Maternal and Neonatal Tetanus

Maternal and Neonatal Tetanus

    Overview

    Claiming thousands of lives every year, maternal and neonatal tetanus (MNT) is a devastating disease caused by toxins released from Clostridium tetani bacteria. With no cure, MNT is responsible for an average 110,000 deaths a year in the African Region. Once contracted, the newborn usually dies within seven days.

    However, MNT is entirely preventable through appropriate immunization of women of child bearing age, and through simple and basic precautionary measures in child delivery.

    Transmission occurs when there is contact between the bacteria and broken skin or dead tissues, such as the wound resulting when an infant's umbilical cord is cut.

    Poor hygienic conditions, lack of access to sterilized childbirth delivery tools, unhygienic practices, and limited access to health services amplify the risk for MNT during childbirth.

    It is estimated that fewer than 5% of neonatal tetanus cases are actually reported, even from well-developed surveillance systems. It is for this reason that the deaths are greater than the numbers indicate. Of the estimated 28 countries with highest numbers of MNT cases, 16 of them are in the African Region - accounting for 90% global neonatal tetanus cases. These are Angola, Burkina Faso, Cameroon, Chad, Cote d'Ivoire, DR Congo, Ethiopia, Ghana, Guinea Bissau, Liberia, Mali, Mauritania, Mozambique, Niger, Nigeria and Senegal.

    Challenges
    • Reaching populations in need of TT vaccines: Rural areas, lacking adequate vaccine service delivery are the areas particularly vulnerable to MNT.
    • Local access to clean and safe delivery practices: The application of clean delivery practices, including the use of sterilized tools to sever the umbilical cord during delivery, clean delivery surfaces and clean hands is crucial in preventing MNT.
    • Effective immunization: For effective prevention, pregnant women must be vaccinated with appropriate number of doses of TT vaccine by the time of their delivery.
    Our strategies/ interventions
    • Assisting countries to develop an MNT plan of action (PoA), outlining their strategies for eliminating MNT.
    • Vaccinating pregnant women with tetanus toxoid vaccine; esp. immunizing pregnant mothers with at least two doses of tetanus toxoid vaccine before delivery.
    • Identifying high risk districts with low TT2 coverage, low DPT3 coverage and an incidence of neonatal tetanus of more than 1 per 1000 live births and respond with appropriate scale-up of routine immunization activities and mass TT immunization of women of child bearing age.
    • Supporting countries to conduct neonatal tetanus surveillance.
    • Promoting safe child delivery practices

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