Neonatal tetanus mortality survey, north and south Omo administrative regions, Ethiopia

Neonatal tetanus (NNT) is the second most frequent cause of infant mortality among the six vaccine preventable infections in developing countries. However, lack of reliable data has largely obscured the importance of the problem in these countries. A community based NNT mortality survey was conducted, using cluster sample method developed by WHO/EPI, in August 1989 in North and South Omo, Ethiopia. The study found 14 neonatal tetanus deaths among 2100 live births which occurred from 15 July 1988 to 15 July 1989, giving NNT mortality rate of 6.7/1000 LB (live births) and an estimated incidence rate of 8.4/1000 LB, accounting for 40% of all neonatal deaths. Male newborns were 2.5 times more commonly affected than females. Cutting of umbilical cord with unsterile instrument, home delivery attended by untrained TBAs, and lack of adequate tetanus TT immunization were found to be associated with increased incidence of NNT. Acceleration and promotion of TT immunization of all women of child bearing age and training of TBAs in proper obstetric care, coupled with continuous supportive supervision, is recommended in order to successfully execute the NNT elimination initiative undertaken by the Ministry of Health.