Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria.
Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria.
PLoS Negl Trop Dis. 2021 Dec 7;15(12):e0010010. doi: 10.1371/journal.pntd.0010010. eCollection 2021 Dec.
Neonatal Tetanus (NNT) is a vaccine preventable disease of public health importance. It is still being encountered in clinical practice largely in developing countries including Nigeria. NNT results from unhygienic delivery practices and some harmful traditional cord care practices. The easiest, quickest and most cost-effective preventive measure against NNT is vaccination of the pregnant women with the tetanus toxoid (TT) vaccine. The case-fatality rate from tetanus in resource-constrained settings can be close to 100% but can be reduced to 50% if access to basic medical care with adequate number of experienced staff is available.
This retrospective study reviewed the admissions into the Special Care Baby Unit (SCBU) of the Ekiti State University Teaching Hospital, Ado-Ekiti from January 2011 to December 2020. The folders were retrieved from the records department of the hospital; Information obtained from folders were entered into a designed proforma for the study.
During the study period, NNT constituted 0.34% of all neonatal admissions with case fatality rate of 52.6%. Seven [36.8%] of the babies were delivered at Mission home/Traditional Birth Attendant's place while 5 [26.3%] were delivered in private hospitals. Cord care was with hot water compress in most of these babies16 [48.5%] while only 9% of the mothers cleaned the cord with methylated spirit. Age at presentation of less than one week was significantly associated with mortality, same with presence of autonomic dysfunction. Low family socio-economic class 5 was significantly associated with poor outcome, so also maternal age above 24 years.
This study revealed that neonatal tetanus is still being seen in our clinical practice with poor outcome and the risk factors are the same as of old. Increased public health campaign, promotion of clean deliveries, safe cord care practices, affordable and accessible health care provision are recommended to combat NNT scourge.
新生儿破伤风（NNT）是一种具有公共卫生重要性的疫苗可预防疾病。它在包括尼日利亚在内的发展中国家的临床实践中仍然很常见。NNT 是由不卫生的分娩方式和一些有害的传统脐带护理方式引起的。预防 NNT 最简单、最快和最具成本效益的措施是给孕妇接种破伤风类毒素（TT）疫苗。在资源有限的环境中，破伤风的病死率接近 100%，但如果能够获得足够数量的有经验工作人员的基本医疗保健，病死率可以降低到 50%。
这项回顾性研究回顾了 2011 年 1 月至 2020 年 12 月期间埃基提州立大学教学医院特殊护理婴儿病房（SCBU）的入院情况。文件夹从医院的记录部门中检索出来；从文件夹中获取的信息被输入到为研究设计的表格中。
在研究期间，NNT 占所有新生儿入院人数的 0.34%，病死率为 52.6%。有 7 名（36.8%）婴儿是在传教所/传统助产妇的地方分娩的，有 5 名（26.3%）是在私立医院分娩的。在这些婴儿中，大多数人用热水敷布护理脐带 16 人（48.5%），只有 9%的母亲用甲基化酒精清洁脐带。在一周内就诊的年龄与死亡率显著相关，同样与自主神经功能障碍的存在相关。低家庭社会经济阶层 5 级与不良结局显著相关，母亲年龄超过 24 岁也是如此。
这项研究表明，新生儿破伤风在我们的临床实践中仍然存在，且预后不佳，其风险因素与以往相同。建议加强公共卫生宣传活动，促进清洁分娩，安全的脐带护理，提供负担得起的和可获得的医疗保健，以打击 NNT 的肆虐。
