Risk factors for neonatal tetanus--Busoga region, Uganda, 2002-2003.

Sheba N. Gitta, F. Wabwire-Mangen, D. Kitimbo, George Pariyo

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Uganda has not achieved the 2005 neonatal tetanus (NNT) global elimination target set by the World Health Organization (WHO). The Busoga region has the highest recorded level of NNT incidence in Uganda. To understand the reasons for this high incidence, a study was conducted to identify NNT risk factors. METHODS: During March-May 2004, a matched case-control study was conducted in the Busoga region for a 2-year study period (2002-2003). Matching variables were sex, residence, and date of birth. A total of 24 cases of NNT (according to the WHO case definition) were identified from hospital records, and 96 community controls (children who survived the neonatal period) were selected. RESULTS: Bivariate analysis indicated that neonates with NNT were more likely to have been delivered outside a health facility, on an unclean surface, without use of gloves, or by unskilled attendants. Mothers of these neonates were less likely to report vaccination during previous pregnancies, administration of 2 doses of tetanus toxoid (TT) during the study pregnancy, or use of certain intravaginal substances (most commonly, herbs) at onset of labor. Multivariate analysis indicated that unclean delivery surfaces (odds ratio [OR] = 38.8; 95% confidence interval [CI] = 2.9-518.1) and primigravidae mothers (OR = 79.5; CI = 1.8-3,472.2) were associated with NNT. Administration of 2 doses of TT during pregnancy, vaccination during previous pregnancies, and intravaginal application of certain substances were protective against NNT. CONCLUSION: These findings underscore the importance of having clean delivery surfaces and of mothers receiving 2 doses of TT during pregnancy. Implementation of these measures might help eliminate NNT from the Busoga region of Uganda.

Original languageEnglish (US)
Pages (from-to)25-30
Number of pages6
JournalMMWR. Morbidity and mortality weekly report
Volume55 Suppl 1
StatePublished - 2006
Externally publishedYes

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Uganda
Tetanus
pregnancy
Tetanus Toxoid
vaccination
Pregnancy
WHO
incidence
confidence
Mothers
Vaccination
multivariate analysis
Odds Ratio
Newborn Infant
Confidence Intervals
Labor Onset
Hospital Records
Health Facilities
labor
Case-Control Studies

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Risk factors for neonatal tetanus--Busoga region, Uganda, 2002-2003. / Gitta, Sheba N.; Wabwire-Mangen, F.; Kitimbo, D.; Pariyo, George.

In: MMWR. Morbidity and mortality weekly report, Vol. 55 Suppl 1, 2006, p. 25-30.

Research output: Contribution to journalArticle

Gitta, Sheba N. ; Wabwire-Mangen, F. ; Kitimbo, D. ; Pariyo, George. / Risk factors for neonatal tetanus--Busoga region, Uganda, 2002-2003. In: MMWR. Morbidity and mortality weekly report. 2006 ; Vol. 55 Suppl 1. pp. 25-30.
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