The dynamics of tetanus epidemiology and control in rural Uttar Pradesh studied through computer simulation

An epidemiological model is constructed for tetanus. The assumptions as well as the steps involved in the construction of the model, are detailed. The impact of alternate immunisation strategies to control tetanus in rural Uttar Pradesh, is studied using this model. The quantification of the expected decline in incidence and mortality over 30 years, for different control strategies, provides the health planner with valuable information. It is seen that the incidence of tetanus neonatorum and tetanus in adults, as well as deaths due to tetanus, progressively decreases as the level of coverage is increased. The most marked reduction is seen over the initial period of intervention. Mass immunisation of the total population, or of just the females in the reproductive age group, leads to temporary decline in the endemic level. Such models are useful for planning in the health sector in India since, they can be constructed with the limited information available.