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EMPHNET 7th Regional Conference 2021: “Towards Public Health Resilience in the EMR: Breaking Barriers” (62)

Published on in Vol 8, No 1 (2022): Jan-Dec

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/36638, first published .
Epidemiological Determinants for Mortality from Neonatal Tetanus in Punjab Province, Pakistan (2020)

Epidemiological Determinants for Mortality from Neonatal Tetanus in Punjab Province, Pakistan (2020)

Epidemiological Determinants for Mortality from Neonatal Tetanus in Punjab Province, Pakistan (2020)

Authors of this article:

Fawad Khurshid1 ;   Muhammad Khalil Ahmad2 ;   Ali Sher Khan3 ;   Muhammad Mehroze Saleem4 ;   Zahida Fatima5 ;   Ambreen Chaudary5 ;   Zeeshan Iqbal Baig5 ;   Khurram Shehzad Akram5 ;   Muhammad Wasif Malik6 ;   Nosheen Ashraf6 ;   Mumtaz Ali Khan5 ;   Jamil Ahmad Ansari6 ;   Aamir Ikram6
Article Authors Cited by (1) Tweetations Metrics

    Abstract

    1Field Epidemiology & Laboratory Training Program, Jampur, Pakistan

    2Government of Punjab, DG Khan, Pakistan

    3World Health Organization, DG Khan, Pakistan

    4World Health Organization - Punjab, Lahore, Pakistan

    5Field Epidemiology & Laboratory Training Program, Islamabad, Pakistan

    6National Institute of Health, Islamabad, Pakistan

    *these authors contributed equally

    Corresponding Author:

    Fawad Khurshid

    Field Epidemiology & Laboratory Training Program

    Dera Road

    Jampur, 33000

    Pakistan

    Phone: 92 333 6106100

    Email: fawad_khurshid@yahoo.com


    Background: Neonatal tetanus (NNT) is a vaccine-preventable disease that occurs at higher incidence in resource-poor countries, presumably because of low maternal immunization rates and unhygienic cord care practices. NNT remains an important cause of infant mortality in rural areas of Punjab Province.

    Objective: This study aims to evaluate and determine the risk factors for mortality in NNT cases and to make recommendations for future strategies.

    Methods: A descriptive study was conducted from July 6 to 14, 2021, at Directorate General Health Office Lahore. The surveillance data set for the year 2020 and clinical notes were reviewed and analyzed. Demographic information, clinical presentation progression, and outcomes were evaluated for all investigated cases, and a comparison analysis was performed between those who survived and those who died.

    Results: Of a total of 176 reported cases, 145 (82.3%) were notified from rural areas of Punjab. The mean age was 9 days, 65 (37%) infants were females, and 111 (63%) were males. The overall mortality was 77 (43.6%), while 31 (17.6%) maternal deliveries were conducted by untrained birth attendants. In addition, 119 (67.6%) women received zero tetanus toxoid (TT) shots in their life. Clinical notes revealed that the group that survived had a significantly greater mean body weight on admission, had later onset of disease, was hospitalized early, and received tetanus immunoglobulin (TIG). The children who could not survive had significantly common clinical features, such as generalized rigidity, fever, and respiratory arrest.

    Conclusions: The increased mortality in rural and tribal areas is suggestive of poor TT immunization coverage. Low literacy, poor socioeconomic status of families, lack of awareness regarding antenatal care, and poor hygienic deliveries conducted by untrained persons remain the main risk factors. Improvement in TT coverage, deployment of trained community midwives, and awareness sessions regarding TT vaccination in hard-to-reach areas are recommended.

    iproc 2022;8(1):e36638

    doi:10.2196/36638

    Keywords

    epidemiological determinants; neonatal tetanus; Punjab; TT immunization 

    Edited by Y Khader; This is a non–peer-reviewed article. submitted 19.01.22; accepted 19.01.22; published 07.02.22

    Copyright

    ©Fawad Khurshid, Muhammad Khalil Ahmad, Ali Sher Khan, Muhammad Mehroze Saleem, Zahida Fatima, Ambreen Chaudary, Zeeshan Iqbal Baig, Khurram Shehzad Akram, Muhammad Wasif Malik, Nosheen Ashraf, Mumtaz Ali Khan, Jamil Ahmad Ansari, Aamir Ikram. Originally published in Iproceedings (https://www.iproc.org), 07.02.2022.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.