A survey of neonatal tetanus at a district general hospital in north-east Nigeria

Hassan, Bala; Popoola, Ayo; Olokoba, AB; Salawu, FK

doi:10.1258/td.2010.100310

Cited by 9 publications

(5 citation statements)

References 10 publications

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“…This finding is similar to previous findings7892023 There were no cases of circumcision or ear piercing recorded as probable portal of entry.…”

Section: Discussionsupporting

confidence: 92%

“…Available data indicates that 18 states (out of 37) are at risk for maternal and neonatal tetanus 4. Many hospital based studies have identified neonatal tetanus as a problem of high magnitude in Nigeria 5678. Maternal immunization and improved obstetric and neonatal care are the main strategies in Nigeria for improving protection against neonatal tetanus 4.…”

Section: Introductionmentioning

confidence: 99%

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A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Bello

Elechi

et al. 2013

Niger Med J

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Background:Neonatal tetanus is a vaccine preventable disease and is a leading cause of neonatal mortality in developing countries. The effectiveness of immunization and hygienic umbilical cord care practices in the prevention of the disease has been established.Objective:The objective of this study was to audit the scourge of neonatal tetanus in a tertiary health facility in a resource-limited setting.Materials and Methods:The study was a retrospective study. Case notes of neonates admitted with clinical diagnosis of tetanus into the Special Care Baby Unit (SCBU) between January 2009 and December 2010 were retrieved and evaluated to identify socio-demographic and clinical characteristics, mode of acquisition and severity of the disease, presence of co-morbidities, duration of hospital stay and outcome.Results:Most of the mothers had no tetanus immunization (66.7%) and the main social class of the children was class V (45.1%) and IV (41.2%), respectively. Only 29.4% of the mothers attended ante-natal care (ANC) while majority of the patients were delivered at home (94.1%). Half of the neonates presented with the severe form of the disease (51.0%). Sepsis is a prominent co-morbidity (59.2%). Morality was high with case fatality of 66.7%.Conclusion:This high prevalence of neonatal tetanus with high mortality is not only disappointing but unacceptable in the 21st century. Therefore, all efforts must be re-focused on current preventive strategies while pursuing new areas such as slow-release mono-dose tetanus vaccine and school health programme as well as advocacy on political will for the sustainability of immunization programmes of women of child-bearing age.

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“…This finding is similar to previous findings7892023 There were no cases of circumcision or ear piercing recorded as probable portal of entry.…”

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Bello

Elechi

et al. 2013

Niger Med J

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“…However, there was no further sterilization of the tools due to a belief that “new is clean.” Razor blades are readily available from most shops and chemists; typically these razor blades are wrapped in wax paper and exposed to open air and dust, which raises concern for tetanus or other forms of bacteria. Although a study from Sudan found the type of tool used to cut the cord not significantly associated with neonatal tetanus [39], there is ample evidence to support that unsterilized tools may increase the risk of neonatal tetanus or omphalitis [13,37,40,41]. …”

Section: Discussionmentioning

confidence: 99%

Local Perceptions, Cultural Beliefs and Practices That Shape Umbilical Cord Care: A Qualitative Study in Southern Province, Zambia

Herlihy

Shaikh

Mazimba³

et al. 2013

PLoS ONE

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BackgroundGlobal policy regarding optimal umbilical cord care to prevent neonatal illness is an active discussion among researchers and policy makers. In preparation for a large cluster-randomized control trial to measure the impact of 4% chlorhexidine as an umbilical wash versus dry cord care on neonatal mortality in Southern Province, Zambia, we performed a qualitative study to determine local perceptions of cord health and illness and the cultural belief system that shapes umbilical cord care knowledge, attitudes, and practices.Methods and FindingsThis study consisted of 36 focus group discussions with breastfeeding mothers, grandmothers, and traditional birth attendants, and 42 in-depth interviews with key community informants. Semi-structured field guides were used to lead discussions and interviews at urban and rural sites. A wide variation in knowledge, beliefs, and practices surrounding cord care was discovered. For home deliveries, cords were cut with non-sterile razor blades or local grass. Cord applications included drying agents (e.g., charcoal, baby powder, dust), lubricating agents (e.g., Vaseline, cooking oil, used motor oil) and agents intended for medicinal/protective purposes (e.g., breast milk, cow dung, chicken feces). Concerns regarding the length of time until cord detachment were universally expressed. Blood clots in the umbilical cord, bulongo-longo, were perceived to foreshadow neonatal illness. Management of bulongo-longo or infected umbilical cords included multiple traditional remedies and treatment at government health centers.ConclusionUmbilical cord care practices and beliefs were diverse. Dry cord care, as recommended by the World Health Organization at the time of the study, is not widely practiced in Southern Province, Zambia. A cultural health systems model that depicts all stakeholders is proposed as an approach for policy makers and program implementers to work synergistically with existing cultural beliefs and practices in order to maximize effectiveness of evidence-based interventions.

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“…(1) vaccination of potential childbearing women and pregnant women; the vaccination schedule should be updated or initiated during prenatal care using tetanus toxoid, a lowcost and effective measure. (1,8,36) Table 3 shows the basic immunization schedule that was proposed by the Brazilian Ministry of Health and the Brazilian Pediatrics Society.…”

Section: Prophylaxis and Controlmentioning

confidence: 99%

Infecção por Clostridium tetani no recém-nascido: revisão sobre o tétano neonatorum

Gomes¹,

Freitas²,

Rodrigues³

et al. 2011

Rev. bras. ter. intensiva

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Although tetanus is a preventable disease by vaccination, it continues to claim lives around the world. Whereas cases of accidental origin reflect insufficient population immunization, tetanus neonatorum reveals a doublenature fault-poor vaccination coverage of adults coupled with difficulties accessing appropriate prenatal care; this situation is aggravated by the extreme severity of tetanus in this age group in which the mortality rate can reach up to 80%. The early detection of tetanus in neonates is essential for immediately initiating the proper therapy. Therefore, although reaching an early diagnosis of tetanus is important, the most relevant aspect is related to the appropriate management and prophylaxis of this disease. Consequently, the aim of this article is to review neonatorum tetanus with an emphasis on its therapy and prevention.

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A survey of neonatal tetanus at a district general hospital in north-east Nigeria

Cited by 9 publications

References 10 publications

A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Local Perceptions, Cultural Beliefs and Practices That Shape Umbilical Cord Care: A Qualitative Study in Southern Province, Zambia

Infecção por Clostridium tetani no recém-nascido: revisão sobre o tétano neonatorum

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