Neonatal Tetanus: A Continuing Menace

Abstract

Background: Tetanus especially that affecting the newborn has continued to contribute to morbidity and mortality in developing countries such as Nigeria despite the availability, for over 30 years of an effective vaccine. Its contributing factors include low immunization coverage, poor obstetric services and illiteracy. This study aims at reviewing the status of neonatal tetanus in UPTH with its characteristics and outcome while highlighting the need for instituting sustainable control measures.
Methods: This is a retrospective analysis, involving the review of hospital records on neonatal tetanus cases treated at the University of Port Harcourt Teaching Hospital from 1995 to 2009. The case notes of all neonatal tetanus patients in the department of paediatrics from 1995-2009 were retrieved and reviewed for age, sex, presenting complaint, immunization status, examination finding, duration of hospitalization and outcome of illness.
Results: Two hundred and ninety six neonates, comprising 174 (58.8%) males and 121(40.9%) females were treated 1(0.3%) of them did not have any record of his or her sex. Most of the mothers did not receive any doses of Tetanus Toxoid [TT] vaccine and delivered outside health facilities. Fifty percent of the cases died. The number and characteristics of the cases and deaths did not change significantly over the period.
Conclusion: Essential obstetric care, strengthening of routine immunization, compulsory immunization of all women of childbearing age and school-age children should be adopted to reduce the incidence of neonatal tetanus in the country, while improved health care will reduce the associated high case fatality rate.

Key Words: Neonatal tetanus, Outcome and trends; Port Harcourt; Nigeria.