Case Reporting for Neonatal Tetanus Surveillance and Practices Influencing Neonatal Tetanus Incidence in Bayelsa state of Nigeria: a Five-year Review

Abstract

Niger Delta Journal of Medical Sciences 29 Background: Neonatal tetanus is a preventable disease that remains a disturbing cause of neonatal morbidity and mortality in low-income countries where maternal and child care is still poor. This study assessed case reporting for neonatal tetanus surveillance and factors influencing disease occurrence in Bayelsa state of Nigeria. Methods: This was a retrospective review of all cases of neonatal tetanus managed in Niger Delta University Teaching Hospital Okolobiri (NDUTH) and Federal Medical Centre Yenagoa (FMC) over a five-year period. Relevant data were extracted from the case files at the hospitals and the cases were traced within the existing neonatal tetanus surveillance system. Results: Forty-eight cases were managed in both facilities (36/75.0% in NDUTH and 12/25.0% in FMC) in the period under review but only 13 cases (27.1%) were reported to the office of the State Epidemiologist. The mean age of cases was 8.98 days (SD = 5.1days); 29 (60.4%) were male while 19 (39.6%) were female. Only 2.1% of the cases were protected at birth and 55.3% of them had their cord treated inappropriately. Most of the mothers (54.2%) had primary education, 8.3% had antenatal care, and all were delivered by traditional birth attendants. Conclusion: There was an under reporting of cases of neonatal tetanus in the state. Inadequate/lack of immunization of women against tetanus and patronage of unskilled birth attendants seemed to drive the incidence of the disease. There is a need to strengthen neonatal tetanus surveillance, improve tetanus vaccination for women of reproductive age, and encourage skilled birth attendance in Bayelsa state.

KEYWORDS: Bayelsa state, cord care, elimination, neonatal tetanus, neonatal tetanus surveillance