A 6-year review of neonatal tetanus at the Stella Obasanjo Hospital, Benin City, South-South Nigeria

Background: Neonatal tetanus is a lethal disease which has remained an important public health problem in developing countries. The global efforts at eliminating neonatal tetanus have resulted in many nations having less than one case of neonatal tetanus per 1,000 live births per district- a goal that Nigeria is striving to achieve. Objective: To evaluate the contribution of neonatal tetanus to morbidity and mortality in the neonatal unit of Stella Obasanjo Hospital (SOH), Benin City, Nigeria. Methods: A retrospective study in which records of admissions over a six-year period (June 2008 to May 2014) were obtained from the neonatal unit records paying particular attention to cases of tetanus. Information retrieved included age, sex, duration of stay in the unit and outcome. Results: A total of 2,324 patients were admitted into the neonatal unit during the study period. Of these, 23 had tetanus, giving an overall prevalence of 1.0% and an annual incidence of four cases. All the cases were out-born. Nine (39.1%) were males while 14 (60.9%) were females giving a M: F ratio of 1: 1.6. The median and modal age at presentation was seven days (range being 2-21 days). Ten (43.8%) patients were discharged home, four (17.4%) discharged against medical advice while nine died; giving a case fatality rate of 39.1% and contributing 3.1% out of the overall mortality of 286 neonates. Conclusion: Neonatal tetanus contribute significantly to morbidity and mortality. The global efforts for disease elimination should be unrelenting. To be counted among nations that have successfully eliminated the disease, we must pay particular attention to public enlightenment.