The burden and challenges of neonatal tetanus in Kilifi district (2004-7)

Eric Maitha, Ministry of Health Kenya
Christopher Nyundo, Ministry of Health Kenya
Evasius K Bauni, Kenya Medical Research Institute (KEMRI)

Neonatal tetanus (NNT) is caused by exotoxin produced by clostridium tetani. Typically the baby cries and suckles in the first 2 days after birth. Between days 3-28 the child stops suckling, developes stiffness and spasms. This study estimates the incidence of NNT in Kilifi district, Kenya to identify high risk areas using disease surveillance and National population census data. The incidence of NNT in Kilifi increased from 0.7 in 2004 to 1.0 per 1000 live births in 2007. NNT is a public health problem (>1 per 1000 live births) in 19/36 locations. Immunisation (TT2+) increased from 4% in 2004 to 17% in 2007. All women who had NNT case delivered at home, 83% applied potentially infectious substances to cord. Neonatal tetanus is a problem in Kilifi and immunisation coverage is low. We recommend strengthening immunisation, hygienic delivery/ care of the cord and a study to describe home deliveries.