Whitman C, Belgharbi L, Gasse F, Torel C, Mattei V, Zoffmann H
Expanded Programme on Immunization, World Health Organization, Geneva.
World Health Stat Q. 1992;45(2-3):248-56.
Neonatal tetanus (NT) can be effectively prevented through immunization and clean delivery practices. However, NT claimed the lives of over 433,000 infants in 1991. It is endemic in 90 countries throughout the world. Community-based neonatal tetanus mortality surveys helped to determine the true incidence of NT and revealed that, before immunization and clean delivery programmes were well established, approximately 1 million children contracted NT each year, of which 800,000 died. Mortality rates varied markedly by locale, ranging from 0 to 70 NT deaths per 1,000 live births. NT is still one of the most underreported notifiable diseases, and routine reporting systems identified only 4% of the NT cases estimated to have occurred in 1990. Based on WHO estimates, tetanus toxoid (TT) immunization and clean delivery practices prevented over 793,000 infant deaths in 1991. Of the 433,000 infants who died of NT that year, approximately 212,000 died in South-East Asia; 127,000 in Africa; 46,000 in the Western Pacific; 37,000 in the Eastern Mediterranean; and 1,300 in Europe. The Pan American Health Organization, using a separate methodology to estimate mortality, calculated that 10,500 newborns died of NT in the Region of the Americans. NT consistently clusters in geographical areas and population groups where shared practices or the environment enhance the risk of cord contamination. 80% of the newborns who died of NT in 1991 were born in South-East Asia or Africa. Of the 90 countries endemic for NT, 10% produce 80% of the world's NT deaths. NT also clusters at country level.(ABSTRACT TRUNCATED AT 250 WORDS)
新生儿破伤风可通过免疫接种和清洁接生措施得到有效预防。然而,1991年新生儿破伤风导致超过43.3万名婴儿死亡。它在全球90个国家呈地方性流行。基于社区的新生儿破伤风死亡率调查有助于确定其真实发病率,并显示在免疫接种和清洁接生计划尚未完善之前,每年约有100万儿童感染新生儿破伤风,其中80万死亡。死亡率因地区而异,每1000例活产中新生儿破伤风死亡数从0到70不等。新生儿破伤风仍是报告最不足的法定传染病之一,常规报告系统仅识别出1990年估计发生的4%的新生儿破伤风病例。根据世界卫生组织的估计,1991年破伤风类毒素免疫接种和清洁接生措施预防了超过79.3万例婴儿死亡。在当年死于新生儿破伤风的43.3万名婴儿中,约21.2万在东南亚死亡;12.7万在非洲;4.6万在西太平洋;3.7万在东地中海;1300在欧洲。泛美卫生组织采用单独的方法估计死亡率,计算出美洲区域有10500名新生儿死于新生儿破伤风。新生儿破伤风在地理区域和人群中持续聚集,这些地方的共同做法或环境增加了脐带污染的风险。1991年死于新生儿破伤风的新生儿中,80%出生在东南亚或非洲。在90个有新生儿破伤风地方性流行的国家中,10%的国家导致了全球80%的新生儿破伤风死亡。新生儿破伤风在国家层面也有聚集现象。(摘要截选于250字)