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. 1991;69(5):573-9.

A reassessment of risk factors for neonatal tetanus

H P Traverso  1 , S Kamil, H Rahim, A R Samadi, J R Boring, J V Bennett
Affiliations

A reassessment of risk factors for neonatal tetanus

H P Traverso et al. Bull World Health Organ. 1991.

Abstract

A hospital-based case-control study was conducted to further examine the risk factors for neonatal tetanus (NNT) in the North-west Frontier Province of Pakistan. Three control infants were concurrently evaluated for each of 102 consecutively diagnosed NNT cases hospitalized over an 8-week period. Application of clarified butter (ghee) during the first few days of life was shown to be a significant risk factor, confirming our previously reported finding. However, the risk appeared to be limited to ghee made in the home from cow's milk. The tool used to cut the umbilical cord was again refuted to be a risk factor; application of topical antibiotics conferred significant protection. Multivariate analysis of the matched data showed that delivery by persons with academic training (physicians, nurses, and lady health visitors) was also protective. Mothers with a past history of NNT babies were shown to have a significantly increased risk, and accounted for more than one-third of all cases in the present study. The findings suggest possible ways to augment the effectiveness of NNT elimination programmes.

PIP: A hospital-based case-control study was conducted to further examine the risk factors for neonatal tetanus (NNT) in the Northwest Frontier Province of Pakistan. 3 control infants were concurrently evaluated for each of 102 consecutively diagnosed NNT cases hospitalized for over an 8-week period. Application for clarified butter (ghee) during the 1st few days of life was seen as a significant risk factor, confirming the previously reported finding of the authors. However, the risk appeared to be limited to ghee made in the home from cow's milk. The tool used to cut the umbilical cord was again refuted to be a risk factor; application of topical antibiotics conferred significant protection. Multivariate analysis of the matched data showed that delivery by persons with academic training (physicians, nurses, and lady health visitors) was also protective. Mothers who had a past history of NNT babies were shown to have a significantly increased risk and accounted for more than 1/3 of all cases in the present study. The findings suggest possible ways to augment the effectiveness of NNT elimination programs. (author's)

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