Eregie C O
Department of Paediatrics, Specialist Hospital, Yola, Adamawa State, Nigeria.
East Afr Med J. 1993 Jul;70(7):434-7.
A cluster survey on neonatal tetanus (NNT) mortality was conducted in Kano Metropolis, Northern Nigeria, to investigate epidemiological factors associated with NNT mortality. The survey was a two-stage cluster sampling technique and lasted for two weeks. A total of 2,623 live-births were recorded over a 12-month period. Less than 40% of the births followed two or more antenatal visits and tetanus toxoid coverage was 32.0%. Over 60% of births were outside hospitals and related facilities. Of the epidemiological factors investigated, only antenatal care, tetanus toxoid coverage, hospital delivery, poor cord management and traditional surgery showed significant association with NNT death. It is suggested that an appropriate community-specific prevention strategy for the region should include health education to improve utilisation of antenatal and hospital-delivery facilities, discourage traditional surgery and improve tetanus toxoid coverage. A case is also made for training and involvement of traditional birth attendants (TBAs) since most deliveries occurred outside hospitals and related facilities.
在尼日利亚北部的卡诺市进行了一项关于新生儿破伤风（NNT）死亡率的整群调查，以调查与NNT死亡率相关的流行病学因素。该调查采用两阶段整群抽样技术，持续了两周。在12个月的时间里共记录了2623例活产。不到40%的分娩进行了两次或更多次产前检查，破伤风类毒素接种覆盖率为32.0%。超过60%的分娩是在医院及相关设施以外进行的。在所调查的流行病学因素中，只有产前护理、破伤风类毒素接种覆盖率、医院分娩、脐带处理不当和传统手术与NNT死亡有显著关联。建议该地区针对特定社区的适当预防策略应包括健康教育，以提高产前和医院分娩设施的利用率，劝阻传统手术并提高破伤风类毒素接种覆盖率。鉴于大多数分娩是在医院及相关设施以外进行的，还应培训并让传统接生员（TBAs）参与进来。
