Abstract
Background
Neonatal tetanus (NNT) is a major cause of newborn deaths especially in the developing world. While efforts aimed at eradicating NNT should be sustained, it is equally imperative to reduce death among affected infants. Therefore, the factors associated with mortality rate in this condition need to be studied.
Methods
The records of infants with NNT over a 15-year period (1991–2005) were reviewed. A statistical comparison of the survivors and fatalities for relevant clinical characteristics was done, and the determinants of fatality rate were also determined using logistic regression.
Results
Ninety-six of 151 newborns with NNT died, giving a mortality rate of 63.6%. The case fatality rate during the study period varied between 33.3% and 100%. More deaths occurred in the infants with low birth weight (P=0.004) within 1 day at the onset of symptoms (P<0.001), whose mothers aged 18 years or less (P=0.001) belonged to socio-economic class V (P=0.001). Determinants of mortality in these infants with NNT included low socio-economic class (P=0.002), no antitetanus vaccination (P=0.006), presentation with spasms (P<0.001), and non-administration of anti-tetanus serum during treatment (P=0.013).
Conclusions
The mortality rate in infants with NNT remains signifi cantly high in Nigeria. Improved maternal anti-tetanus vaccination and timely recognition and treatment of affected infants may jointly reduce the incidence and fatality rate of NNT.
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References
Fetuga MB, Ogunlesi TA, Adekanmbi AF, Olanrewaju DM, Olowu AO. Comparative analyses of childhood mortality in Sagamu, Nigeria: implications for the Fourth MDG. South Afr J Child Health 2007;1:106–111.
Lawoyin TO. Infant and maternal deaths in rural south west Nigeria: a prospective study. Afr J Med Med Sci 2007;36: 235–241.
Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? where? why? Lancet 2005;365:891–900.
Chowdhury ME, Akhter HH, Chongsuvivatwong V, Geater AF. Neonatal mortality in rural Bangladesh: an exploratory study. J Health Popul Nutr 2005;23:16–24.
Ogunlesi TA, Ogunfowora OB, Adekanmbi AF, Fetuga MB, Runsewe-Abiodun TI, Ogundeyi MM. Neonatal mortality at Olabisi Onabanjo University Teaching Hospital, Sagamu. Nig J Paediatr 2006;33:40–46.
Eregie CO. Epidemiological factors associated with neonatal tetanus mortality: observations from a cluster survey in Nigeria. East Afr Med J 1993;70:434–437.
Ogunlesi TA, Okeniyi JA, Owa JA, Oyedeji GA. Neonatal tetanus at the close of the 20th century in Nigeria. Trop Doct 2007;37:165–167.
Basu S, Paul DK, Ganguly S, Chandra PK. Risk factors for mortality from neonatal tetanus: 7 years experience in North Bengal, India. Ann Trop Paediatr 2006;26:233–239.
Vandelaer J, Birmingham M, Gasse F, Kurian M, Shaw C, Garnier S. Tetanus in developing countries: an update on the Maternal and Neonatal Tetanus Elimination Initiative. Vaccine 2003;21:3442–3445.
Ertem M, Cakmak A, Saka G, Ceylan A. Neonatal tetanus in the South-Eastern region of Turkey: changes in prognostic aspects by better health care. J Trop Pediatr 2004;50:297–300.
Oyedeji GA. Socioeconomic and cultural background of hospitalized children in Ilesa. Nig J Paediatr 1985;12:111–117.
Davies-Adetugbo AA, Torimiro SE, Ako-Nai KA. Prognostic factors in neonatal tetanus. Trop Med Int Health 1998;3:9–13.
Yramiş A, Taş MA. Neonatal tetanus in the southeast of Turkey: risk factors, and clinical and prognostic aspects. Review of 73 cases, 1990–1999. Turk J Pediatr 2000;42:272–274.
Oyedeji GA, Olamijulo SK, Joiner TK. Neonatal tetanus in Ilesha, Nigeria: a review of present status. Nig Med J 1982;12: 131–135.
Chan MCK, Hart CA, Igbagiri FP, Oruamabo RS. Placental transfer of tetanus antibodies: is there an impairment in Nigeria? Nig J Paediatr 1994;21:94–100.
Okeniyi JAO, Dedeke IOF, Ogunlesi TA, Oyedeji GA. Prevention of neonatal tetanus: more preached and less practiced. Nig Med Pract 2006;50:39–41.
Bricks LF. Vaccines in pregnancy: a review of their importance in Brazil. Rev Hosp Clin Fac Med Sao Paulo 2003;58:263–274.
Owa JA, Makinde OO. Improved survival rate in neonatal tetanus among infants of immunised mothers. Nig Med J 1990; 20:149–152.
Gupta SD, Keyl PM. Effectiveness of prenatal tetanus toxoid immunization against neonatal tetanus in a rural area in India. Pediatr Infect Dis J 1998;17:316–321.
Quddus A, Luby S, Rahbar M, Pervaiz Y. Neonatal tetanus: mortality rate and risk factors in Loralai District, Pakistan. Int J Epidemiol 2002;31:648–653.
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Fetuga, B.M., Ogunlesi, T.A. & Adekanmbi, F.A. Risk factors for mortality in neonatal tetanus: a 15-year experience in Sagamu, Nigeria. World J Pediatr 6, 71–75 (2010). https://doi.org/10.1007/s12519-010-0010-9
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DOI: https://doi.org/10.1007/s12519-010-0010-9