Babatunde et al
Greener Journal of Medical Sciences Vol. 4 (2), pp. 042-047, September 2014.
ISSN: 2276-7797 © 2014 Greener Journals
Manuscript Number: 062014273
Neonatal Tetanus in Federal Medical Center, Ido-Ekiti, South West Nigeria in a five year Retrospective Study
*1Oluwole Adeyemi Babatunde, 2Victoria Olufunmilayo Adebara, 3Oladele Ademola Atoyebi,
4Oluwagbeminiyi Abiodun Oluwagbemi
1Department of Community Medicine, Federal Medical Center, Ido-Ekiti, Nigeria. Postal address: P. O. Box 6170, Ilorin, Kwara State.
2Department of Paediatrics, Federal Medical Center, Ido-Ekiti, Nigeria.
3Department of Community Medicine, Federal Medical Center, Ido-Ekiti, Nigeria.
4Department of Family Medicine, Federal Medical Center, Ido-Ekiti, Nigeria.
*Corresponding Author’s Email: wolleking @yahoo .com; Phone Numbers: +2348034314305, +2348182874271
Introduction: Neonatal Tetanus, though a preventable disease through simple measures, still remains a cause of neonatal mortality in Nigeria.
Methodology: This was a review of all cases of neonatal tetanus in Federal Medical Centre, Ido Ekiti between January 2007 and December 2012. It was performed using patients’ case notes and the diagnosis of tetanus was clinical in all cases.
Results: There were six patients admitted during the five year period. The mean age was 7.7 days. There were 5 females (83.3%) and 1 male (16.7%). The average number of days spent on admission in the hospital was 15.2 days with the minimum being 1 day and the maximum 33 days. The mean age at which the first spasm occurred was at 7.5 days. Only 1 (16.7%) was delivered in a health facility, 67.7% had fomentation done on their umbilical cords, 33.3% had septic umbilical cords only 1 (16.7%) was delivered in a health facility. Three of the patients were delivered in religious centres called mission homes. Five (83.3%) of the mothers were teenagers and unmarried, 2 (33.3%) had partial antenatal care, 4 (67.7%) had no antenatal care while none of them received up to 2 doses of tetanus toxoid vaccine. The case fatality rate was 50%.
Conclusion: Teenage motherhood, poor antenatal care, inadequate immunization of mothers with tetanus toxoid vaccine and poor umbilical cord care are identified as risk factors for neonatal tetanus. It should be ensured that gender equality campaigns are strengthened, traditional birth attendants trained in issues of maternal and child health, and immunization campaigns for mothers and neonates improved.
Keywords: Antenatal care, Neonate, Teenage mothers, Tetanus.
Akanni NA, Nte AR, Oruamabo RS (2004). Neonatal tetanus in Nigeria: One social scourge too many! Nigerian Journal of Paediatrics. 31 (1): 1-9.
Alhaji MA, Bello MA, Elechi HA, Akuhwa RT, Bukar FL, Ibrahim HA (2013). A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria. Niger Med J. 54(6): 398–401.
Ambe JP, Bello M, Yahya SJ, Omotara BA (2009). Umbilical cord care practices in Konduga local government area of Borno State, North-eastern Nigeria. The Internet J Trop Med. 5.
Asekun-Olarinmoye EO, Lawoyin TO, Onadeko MO (2003). Risk factors associated with neonatal tetanus in Ibadan, Nigeria - a revisit. Afr J Med Sci. 32: 275–8.
Anah MU, Etuk IS, Ikpeme OE, Ntia HU, Ineji EO, Archibong RB (2008). Post Neonatal Tetanus in Calabar, Nigeria: A 10- Year Review. Niger Med. Pract. 54: 45-47.
Blencowe H, Lawn J, Vandelaer J, Roper M, Cousens S (2010). Tetanus toxoid immunization to reduce mortality from neonatal tetanus. Int. J. Epidemiol. 39 (suppl. 1): i102-i109.
Bunyamin DB, Uzun H, Yilmaz-Keskin E, Tas T, Gunes A, Kocamaz H, Konca C, Tas MA (2008). Neonatal tetanus in Turkey; what has changed in the last decade. BMC Infectious Diseases. 8:112.
Centers for Disease Control and Prevention (2011). Tetanus Surveillance: United States, 2001-2008. Weekly. 60(12): 365-369.
Cooley ML, Unger DG (1991). The role of family support in determining developmental outcomes in children of teen mothers. Child Psychiatry and Human Development. 21(3):217-234.
Davies-Adetugbo AA, Torimiro SEA, Ako-Nai KA (1998). Prognostic factors in neonatal tetanus. Trop Med & Intl Health. 3 (1): 9-13.
Dey AC, Saha L, Shahidullah M (2011). Risk factors, morbidity and mortality of neonatal tetanus. Mymensingh Med J. 20 (1): 54-8.
Emodi IJ, Ikefuna AN, Obichukwu C (2011). Incidence and outcome of neonatal tetanus in Enugu over a 10-year period. South African Journal of Child Health. 5(4).
Ertem M, Cakmak A, Saka G, Ceylan A (2004). Neonatal tetanus in the south-eastern region of Turkey: changes in prognostic aspects by better health care. J Tropic Pediatr. 50: 297-300.
Geronimus AT, Korenman S (1993). Maternal youth or family background? On the health disadvantages of infants with teenage mothers. American Journal of Epidemiology. 137 (2):213-225.
Hassan B, Popoola A, Olokoba A, Salawu FK (2011). A survey of neonatal tetanus at a district general hospital in north-east Nigeria. Trop. Doct. 41 (1):18-20.
Lambo JA, Memon MI, Khahro ZH, Lashari MI (2011). Epidemiology of neonatal tetanus in rural Pakistan. J Pak Med Assoc. 61(11): 1099-103.
Ogunlesi TA, Okeniyi JAO, Owa JA, Oyedeji GA (2001). Neonatal tetanus at the close of the 20th century in Nigeria. Trop. Doct. 37(3): 165-167.
Omoigberale AI, Abiodun PO (2005). Upsurge in neonatal tetanus in Benin City, Nigeria. East African Medical Journal. 82 (2).
Onalo R, Ishiaku HM, Ogala WN (2011). Prevalence and outcome of neonatal tetanus in Zaria, Northwestern Nigeria. J Infect Dev Ctries. 5(4): 255-259.
Oruamabo RS (2007). Neonatal tetanus in Nigeria: does it still pose a major threat to neonatal survival? Arch dis child. 92: 9-10.
Oyedeji OA, Fadero F, Joel-Medewase V, Elemile P, Oyedeji GA (2012). Trends in neonatal and post-neonatal tetanus admissions at a Nigerian teaching hospital. J. Infect. Dev. Ctries. 6(12):847-853.
Pan American Health Organization (2005). Neonatal tetanus elimination field guide 2nd edition.
Peterside O, Duru C, George B (2012). Neonatal Tetanus At The Niger Delta University Teaching Hospital: A 5 Year Retrospective Study. The Internet Journal of Pediatrics and Neonatology. 14(2).
Roper MH, Vandelaer JH, Gasse FH (2008). Maternal and neonatal tetanus. Lancet; 371: 385-386.
World Health Organization (2006). WHO position on tetanus vaccine. Weekly epidemiological record. 81:197-208.
World Health Organization (2008) Tetanus. Available from: http://www.who.int/immunization/topics/tetanus/en/index.html (accessed 14th January 2013).