Risk factors for mortality from neonatal tetanus: 7 years experience in North Bengal, India

Abstract

Neonatal tetanus (NNT), a preventable disease, remains an important cause of infant mortality in developing countries such as India. To evaluate the demographic and clinical data of NNT in North Bengal, India and determine the risk factors for mortality. Hospital records of all cases of NNT admitted over a 7-year period (1997-2003) were analysed. Demographic data, clinical presentation, progression and outcome were evaluated and comparisons made between the group who survived and those who died. The overall mortality was 66.3%. The group who survived had a significantly greater mean bodyweight on admission, later onset of the disease and were hospitalised early. Risus sardonicus, generalised rigidity, fever, intercurrent infections and respiratory arrest were significantly more common in the fatal group. Although over the 7 years improvement was observed in admissions for NNT, maternal literacy and the economic status of families, there is a persisting lack of awareness regarding antenatal care, and deliveries are still conducted unhygienically by untrained persons.