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

Area of Science:

• Public Health
• Vaccinology
• Epidemiology

Background:

• Tetanus remains a significant global health threat, causing substantial mortality, particularly maternal and neonatal tetanus (MNT).
• Neonatal tetanus alone caused an estimated 200,000 deaths in 2000, with 90% concentrated in 27 of 57 priority countries.
• MNT is preventable through maternal immunization during pregnancy.

Purpose of the Study:

• To outline strategies for the elimination of maternal and neonatal tetanus (MNT) by 2005.
• To highlight the importance of immunization for women of childbearing age in achieving MNT elimination goals.
• To describe the "high risk approach" and supplemental immunization activities (SIAs) as key interventions.

Main Methods:

• Implementing clean delivery practices.
• Administering tetanus toxoid (TT) containing vaccines to pregnant women and women of childbearing age in high-risk areas.
• Utilizing supplemental immunization activities (SIAs) to reach underserved populations.

Main Results:

• Supplemental immunization activities (SIAs) have reached approximately 17 million women with at least two doses of TT vaccine in the past three years.
• An estimated 200 million additional women need to be targeted in the coming years.
• SIAs are expected to significantly reduce the burden of MNT.

Conclusions:

• MNT elimination requires a multi-pronged approach including routine immunization, clean delivery practices, and targeted SIAs.
• The "high risk approach" is essential for reaching women in underserved areas.
• Sustained efforts in immunization and clean delivery are necessary to maintain MNT elimination.