Date of Conferral

2016

Degree

Ph.D.

School

Public Health

Advisor

Hadi Danawi

Abstract

The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and cord care, and neonatal mortality as the outcome variable. Data from 332 NNT records were extracted through retrospective records review and analyzed using a logistic regression model. The prevalence of NNT and mortality rate were 336 cases and 3.4 deaths per 100,000 population, respectively, while the prevalence of NNT and mortality rate reported through the IDSR system were 111 cases and 1.0 death per 100,000 population, respectively. Only neonates whose mothers had 1 dose of tetanus toxoid vaccine were significantly associated with NNT mortality, (p < 0.05), OR = 4.12, 95% CI [1.04, 16.29]. Frequency of antenatal visits, place of delivery, and cord care were all not significant predictors of NNT mortality. Implications for positive social change include gaining knowledge on associations between NNT risk factors and neonatal mortality, and strengthening the NNT surveillance system with the capacity for early detection of potential risk factors to develop specific public health interventions aimed at improving the outcome of neonatal tetanus.

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