Tetanus in developing countries: an update on the Maternal and Neonatal Tetanus Elimination Initiative

Vandelaer, Jos; Birmingham, Maureen; Gasse, François; Kurian, Mary; Shaw, Cheryl; Garnier, S.

doi:10.1016/s0264-410x(03)00347-5

Cited by 133 publications

(96 citation statements)

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“…The focus of the renewed programme for elimination of maternal and neonatal tetanus was to assist the 57 countries (now 58, since East Timor has been established as an independent country) where maternal and neonatal tetanus persisted as a public-health problem. 6,14 By February 2007, 40 countries had implemented tetanus campaigns in high-risk areas, targeting more than 94 million women, and protecting more than 70 million with at least two doses of tetanus toxoid. Ten of the 58 priority countries showed elimination of maternal and neonatal tetanus, as did seven Indian states.…”

Section: Control: the Maternal And Neonatal Tetanus Elimination Initimentioning

confidence: 99%

“…13 This disease now accounts for 5-7% of worldwide neonatal mortality, compared with 14% in 1993. 14,15 Estimates of present incidence and mortality of maternal tetanus are unavailable; however, the number of deaths worldwide from this disease has probably undergone a commensurate reduction. In developed countries, tetanus is now little more than a medical curiosity; maternal and neonatal tetanus are exceedingly rare.…”

mentioning

confidence: 99%

“…In developed countries, tetanus is now little more than a medical curiosity; maternal and neonatal tetanus are exceedingly rare. 16,17 However, tetanus as a whole continues to cause about 213 000-293 000 deaths worldwide each year, 14,18,19 predominantly in low-income and middleincome countries. Deaths from maternal or neonatal tetanus are concentrated in 48 countries, mostly in Asia and Africa (figure 2).…”

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confidence: 99%

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Maternal and Neonatal Tetanus

Roper

Vandelaer

Gasse

2008

Obstetric Anesthesia Digest

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Maternal and neonatal tetanus are important causes of maternal and neonatal mortality, claiming about 180 000 lives worldwide every year, almost exclusively in developing countries. Although easily prevented by maternal immunisation with tetanus toxoid vaccine, and aseptic obstetric and postnatal umbilical-cord care practices, maternal and neonatal tetanus persist as public-health problems in 48 countries, mainly in Asia and Africa. Survival of tetanus patients has improved substantially for those treated in hospitals with modern intensive-care facilities; however, such facilities are often unavailable where the tetanus burden is highest. The Maternal and Neonatal Tetanus Elimination Initiative assists countries in which maternal and neonatal tetanus has not been eliminated to provide immunisation with tetanus toxoid to women of childbearing age. The ultimate goal of this initiative is the worldwide elimination of maternal and neonatal tetanus. Since tetanus spores cannot be removed from the environment, sustaining elimination will require improvements to presently inadequate immunisation and health-service infrastructures, and universal access to those services. The renewed worldwide commitment to the reduction of maternal and child mortality, if translated into effective action, could help to provide the systemic changes needed for long-term elimination of maternal and neonatal tetanus.Tetanus in the first 28 days of life (neonatal tetanus) was long recognised by clinicians in resource-poor settings as an important cause of neonatal death. However, since babies affected by this disease usually are born at home and die there without registration of either event, the true burden was unknown. In the 1970s and 1980s, community-based surveys about neonatal tetanus from more than 40 countries showed that fewer than 10% of tetanus-related cases and deaths were routinely reported in most countries: in some regions, the reporting fraction was as low as 2-5%. 1,2 Estimates based on the results of these surveys, and tetanus data routinely reported to WHO suggested that, in the 1980s, more than 1 million deaths every year were attributable to tetanus, with an estimated 787 000 deaths in 1988 from neonatal tetanus alone. 1,3 In 1989, the worldwide public-health community made a commitment to the elimination of neonatal tetanus (defined as fewer than one case of neonatal tetanus per 1000 livebirths in all districts) by 1995. 3,4 Maternal tetanus is defined as tetanus during pregnancy, or within 6 weeks of the end of pregnancy (whether pregnancy ended with birth, miscarriage, or abortion), and has the same risk factors and means of prevention as neonatal tetanus. In the early 1990s it was estimated to account for about 5% of maternal mortality, or 15 000-30 000 deaths every year. 5,6 In 1999, the elimination of maternal tetanus was added to the goals of the elimination programme for neonatal tetanus, and the initiative was renamed the Maternal and Neonatal Tetanus Elimination Program. 6 Good progress has been made in the 15 ...

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Section: Control: the Maternal And Neonatal Tetanus Elimination Initimentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Maternal and Neonatal Tetanus

Roper

Vandelaer

Gasse

2008

Obstetric Anesthesia Digest

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“…Maternal and Neonatal tetanus (MNT) is a major health problem in developing countries, and incurs high mortality where compulsory immunization of children is not enforced (UNICEF, WHO, UNFPA, 2000;Vandelaer et al, 2003;Griffiths et al, 2004;Pantipa et al, 2007). The World Health Organization's (WHO) implementation of the Neonatal Tetanus Elimination Program in 1989 was a major step toward eliminating this disease (WHO, 1989).…”

Section: Introductionmentioning

confidence: 99%

“…The World Health Organization's (WHO) implementation of the Neonatal Tetanus Elimination Program in 1989 was a major step toward eliminating this disease (WHO, 1989). However, even though a safe and highly effective vaccine is available, MNT still causes an estimated 309,000 deaths annually worldwide (Vandelaer et al, 2003). Mortality is 135 times higher in the developing countries as compared to developed countries.…”

Section: Introductionmentioning

confidence: 99%

Seroepidemiological surveillance of antitetanus antibodies in Pakistani childbearing women: A population based survey

Parveen¹

2012

Afr. J. Pharm. Pharmacol.

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Maternal and Neonatal Tetanus is a severe, often fatal ailment characterized by sweeping augmented strictness and convulsive spasms of skeletal muscles. Vaccination is the most steadfast method of forbearance against this disease and has inculcated to lessen mortalities. The present study was carried out with a view to assess the serum levels of tetanus antitoxins in randomly selected rural and urban women to find out the effect of age, number of pregnancy, parity and number of injections at the time of delivery. The study was cross-sectional in design and hospital-based. The gold standard mouse neutralization assay was employed despite being costly and cumbersome. Antibody titre of each sample was determined by seroneutralization method. 1504 women, randomly selected from various hospitals of age 15 to 40 years, 1064 (0.000) were vaccinated, which are significant while 440 were unvaccinated women and taken as control. The 65% (p = 0.000) women had antibody titre higher than protective level which is significant, 28% equal to protective level and 6.7% below protective level. Average antibody titre of 3rd trimester was higher than 2nd trimester (p = 0.000) which is significant. Immunization awareness and practice was higher in < 30 (78%) than > 30 years in women (63%) of both rural and urban areas but practice was comparatively higher in urban (74%) than rural area (67%). These finding shows that tetanus vaccination in our population is generally effective and cannot be protected by herd immunity, as tetanus is not communicable disease.

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