Hassan Bala, Popoola Ayo, Olokoba Abdulfatai, Salawu Fatai K
Department of Paediatrics, State Specialist Hospital, Maiduguri, Nigeria.
Trop Doct. 2011 Jan;41(1):18-20. doi: 10.1258/td.2010.100310.
Neonatal tetanus (NNT) remains among the leading causes of morbidity and mortality in Nigeria and a huge challenge in achieving the fourth goal of the Millennium Development Goals. We reviewed the morbidity and mortality pattern among neonates with NNT admitted to the District General Hospital in north-east Nigeria from 2006 to 2009. Half of the patients were from rural areas and were delivered at home by untrained traditional birth attendants with no prior antenatal health care. Razor blades and scissors were the instruments used to cut the cord in nonhygienic conditions. Spasticity, lack of sucking, trismus, fever, omphalitis, risus sardonicus and opisthotonus were the most common presenting signs and symptoms. Overall, mortality was 56%. Health education of mothers and traditional birth attendants, the promotion of hospital delivery and antenatal tetanus immunization of all pregnant women, particularly in rural areas, are recommended if NNT is to be prevented.
新生儿破伤风（NNT）仍是尼日利亚发病和死亡的主要原因之一，也是实现千年发展目标第四个目标面临的巨大挑战。我们回顾了2006年至2009年期间尼日利亚东北部地区综合医院收治的新生儿破伤风患儿的发病和死亡情况。一半的患儿来自农村地区，由未经培训的传统接生员在家接生，且未接受过产前保健。剃须刀片和剪刀是在不卫生条件下用于剪断脐带的工具。痉挛、吸吮无力、牙关紧闭、发热、脐炎、苦笑面容和角弓反张是最常见的症状和体征。总体死亡率为56%。如果要预防新生儿破伤风，建议对母亲和传统接生员进行健康教育，推广住院分娩，并为所有孕妇，尤其是农村地区的孕妇接种破伤风疫苗。
