Limited progress in tetanus elimination

While substantial progress has been achieved towards the global elimination of neonatal tetanus, the limited progress in Africa is of great concern, the World Health Organisation (WHO) said in a recent report. An estimated 95,000 deaths related to neonatal tetanus was reported in Africa in 1997, in spite of the availability of a safe and highly effective vaccine, the report, appearing in WHO’s weekly Epidemiological Record, said. While global neonatal tetanus deaths are estimated to have declined by 39 percent between 1990-97 - from 408,000 to 248,000 -, the death rate in Africa decreased by only seven percent during the same period. The only increases in mortality rates observed anywhere in the world were in the DRC (eight percent), Mali (22 percent) and Senegal (four percent). Eleven of the 12 countries with estimated 1990 neonatal tetanus mortality rates of five or more per 1,000 live births were in Africa, the report said. Neonatal tetanus, the second leading cause of death from vaccine-preventable diseases among children worldwide, cannot be completely eradicated because the organism that causes the disease is widespread in the environment. Strategies for the sustainable elimination of cases include vaccination of pregnant women with tetanus toxoid, provision of clean delivery services to all pregnant women, and supplemental vaccination for women of child-bearing age in targeted high-risk areas. With increased political commitment and sufficient resources to accelerate efforts, eliminating the disease by the year 2000 is feasible, the report added.