| Popis: |
The conservative management of neonatal tetanus usually involves use of intravenous Iv sedative drugs and is hazardous unless monitored with a high level of nursing observation. This is often not available in hospitals where this condition is most commonly seen and many iatrogenic deaths occur. A simplified oral regime for the treatment of neonatal tetanus in 22 patients admitted to Mutare General Hospital in Zimbabwe is described and a mortality of 36.4% was recorded. The traditional birth attendant training scheme which commenced in Mainicaland in 1982 is described. The oral treatment regime involves the passing of a naso-gastric tube after sedation if necessary, and administration of tetanus antiserum (1 intramuscular dose of 10,000 units), procaine penicillin for 7 days and kanamycin it necessary. Expressed breast milk was given by naso-gastric tube until the baby was able to nurse. Cooperation with traditional birth attendants has been demonstrated elsewhere to dramatically reduce neonatal mortality rates, and to a lesser degree, neonatal tetanus deaths. In combination with antenatal tetanus prophylaxis it would be expected that neonatal tetanus could be eradicated even in a population where a large proportion of birth take place at home. |
