Nass Shafique Sani, Danawi Hadi, Cain Loretta, Sharma Manoj
World Health Organization, Katsina State, Nigeria.
Health Serv Res Manag Epidemiol. 2017 Sep 6;4:2333392817723970. doi: 10.1177/2333392817723970. eCollection 2017 Jan-Dec.
The mortality rate of neonatal tetanus (NNT) remains high in Nigeria. The study was guided by Mosley and Chen's model for the elements of child survival in developing countries. The goal of the study was to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and cord care with neonatal mortality as the outcome variable.
The study is a retrospective record review using data from 332 NNT records and analyzed using a logistic regression model.
Neonates whose mothers had 1 dose of tetanus toxoid vaccine were found to be 4% less prone to NNT mortality compared to neonates whose mothers did not have any dose of tetanus toxoid vaccine during pregnancy ( < .05, odds ratio = 4.12, 95% confidence interval = 1.04-16.29. Frequency of antenatal visits, place of delivery, and cord care were all not significant predictors of NNT mortality.
The study shows that there is association between NNT risk factors and neonatal mortality, hence the need to further strengthen the NNT surveillance system for early detection of potential risk factors. This would help develop specific public health interventions aimed at improving the outcome of NNT.
The identification and analysis of NNT mortality risk factors and promoting tetanus toxoid vaccination among pregnant women are effective strategies toward attaining NNT elimination goals in Nigeria.
在尼日利亚,新生儿破伤风(NNT)的死亡率仍然很高。该研究以莫斯利和陈提出的发展中国家儿童生存要素模型为指导。研究目的是评估选定的新生儿破伤风风险因素、产妇破伤风类毒素注射次数、产前检查频率、分娩地点和脐带护理与以新生儿死亡率为结果变量之间的关联。
该研究是一项回顾性记录审查,使用了332份新生儿破伤风记录的数据,并采用逻辑回归模型进行分析。
与孕期未接种任何剂量破伤风类毒素疫苗的新生儿相比,母亲接种过1剂破伤风类毒素疫苗的新生儿患新生儿破伤风死亡的可能性低4%(P<0.05,比值比=4.12,95%置信区间=1.04-16.29)。产前检查频率、分娩地点和脐带护理均不是新生儿破伤风死亡的显著预测因素。
该研究表明,新生儿破伤风风险因素与新生儿死亡率之间存在关联,因此有必要进一步加强新生儿破伤风监测系统,以便早期发现潜在风险因素。这将有助于制定旨在改善新生儿破伤风结局的具体公共卫生干预措施。
识别和分析新生儿破伤风死亡风险因素以及促进孕妇接种破伤风类毒素疫苗是尼日利亚实现消除新生儿破伤风目标的有效策略。