Progress Toward Maternal and Neonatal Tetanus Elimination - Worldwide, 2000-2018
| Autor: | Rania A. Tohme, Bilal Ahmed, Nasir Yusuf, Azhar Abid Raza, Henry Njuguna |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Health (social science) Epidemiology Health Toxicology and Mutagenesis Global Health 01 natural sciences 03 medical and health sciences 0302 clinical medicine Health Information Management Health facility Pregnancy Environmental health Global health Tetanus Toxoid Medicine Humans 030212 general & internal medicine Full Report 0101 mathematics Disease Eradication Tetanus business.industry Immunization Programs Public health 010102 general mathematics Toxoid Infant Newborn General Medicine medicine.disease Neonatal tetanus Vaccination Population Surveillance Birth attendant Female business |
| Zdroj: | Morbidity and Mortality Weekly Report |
| ISSN: | 1545-861X |
| Popis: | Maternal and neonatal tetanus* (MNT) remains a major public health problem, with an 80%-100% case-fatality rate among neonates, especially in areas with poor immunization coverage and limited access to clean deliveries (i.e., delivery in a health facility or assisted by medically trained attendants in sanitary conditions) and umbilical cord care (1). In 1989, the World Health Assembly endorsed the elimination† of neonatal tetanus (NT), and in 1999, the initiative was relaunched and renamed the MNT elimination§ initiative, targeting 59¶ priority countries (1). Elimination strategies include 1) achieving ≥80% coverage with ≥2 doses of tetanus toxoid-containing vaccine (TTCV) among women of reproductive age through routine immunization of pregnant women and supplementary immunization activities (SIAs)** in high-risk areas and districts††; 2) achieving care at ≥70% of deliveries by a skilled birth attendant (SBA)§§; and 3) enhancing surveillance for NT cases (1). This report summarizes progress toward achieving MNT elimination during 2000-2018. Coverage with ≥2 doses of TTCV (2 doses of tetanus toxoid [TT2+] or 2 doses of tetanus-diphtheria toxoid [Td2+]) among women of reproductive age increased by 16%, from 62% in 2000 to 72% in 2018. By December 2018, 52 (88%) of 59 priority countries had conducted TTCV SIAs, vaccinating 154 million (77%) of 201 million targeted women of reproductive age with TT2+/Td2+. Globally, the percentage of deliveries assisted by SBAs increased from 62% during 2000-2005 to 81% during 2013-2018, and estimated neonatal tetanus deaths decreased by 85%, from 170,829 in 2000 to 25,000 in 2018. By December 2018, 45 (76%) of 59 priority countries were validated by WHO as having achieved MNT elimination. To achieve elimination in the remaining 14 countries and sustain elimination in countries that have achieved it, implementation of MNT elimination strategies needs to be maintained and strengthened, and TTCV booster doses need to be included in country immunization schedules as recommended by the World Health Organization (WHO) (2). In addition, integration of maternal, newborn, and child health services with vaccination services is needed, as well as innovative approaches to target hard-to-reach areas for tetanus vaccination and community engagement to strengthen surveillance. |
| Databáze: | OpenAIRE |
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