Cluster survey for poliomyelitis and neonatal tetanus in Ilorin, Nigeria.

The incidence of poliomyelitis and neonatal tetanus in Ilorin Local Government Area was estimated using a 40-cluster, retrospective survey of neonatal tetanus deaths and lameness from poliomyelitis in March and April 1988. The survey identified 19 neonatal tetanus deaths among 1601 livebirths, giving an incidence rate of 14.9/1000 livebirths. Some 31 residual paralytic polio cases were identified among 4576 children aged five to nine years, giving a prevalence rate of 6.8/1000 children in this age group and an annual incidence rate of 38.3/100,000 general population. Immunization of pregnant women with tetanus toxoid, had a greater impact on mortality from neonatal tetanus than delivery in hospital or birth at home attended by a traditional birth attendant. Antenatal coverage with two doses of tetanus toxoid was 62.6%. Poliomyelitis and neonatal tetanus still constitute important causes of childhood morbidity and mortality in Ilorin and antenatal tetanus immunization coverage is not yet sufficient to control neonatal tetanus in this population. The target age for immunization with tetanus toxoid should be extended to include all women of childbearing age. Further retrospective surveys from other Nigerian states are needed to determine the magnitude of the neonatal tetanus problem throughout the country.