Neonatal Tetanus: why every woman of child bearing age needs to get vaccinated

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Few weeks ago, a friend of mine called me that his wife give birth he was so happy(who wont be happy being a first time father), though the wife registered at a private hospital nut she ended up giving birth at her parents house when she went to visit them as it was not yet her EDD, after the home delivery she was immediately taken to the hospital she registered and all the necessary check up’s were done and they said there is nothing to worry about, being a first time mom they advised she be admitted and observes for two days, during her stay in the hospital she kept on insisting something is not right with the baby as according to her the baby was vibrating but the doctors insisted nothing was wrong. On getting home after the admission she insisted the child be taken to a government hospital as she is not comfortable with the baby’s vibration, my friend being open to seek medical attention and they mother-in-law too didn’t suggest any concortion( thank goodness for that), the child was taken to the hospital and he was found to be infected with Tetanus, the mother was questioned as to whether she took the Tetanus Toxoid for pregnant women her reply was negative and the reason she gave was that she wasn’t permitted at her place of work as the vaccine is usually given on a day different from the antenatal clinic days. The child was treated and they were later discharged, this story made me see more reason we need to further educate the public both men and women, men are included so they can remind their wide especially the pregnant ones about taking their vaccine.

Neonates are newborns usually under 1month of age. Tetanus is a disease that affects the nervous system and is caused by a bacteria that enters the body through open wounds and in newborns it is usually through the umbilical cord. Clostrodium Tetani is the name of the causative agent of Tetanus disease. People of all age can get Tetanus, but the disease is particularly common and serious in newborns. When Tetanus occurs in newborn it is usually referred to as Neonatal Tetanus, most infant who get the disease die and it has a higher rate in Africa and the Western Pacific.
SYMPTOMS
Excessive crying
Difficulty in ducking
Rigidity of muscles leading to development of general convulsion
CAUSES
* Poor hygiene: poor sanitation especially is a key link to how Tetanus can be transmitted since the bacteria is found in the soil and cow dungs. According to UNICEF, over 2.6 billion people worldwide do not have access to improved sanitation, with about 2 billion living in rural areas. This means that these population are exposed to high risk of Tetanus infection in neonates, children as well as adults who work or dwell in such unhygienic environment

* Harmful traditional health practices: there are a lot of harmful practices associated with caring for the umbilical cord such as massage with cloth places on hot lantern as the lanterns are exposet and could even be rusted hence it might be contaminated with the bacteria and this could lead to the newborn being infected. Some even use cow dung to treat umbilical cord which is very risky as the bacteria itself live in cow dungs. The healthy way of caring for the umbilical cord is frequent cleaning with a clean cotton wool and methylated spirit( every 2 hours is the suggested interval).

* Poor attendance of antenatal clinic: some expectant mothers do not attend antenatal clinic especially those in rural areas they belief since they have no plan of giving birth in the hospital then no need to attend the clinic. The importance of antenatal clinice is mostly underestimated as some that even attend get there late when they most have finished with the health talk, this attitude needs to stop as a of information is passed during the health talk as a mother if you have been educated concerning Neonatal Tetanus, the importance of taking the Tetanus toxoid and how to care for the umbilical cord and you follow it religiously, you will be contributing to the country”s healthy population.

* Unhygienic delivery: during the period of delivery, there is need to cut the umbilical cord if the newborn is delivered at home or by an untrained traditional birth attendant, there is every probability that the instruments used during the delivery are not sterilised and might be contaminated with the Tetanus bacteria which could get the child infected with Tetanus especially if the mother is not vaccinated against Tetanus during pregnancy.

* Non-utilization of Tetanus Toxoid during pregnancy: some women that register for delivery at government hospitals where the vaccine is readily available without payment do not take this vaccine despite being told the importance some will not even take at the appointed date forgetting that the vaccine work in a particular manner, they reason for their refusal I belief is best known to them but even if they feel they or their newborn can’t be contact they infection, they should remember that registring at a particular hospital doesn’t guarantee their giving birth there because, labour can occur anytime and anywhere , we have seen cases of people going into labour in the market on the road and even at home and might not be able to make it to the hospital before giving birth during this process, there are no available sterilised delivery equipment and the people around might need to improvise or use unsterilised equipment and this is putting the baby at risk, so mothers please ensure you get vaccinated attaint Tetanus, those that have completed theirs should not forget about booster dose.

TETANUS TOXOID
In Nigeria, tetanus vaccine is given to children from six weeks upwards though according to the immunizations pattern now, it is given along with other vaccines and they are together called Pentavalent vaccine in which Diphtheria and Pneumonia vaccines are included.
Tetanus toxoid have also been recommended for women of child bearing age I.e any woman capable of getting pregnant no matter the age should get vaccinated but this vaccine have been made compulsory for all pregnant women. After the first dose which have no immunit, second dose is taken 4 weeks later, the third dose is taken six months later, fourth dose is after a year and the fifth dose is taken a year after the fourth, after that all that is needed is booster dose which should be taken every ten years. The vaccine is expected to protect the mother andied the child also through transfer of tetanus allntibodies to the foetus.
According to WHO”s 2016 report on Maternal and Neonatal tetanus , Nigeria
is one of the 18 countries yet to eliminate the disease as Neonatal Tetanus still count for up to 20 percent of child mortality in Nigeria.
A lot of mothers have lost their newborns due to Neonatal Tetanus due to ignorance and sometimes non-challant attitude, some mothers do not even known that the symptoms their newborn is showing is that of Tetanus and the diseases is acute ( it occurs for a short time and very deadly). As parents let’s be vigilant about our newborn and when we notice any thing unusual let’s always seek for immediate medical attention and if you feel your newborn is not being attendes to as espectes or not responding to treatment you can seek for other paediatricians opinion also follow whatever we attended being told at the antenatal class religiously.

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