Tetanus in Ethiopia: Unveiling the Blight of an Entirely Vaccine-Preventable Disease

Abstract

Today, tetanus exacts its toll only in resource-poor countries like Ethiopia. Agrarian rural life with limited vaccine typifies tetanus risk in Ethiopia where current tetanus control trends on expanding infant immunization and eliminating highly prevalent maternal and neonatal tetanus (MNT). Protection by infant tetanus immunization primers disappears within an average of 3 years, if not followed by boosters. Second-year of life, school-based, and universal 10-yearly tetanus immunizations need to be supplemented. Facility-based reviews in Ethiopia reveal a continued burden of tetanus at tertiary-level hospitals where ICU care is suboptimal. Quality of medical care for tetanus is low - reflected by high case-fatality-rates. Opportunities at primary-health-care-units (antenatal-care, family planning, abortion, wound-care, tetanus-survivors) need to be fully-utilized to expand tetanus immunization. Prompt wound-care with post-exposure prophylaxis and proper footwear must be promoted. Standard ICU care needs to exist. Realization of cold-chain-flexible, needle-less and mono-dose vaccine programs allow avoiding boosters, vaccine-refrigeration, and improve compliance.

Tetanus in New Zealand children: Intensive care management of a vaccine preventable disease

“…Even with modern intensive care measures, the mortality remains approximately 10%. Due to a combination of reduced access to immunisation programmes and lack of intensive care resources, mortality and morbidity from tetanus remains very high in developing countries . Case fatality rate, excluding neonatal tetanus, has been reported to be as high as 50% in several African countries .…”

“…Due to a combination of reduced access to immunisation programmes and lack of intensive care resources, mortality and morbidity from tetanus remains very high in developing countries. [3][4][5] Case fatality rate, excluding neonatal tetanus, has been reported to be as high as 50% in several African countries. 3,4 Neonatal tetanus carries the highest mortality burden accounting for 1% of all global neonatal deaths in 2013.…”

“…[3][4][5] Case fatality rate, excluding neonatal tetanus, has been reported to be as high as 50% in several African countries. 3,4 Neonatal tetanus carries the highest mortality burden accounting for 1% of all global neonatal deaths in 2013. 6 Transmission is related to lack of maternal antibodies, unsanitary delivery conditions and infection of the unhealed umbilical stump.…”

“…2 Early wound debridement in particular should be emphasised to prevent further toxin release. 3 The nursing environment is important to support stimulus free conditions and help reduce the frequency of spasms.…”

Factors Associated with Protection of Last Live Birth against Neonatal Tetanus among Mother Age 15-49 in Ethiopia: A Multilevel Analysis Using EDHS 2016

“…However, these studies were analyzed using single-level analysis which does not consider the hierarchical structure of the data and are limited in scope and context. [6][7][8][9][10][11]. Therefore; this studyaimed toassess the individual and community level factors associated with protections of last live birth against neonatal tetanus among mothers in Ethiopia using multilevel analysis of the Ethiopia Demographic and Health Survey (EDHS) 2016 data.…”