Neonatal Tetanus, Yet Not Gone: Infectious Disease Hospital Experience.
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Date
2015-09
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Abstract
Background: Although neonatal tetanus (NT) has been declared eliminated from Bangladesh in
June 2008, it is not uncommon in Infectious Disease Hospital (IDH) in Dhaka. There are various
presentations of NT cases and treatment practices also vary. Objective: This study was conducted
to describe our experiences with NT at IDH outlining the clinical characteristics, maternal
immunization and treatment outcome. Materials and Methods: Thirty neonates admitted with
tetanus in IDH from March 2011 to December 2012 were observed prospectively to study risk
factors, clinical features and outcomes during hospital stay. Results: Among 30 neonates with
tetanus 80% were male. Eighty seven percent of these cases were delivered at home and 83% of
mothers did not receive any dose of tetanus toxoid (TT). Fifty percent of the neonates were
admitted within 3–5 days of age. Shidur (Vermillion) was applied to the cord stump in 23%
neonates. Hot soak was applied to the umbilicus in 5 (17%) neonates. Presenting features were
convulsion and/or stiffness or rigidity (93%), inability to suck (90%) and umbilical infection
(70%). During hospital care multiple cardiac arrests developed in 86% neonates and apnea
developed in 60% of the neonates. Treatment was given in pediatric ward. Case fatality rate was
50%. Conclusion: Risk factors observed in NT cases were maternal non-immunization, unhygienic
delivery practices and application of substances in the umbilicus. Antenatal TT administration and
universal immunization under school health program should be more emphasized to prevent NT.
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Keywords
Neonatal tetanus, Maternal immunization, Infectious disease
Citation
Ehsan Amimul, Akter Shaheen, Salam Fatema. Neonatal Tetanus, Yet Not Gone: Infectious Disease Hospital Experience. Journal of Enam Medical College. 2015 Sept; 5(3): 161-165.