Neonatal tetanus in a tertiary care hospital

Objective: to determine the demographic characteristics,clinical profile and outcome of neonatal tetanus. study design: case series. place and duration: neonatal department of national institute of child health,karachi from january 2005 to june 2012. material & methods: the records of patients with clinical diagnosis of neonatal tetanus fulfilling the standard case definition were included in the study. the data from patients' files were recorded on the proforma. data was analyzed with appropriate statistical test. p value of < 0.05 was taken as significant. results: data of a total 394 patients were reviewed. mean age and weight at presentation was 8.99±4.54 days and 2.77±1.27 kg respectively. male were 270 (68.5%) while female were 124 (31.5%). majority (77.92%) were delivered at home and by untrained dais. three hundred forty six mothers (87.82%) were unimmunized while 12.8% were partially immunized against tetanus. lock jaw (84.26%) and spasm (88.57%) were the commonest presentation. the overall mortality was 29.19%,whereas 54.31% patients improved and were discharged. the patients who were mechanically ventilated had a mortality of 21.5%. preterm with tetanus fared the worst as 98.4% expired. conclusion: neonatal tetanus (nt) still remains a major health problem and an important contributor to neonatal and infant mortality in pakistan. unimmunized mothers,home deliveries,and cord cutting by unhygienic instruments were the major factors contributing to neonatal tetanus.