Muhammad Akbar Nizamani.
Neonatal Tetanus and role of Teaching Hospital in prevention.
Pak Paed J Jan ;22(2):61-6.

Pakistan is signatory to World Summit 90 to eliminate Neonatal Tetanus (NNT) by the year 2000. Yet number of cases and mortality caused by the disease remains high and preventive activities i.e. TT (Tetanus Toxoid) immunization of child bearing age women and training of Traditional Birth Attendants (TBA) remains low or ineffective. A study was conducted at Pediatric Department, Peoples Medical College Hospital (PMCH) Nawabshah to know the number of NNT cases, management problems, prognostic factors and mortality rate from January 1995 to August 19%. Preventive activities at the hospital were also reviewed simultaneously. Study shows that NNT (136 cases) comprised 1.9% of total admissions (7140) and 9.1% of neonatal admissions (1555) but total deaths (65) comprised 5.4% of total admissions and 15.2% of NNT deaths with a mortality rate of 47.7%. It was seen that classical neonatal scoring system for prognosis was useful but few other factors should also be considered. Study shows that majority of deliveries were still conducted by untrained Dais. No action was taken on formal reporting system and lot of opportunities for TT vaccination were being missed. Study concludes that TBA training activities should be increased EPI programme should be revitalized, reporting system should be made personnel oriented and stock should be taken of lost opportunities of TT vaccination at teaching hospital.

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