Li L, Liu W H, Liao S H
Anti-epidemic Station of Long Yan District, Fujian Province.
Zhonghua Liu Xing Bing Xue Za Zhi. 1996 Apr;17(2):83-6.
Neonatal Tetanus (NT) has been set by WHO as one of the most important diseases to be under control. Its incidence rate at some counties and cities in Southern Fujian province exceeded set out levels. Both retrospective and cohort studies were carried. It was found that in rural areas only 8.66% (319/3,683) pregnant women gave births at hospital and 94.85% (129/136) NT cases were delivered by untrained midwives. When TAT was tested in mothers and newborns, only 23.81% and 20.65% of them reached protective level. This shows the main reasons for high NT incidence rate were due to poor medical treatment during delivery and low antibody level. Using tetanus toxin (TT) to fully immunize pregnant women, no side effects were observed and TAT antibody levels for mothers and newborns were increasing to reach 100% (99/99) and 93.94% (93/99) relatively. When immunizing women at child-bearing age with TT, 90.40% (113/125) of them still had TAT up to protective level in 3 years. A total number of 8,882 newborns whose mothers had been fully vaccinated with TT were investigated, no NT case occurred. Among 4,835 newborns whose mothers did not receive vaccination, some NT cases were identified. The incidence rate was as high as 5.28%. These results showed that the TT vaccination in women at child-bearing age should be considered as the major strategy for NT prevention.
新生儿破伤风已被世界卫生组织列为需控制的最重要疾病之一。福建省南部一些县市的发病率超过了规定水平。开展了回顾性研究和队列研究。结果发现,农村地区只有8.66%(319/3683)的孕妇在医院分娩,94.85%(129/136)的新生儿破伤风病例由未经培训的助产士接生。对母亲和新生儿进行破伤风抗毒素(TAT)检测时,只有23.81%和20.65%的检测结果达到保护水平。这表明新生儿破伤风发病率高的主要原因是分娩时医疗条件差和抗体水平低。使用破伤风类毒素(TT)对孕妇进行全程免疫,未观察到副作用,母亲和新生儿的TAT抗体水平分别相对提高到100%(99/99)和93.94%(93/99)。对育龄妇女用TT进行免疫时,3年后仍有90.40%(113/125)的妇女TAT达到保护水平。对8882名母亲已全程接种TT的新生儿进行了调查,未发现新生儿破伤风病例。在4835名母亲未接种疫苗的新生儿中,发现了一些新生儿破伤风病例,发病率高达5.28%。这些结果表明,对育龄妇女进行TT疫苗接种应被视为预防新生儿破伤风的主要策略。