Abstract
The factors associated with neonatal tetanus occurrence were rank ordered in a survey of 1867 children from a community in Nigeria with a previously documented high prevalence of this infection. The study, restricted to children born in 1992, 1993, and 1994, was conducted in the first 2 weeks of 1995. There were 28 cases of neonatal tetanus, for a rate of 15/1000 live births. Although cases and controls lived under similar social and environmental circumstances, three factors emerged as significant risk factors for neonatal tetanus: 1) lack of maternal education to the secondary level, 2) lack of antenatal care, and 3) delivery in a nonmedical establishment. Moreover, these three factors were linked. Mothers educated beyond the primary school level were more likely to understand the importance of antenatal care and to receive tetanus toxoid vaccination; if they received antenatal care, they were more likely to deliver in a medical establishment. Thus, eradication of illiteracy among women in Nigeria represents a priority in the effort to prevent neonatal tetanus.
Published Version
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