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© 1993 Oxford University Press

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Neonatal Tetanus Mortality in Coastal Kenya: A Community Survey

PETER BJERREGAARD*,**, ROBERT STEINGLASS*, D M MUTIE{dagger}, GEOFFREY KIMANI{dagger}, MARY MJOMBA{dagger} and VINCENT ORINDA{ddagger},§

* REACH Project (John Snow Inc.) 1616 North Fort Myer Drive, 11th Floor, Arlington, VA 22209, USA
** Current address: Danish Institute for Clinical Epidemiology Copenhagen, Denmark
{dagger} Ministry of Health Kenya
{ddagger} Department of Pediatrics, University of Nairobi Kenya

§ Current address: UNICEF, Namibia

In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000 livebirths. The neonatal and NNT mortality rates were higher in boys than in girls. Neonatal tetanus was not associated with mother's age, parity, or history of previous child death. The majority of the children (72%) were adequately protected at birth against NNT; in those with documented protection NNT mortality was 0, in those with undocumented protection 1.2 and in other children 8.5 per 1000 livebirths. Other risk factors for NNT included home delivery, untrained assistance during delivery, unhygienic cord cutting and application of potentially infectious substances on the umbilical stump. The survey indicates that over the past decade the surveyed area has greatly reduced neonatal and NNT mortality. Possible strategies for accelerated NNT control have been identified by the survey.

Received 1 August 1992


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