Risk factors for mortality in neonatal tetanus: a 15-year experience in Sagamu, Nigeria

Fetuga, B. L.; Ogunlesi, TA; Adekanmbi, Folashade

doi:10.1007/s12519-010-0010-9

Cited by 24 publications

(27 citation statements)

References 11 publications

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“…6 However, hospital-based data of pediatric tetanus cases from various Third World countries clearly show that the disease is still endemic in these parts of the world, with varying incidences. 1,3,4,7 This study shows relatively high average tetanus admissions in the post-neonatal age group, with nearly 42 cases per year, higher than most studies and also higher than those reported earlier from hospitals of India. 8,9 Our centre being a referral children's hospital with a special tetanus ward could possibly explain the high admission rate.…”

Section: Discussionmentioning

confidence: 50%

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Tetanus – still a scourge in the 21st century: a paediatric hospital-based study in India

et al. 2012

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Tetanus remains endemic in India. A retrospective hospital-based study was conducted to review the profile of all children admitted with diagnosis of tetanus between January 2009 and December 2010. A total of 140 cases of tetanus were admitted; 45 cases of neonatal tetanus (NT) and 77 cases of post-neonatal tetanus (PNT) were studied. Age of presentation of NT was 9.4 ± 1.2 days. Home-delivered children accounted for 86.7% of cases, with 77.8% being attended by untrained birth attendants. Unimmunized mothers accounted for 93.4%. In PNT, otogenic route of infection and trauma were present in 58.4% and 23.3% of cases, respectively. The rate of hospital admission of tetanus remains high. Unlike previously published reports, otogenic route is the most common mode of PNT infection in this study. Improving immunization, increasing deliveries by skilled birth attendants and prompt treatment of suppurative otitis media are the main areas in which public health initiatives need to be focused.

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Section: Discussionmentioning

confidence: 50%

“…1,3,7 Thus, this study identifies an important issue of focus for health policy makers, namely that prompt treatment of suppurative otitis media and reviewing the immunization status of such patients can prevent tetanus.…”

Section: Discussionmentioning

confidence: 99%

Tetanus – still a scourge in the 21st century: a paediatric hospital-based study in India

et al. 2012

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“…Hence, it is not surprising as noted in this study that, caregiver's partner's education, is associated with patronage of pharmacy store and medicine vendors and to some extent home care for managing diarrhoea episode. In addition, the decision of the educated caregivers to use home treatment, have been attributed to their ability to utilize health information wisely[38]. …”

Section: Discussionmentioning

confidence: 99%

Socio-economic determinants in selecting childhood diarrhoea treatment options in Sub-Saharan Africa: A multilevel model

et al. 2011

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BackgroundDiarrhoea disease which has been attributed to poverty constitutes a major cause of morbidity and mortality in children aged five and below in most low-and-middle income countries. This study sought to examine the contribution of individual and neighbourhood socio-economic characteristics to caregiver's treatment choices for managing childhood diarrhoea at household level in sub-Saharan Africa.MethodsMultilevel multinomial logistic regression analysis was applied to Demographic and Health Survey data conducted in 11 countries in sub-Saharan Africa. The unit of analysis were the 12,988 caregivers of children who were reported to have had diarrhoea two weeks prior to the survey period.ResultsThere were variability in selecting treatment options based on several socioeconomic characteristics. Multilevel-multinomial regression analysis indicated that higher level of education of both the caregiver and that of the partner, as well as caregivers occupation were associated with selection of medical centre, pharmacies and home care as compared to no treatment. In contrast, caregiver's partners' occupation was negatively associated with selection medical centre and home care for managing diarrhoea. In addition, a low-level of neighbourhood socio-economic disadvantage was significantly associated with selection of both medical centre and pharmacy stores and medicine vendors.ConclusionIn the light of the findings from this study, intervention aimed at improving on care seeking for managing diarrhoea episode and other childhood infectious disease should jointly consider the influence of both individual SEP and the level of economic development of the communities in which caregivers of these children resides.

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“…This phenomenon could be attributed to several factors, including the severity of illness at presentation, the limited number of skilled intensive care personnel, the inadequate facilities, and the high incidence of associated sepsis [3,7,10,12].…”

Section: Discussionmentioning

confidence: 99%

“…Although some data on neonatal tetanus in western parts of Nigeria have been recently published by Ogunlesi et al [6] and Fatuga et al [7], only cases seen towards the end of the last millennium have been considered. Therefore, to assess the progress made so far in the elimination of neonatal tetanus in Nigeria, the incidence and the outcome of the disease in Zaria were examined.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and outcome of neonatal tetanus in Zaria, Northwestern Nigeria

Onalo

Ishiaku

Ogala

2011

J Infect Dev Ctries

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Introduction: Neonatal tetanus is a highly debilitating disease with high mortality. Global efforts at eliminating the disease in developing countries are yielding results but slower than expected. The high case fatality of neonatal tetanus remains a therapeutic challenge to physicians and requires continuous evaluation. This study aimed to determine the incidence and outcome of neonatal tetanus in Zaria, northwestern Nigeria. Methodology: A retrospective study of neonatal tetanus was conducted at the Neonatal Unit of Ahmadu Bello University Teaching Hospital, Zaria, between January 2005 and December 2009. Data generated were analyzed using the Epi Info version 3.5.1 software and statistical significance was set at p < 0.05. Results: Of the 2,692 newborns admitted during the study period, 20 had tetanus, giving an overall prevalence of 0.7%. There were 14 males and 6 females (male to female ratio 2.3:1). The mean age and weight at presentation were 8.3 ± 4.0 days and 2.7 ± 0.3 kg, respectively. The mean incubation period was 3.2 ± 2.0 days. Four infants (20.0%) survived, one was discharged against medical advice and 15 (75.0%) died. Factors associated with mortality were presentation at less than seven days of life, low Hendrickse score at presentation (p = 0.0005) and hypoglycaemia (p = 0.0374). Conclusion: The incidence and the mortality rate of neonatal tetanus appear to be lower than those previously reported by our centre for the same region. Therefore, the ongoing global efforts for disease elimination and further improvements in the quality of care should be sustained.

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Risk factors for mortality in neonatal tetanus: a 15-year experience in Sagamu, Nigeria

Abstract: The mortality rate in infants with NNT remains signifi cantly high in Nigeria. Improved maternal anti-tetanus vaccination and timely recognition and treatment of affected infants may jointly reduce the incidence and fatality rate of NNT.

Cited by 24 publications

References 11 publications

Tetanus – still a scourge in the 21st century: a paediatric hospital-based study in India

Tetanus – still a scourge in the 21st century: a paediatric hospital-based study in India

Socio-economic determinants in selecting childhood diarrhoea treatment options in Sub-Saharan Africa: A multilevel model

Prevalence and outcome of neonatal tetanus in Zaria, Northwestern Nigeria

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