5.03). Thus, improvement on ANC, anti-tetanus immunization and ensuring hygienic deliveries are crucial for eliminating NNT in the 21st century.

Trends in neonatal and post-neonatal tetanus admissions at a Nigerian teaching hospital

“…Tetanus is a vaccine preventable disease and a significant cause of morbidity and mortality in developing countries [1,2,3,4]. The disease is usually classified into neonatal and post-neonatal tetanus in the paediatric age group.…”

“…A previous study found that neonatal tetanus is a public health problem accounting for 400,000 deaths annually in the developing world [5]. Regardless of programs recommended by the World health organization for its elimination by the year 2000 [6], 124,000 cases and 98,000 deaths attributable to neonatal tetanus were reported between 1998 and 1999 in Africa [1]. Nigeria alone accounts for 40% of this figure in spite of gross under reporting [1].…”

“…Regardless of programs recommended by the World health organization for its elimination by the year 2000 [6], 124,000 cases and 98,000 deaths attributable to neonatal tetanus were reported between 1998 and 1999 in Africa [1]. Nigeria alone accounts for 40% of this figure in spite of gross under reporting [1]. Thus it is not surprising that neonatal tetanus has been described as the scourge of Nigerian children [7].…”

“…Thus it is not surprising that neonatal tetanus has been described as the scourge of Nigerian children [7]. Recent studies conducted in Nigeria in the early part of this millennium still show that tetanus has been able to transit across the millenniums retaining its significance as a cause of mortality in the neonatal age group [1,8].…”

Prevalence and outcome of neonatal tetanus in Zaria, Northwestern Nigeria

“…Although some data on neonatal tetanus in western parts of Nigeria have been recently published by Ogunlesi et al [6] and Fatuga et al [7], only cases seen towards the end of the last millennium have been considered. Therefore, to assess the progress made so far in the elimination of neonatal tetanus in Nigeria, the incidence and the outcome of the disease in Zaria were examined.…”