Neonatal tetanus: review of progress.

Area of Science:

• Public Health
• Epidemiology
• Global Health

Background:

• Neonatal tetanus (NT) elimination is a global public health goal, targeting <1 case per 1000 live births per district.
• Maternal immunization and clean delivery practices significantly reduced neonatal deaths from tetanus in 1993.

Purpose of the Study:

• To assess the progress and remaining challenges in achieving global neonatal tetanus elimination.
• To identify priority countries and necessary interventions for NT eradication.

Main Methods:

• Analysis of 1993 estimates on neonatal tetanus incidence and mortality.
• Identification of countries with high NT rates and districts not meeting elimination targets.

Main Results:

• Over 700,000 neonatal deaths were prevented in 1993, with 70% averted in India, Bangladesh, and Indonesia.
• Despite progress, approximately 500,000 neonatal deaths due to tetanus still occurred globally in 1993, predominantly in 12 countries.
• 26 priority countries, mostly in the African Region, account for 90% of the global NT incidence.

Conclusions:

• Achieving NT elimination by 1995 requires a high-risk approach, immunization, and potentially "Days of Tranquility."
• Substantial political commitment and an estimated US$30 million in financial support are crucial for programs in the 26 priority countries.