Abstract
BackgroundTetanus in newborns, is an under-reported public health problem and a major cause of mortality in developing countries. This study aimed to determine the predictors and outcome of tetanus in newborn infants in the slums of Bin-Qasim town, Karachi, Pakistan.MethodsWe conducted a case–control study at primary health care centers of slums of Bin-Qasim town, area located adjacent to Bin Qasim seaport in Karachi, from January 2003 to December 2013. Cases were infants aged ≤30 days with tetanus, as defined by the World Health Organization. Controls were newborn infants aged ≤30 days without Tetanus, who were referred for a checkup or minor illnesses. The case to control ratio was 1:2.ResultsWe analyzed 26 cases and 52 controls. The case fatality was 70.8%. We identified four independent predictors of Tetanus in newborns: maternal education (only religious education with no formal education OR 51.95; 95% CI 3.69–731), maternal non-vaccination (OR 24.55; 95% CI 1.01–131.77), lack of a skilled birth attendant (OR 44.00; 95% CI 2.30–840.99), and delivery at home (OR 11.54; 95% CI 1.01–131.77).ConclusionsWe identified several potentially modifiable socio-demographic risk factors for Tetanus in newborns, including maternal education and immunization status, birth site, and lack of a skilled birth attendant. Prioritization of these risk factors could be useful for planning preventive and cost-effective measures.
Highlights
Tetanus in newborns, is an under-reported public health problem and a major cause of mortality in developing countries
Controls were newborn infants aged ≤30 days without Tetanus selected from the same population and referred to the same primary health centers, either for a checkup or minor illnesses
Educational status was divided in three categories: None (Neither went to school nor have religious education) went to school (Those completed primary or secondary education), Only religious education (Those who never went to school but had non-formal religious education at home or somewhere else); Vaccination status was defined as vaccinated i.e. complete and un-vaccinated i.e. partial or no vaccination against Tetanus
Summary
Tetanus in newborns, is an under-reported public health problem and a major cause of mortality in developing countries. This study aimed to determine the predictors and outcome of tetanus in newborn infants in the slums of Bin-Qasim town, Karachi, Pakistan. Elimination of tetanus in newborns is an essential and attainable Millennium Development Goal [1, 2]. Tetanus in newborns is still a major cause of death in lower and middle income countries, such as Pakistan [3, 4]. In 2008, estimated deaths due to Tetanus in newborns were 59,000 [3] and these mainly occurred in poor communities [3, 4]. To establish predictors and potential strategies to modify the incidence of Tetanus in newborns, we conducted a case–control study in the slums of Bin-Qasim town, Karachi, Pakistan
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