Gomal Journal of Medical Sciences (Jul 2017)
NEONATAL TETANUS: RISK FACTORS AND OUTCOME
Abstract
Background: Neonatal tetanus (NNT) is one of the childhood’s preventable diseases and a leading cause of neonatal death especially in developing countries. This study was done to determine the outcome and factors contributing to the neonatal tetanus. Materials & Methods: This cross sectional study was conducted at the Sifwat Ghayoor Memorial Government Children Hospital, Peshawar, Pakistan over a period of one year from 1st August 2015 to 31st July 2016. Hundred confirmed cases of neonatal tetanus admitted to the hospital were enrolled in the study using consecutive non probability sampling technique. Study variables were Age in days, weight, area of residence, birth order of child, gender, monthly income, mother’s education, family type, H/O antenatal visits, mode of delivery, delivery performed by trained birth attendant, health facility near home, and outcome of the disease. Results: Seventy four (74%) were male while 26(26%) cases were female. The mean age at admission was 8.34±3.54 days. Mean weight of the neonates admitted with NNT was 3.28±0.61 Kg. A great number of deliveries were taken place at home 78(78%), 70(70%) deliveries were conducted without a trained birth attendant, in a great number of cases 75(75%) materials other than antiseptic were applied to the umbilical cord, the umbilical cord was cut with non sterile instrument in 78% cases and 36(36%) patients died out of 100 (95% Confidence Interval 26.43-45.57). Conclusion: Factors leading to neonatal tetanus are; non immunization of mothers during pregnancy, home delivery, delivery by non skilled birth attendants, application of ghee/surma on umbilical cord and cutting of umbilical cord by unsterilized tools. With proper immunization, antenatal care and hygienic delivery practices, disease can be controlled and mortality can be reduced.