[Research on factors affecting neonatal tetanus and its prevention through immunization]

Neonatal Tetanus (NT) has been set by WHO as one of the most important diseases to be under control. Its incidence rate at some counties and cities in Southern Fujian province exceeded set out levels. Both retrospective and cohort studies were carried. It was found that in rural areas only 8.66% (319/3,683) pregnant women gave births at hospital and 94.85% (129/136) NT cases were delivered by untrained midwives. When TAT was tested in mothers and newborns, only 23.81% and 20.65% of them reached protective level. This shows the main reasons for high NT incidence rate were due to poor medical treatment during delivery and low antibody level. Using tetanus toxin (TT) to fully immunize pregnant women, no side effects were observed and TAT antibody levels for mothers and newborns were increasing to reach 100% (99/99) and 93.94% (93/99) relatively. When immunizing women at child-bearing age with TT, 90.40% (113/125) of them still had TAT up to protective level in 3 years. A total number of 8,882 newborns whose mothers had been fully vaccinated with TT were investigated, no NT case occurred. Among 4,835 newborns whose mothers did not receive vaccination, some NT cases were identified. The incidence rate was as high as 5.28%. These results showed that the TT vaccination in women at child-bearing age should be considered as the major strategy for NT prevention.