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Neonatal tetanus in the world today.

J P Stanfield, A Galazka

    Bulletin of the World Health Organization
    |January 1, 1984
    PubMed
    Summary

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    Neonatal tetanus is a significant, preventable cause of newborn deaths globally. Improving maternal immunization and skilled birth attendance can eliminate this serious public health issue.

    Area of Science:

    • Public Health
    • Epidemiology
    • Maternal and Child Health

    Background:

    • Neonatal tetanus is a major contributor to preventable newborn morbidity and mortality, particularly in developing nations.
    • Historically underestimated, neonatal tetanus is now recognized as a critical health challenge, causing over half a million newborn deaths annually.
    • Existing reporting systems significantly under-report tetanus cases, identifying only 2-5% of estimated occurrences, necessitating more accurate incidence and mortality data.

    Purpose of the Study:

    • To highlight the significant impact of neonatal tetanus as a global health problem.
    • To emphasize the need for accurate data on neonatal tetanus incidence and mortality.
    • To advocate for strategies to eliminate neonatal tetanus worldwide.

    Main Methods:

    Keywords:
    Bacterial And Fungal DiseasesData AnalysisDeliveryDelivery Of Health CareDemographic FactorsDiseasesHealthHealth PersonnelHealth ServicesHealth SurveysImmunizationInfant MortalityInfectionsMaternal Health ServicesMaternal-child Health ServicesMedicineMidwivesMortalityNeonatal Diseases And AbnormalitiesNeonatal MortalityObstetrical SurgeryPopulationPopulation CharacteristicsPopulation DynamicsPreventive MedicinePrimary Health CareResearch MethodologySampling StudiesSex FactorsStudiesSurgerySurveysTetanus--prevention and controlTraining ProgramsWorld

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    • The study synthesizes findings from community-based surveys to estimate neonatal tetanus mortality rates.
    • It analyzes the proportion of neonatal deaths attributable to tetanus.
    • It reviews existing health service data and compares it with survey-based estimates.

    Main Results:

    • Neonatal tetanus mortality rates vary widely, from under 5 to over 60 deaths per 1000 live births.
    • Tetanus accounts for 23% to 72% of all neonatal deaths in affected regions.
    • Under-reporting is severe, with routine systems capturing only a small fraction of actual cases.

    Conclusions:

    • Eliminating neonatal tetanus is an achievable public health goal.
    • Key strategies include increasing tetanus toxoid immunization coverage for women of childbearing age and improving maternity care with trained birth attendants.
    • Neonatal tetanus mortality serves as a crucial indicator for maternal health service quality, immunization program impact, and progress toward "Health for All."