Abstract
Maternal or neonatal tetanus causes deaths primarily in Asia and Africa and is usually the result of poor hygiene during delivery. In 2011, three neonatal tetanus cases were investigated in Papua New Guinea, and all three cases were delivered at home by untrained assistants. The babies were normal at birth but subsequently developed spasms. A neonatal tetanus case must be viewed as a sentinel event indicating a failure of public health services including immunization, antenatal care and delivery care. The confirmation of these cases led to the drafting of the Papua New Guinea National Action Plan for Maternal and Neonatal Tetanus Elimination. This included three rounds of a tetanus toxoid supplementary immunization campaign targeting women of childbearing age (WBCA) and strengthening of other clean delivery practices. The first immunization round was conducted in April and May 2012, targeting 1.6 million WBCA and achieved coverage of 77%. The government of Papua New Guinea should ensure detailed investigation of all neonatal tetanus cases reported in the health information system and perform subprovincial analysis of tetanus toxoid coverage following completion of all three immunization rounds. Efforts also should be made to strengthen clean delivery practices to help eliminate maternal and neonatal tetanus in Papua New Guinea.
Highlights
Tetanus causes around 300 000 deaths worldwide each year predominantly in low-income and middle-income countries, and deaths from maternal or neonatal tetanus are concentrated mostly in Asia and Africa.[1]
(PMGH) and one case of Neonatal tetanus (NNT) was reported from Rumginae Rural Hospital (RRH) in Western Province of Papua New Guinea
The two cases that were admitted to PMGH survived, while the case at RRH died three days after admission to the hospital; there was no fatality among the mothers
Summary
Siddharta Sankar Datta,a Roland Barnabas,b Adeline Sitther,c Laura Guarenti,a Steven Toikilik,d Grace Kariwigae and Gerard Pai Suid. A neonatal tetanus case must be viewed as a sentinel event indicating a failure of public health services including immunization, antenatal care and delivery care. The confirmation of these cases led to the drafting of the Papua New Guinea National Action Plan for Maternal and Neonatal Tetanus Elimination. This included three rounds of a tetanus toxoid supplementary immunization campaign targeting women of childbearing age (WBCA) and strengthening of other clean delivery practices.
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