부산대학교 도서관

Background: Neonatal Tetanus (NNT) is a vaccine preventable disease of public health importance. It is still being encountered in clinical practice largely in developing countries including Nigeria. NNT results from unhygienic delivery practices and some harmful traditional cord care practices. The easiest, quickest and most cost-effective preventive measure against NNT is vaccination of the pregnant women with the tetanus toxoid (TT) vaccine. The case-fatality rate from tetanus in resource-constrained settings can be close to 100% but can be reduced to 50% if access to basic medical care with adequate number of experienced staff is available. Materials and methods: This retrospective study reviewed the admissions into the Special Care Baby Unit (SCBU) of the Ekiti State University Teaching Hospital, Ado-Ekiti from January 2011 to December 2020. The folders were retrieved from the records department of the hospital; Information obtained from folders were entered into a designed proforma for the study. Results: During the study period, NNT constituted 0.34% of all neonatal admissions with case fatality rate of 52.6%. Seven [36.8%] of the babies were delivered at Mission home/Traditional Birth Attendant's place while 5 [26.3%] were delivered in private hospitals. Cord care was with hot water compress in most of these babies16 [48.5%] while only 9% of the mothers cleaned the cord with methylated spirit. Age at presentation of less than one week was significantly associated with mortality, same with presence of autonomic dysfunction. Low family socio-economic class 5 was significantly associated with poor outcome, so also maternal age above 24 years. Conclusion: This study revealed that neonatal tetanus is still being seen in our clinical practice with poor outcome and the risk factors are the same as of old. Increased public health campaign, promotion of clean deliveries, safe cord care practices, affordable and accessible health care provision are recommended to combat NNT scourge. Author summary: Neonatal Tetanus (NNT) is a vaccine preventable disease of public health importance still being encountered in clinical practice largely in developing countries however, there are still foci of tetanus cases in the developed world, although exceedingly rare. Tetanus is a toxin mediated disease responsible for the death of hundreds of newborns every year, unfortunately most of these deaths are not recorded because most of the affected babies do not have contact with health facilities. Only 5% of cases are reported to present in health facilities. The Maternal and Neonatal Tetanus Elimination initiative has made remarkable progress as more than three quarter of the priority countries have attained elimination, and the remaining countries seems to be making steady progress over the years. NNT is still being seen in our health facilities. Poor antenatal clinic attendance, unsupervised deliveries, poor cord care, low maternal literacy level and low socio-economic status were some of the major risk factors for NNT in this study. Mortality from NNT is still high as there is no means of ventilatory support for affected babies. There is the need to encourage mothers to attend antenatal care during pregnancy, get vaccinated and have supervised deliveries. There is also the need for public enlightenment campaign on the appropriate and approved cord care methods. It may also be important to consider incorporating tetanus vaccination into the School Health Programme (SHP) to ensure that every female child gets adequate protection before commencement of childbearing. [ABSTRACT FROM AUTHOR]