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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 289-290
Maternal and neonatal tetanus elimination accomplished from the south-east Asian Region: World Health Organization


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

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Date of Web Publication5-May-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Maternal and neonatal tetanus elimination accomplished from the south-east Asian Region: World Health Organization. Ann Trop Med Public Health 2017;10:289-90

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Maternal and neonatal tetanus elimination accomplished from the south-east Asian Region: World Health Organization. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 19];10:289-90. Available from: http://www.atmph.org/text.asp?2017/10/1/289/205581
Dear Sir,

Maternal and neonatal tetanus (MNT) has been acknowledged as one of the significant preventable causes of neonatal and maternal deaths, especially in developing nations.[1] Even though, the condition can be easily prevented by the immunization of the women during pregnancy with the tetanus toxoid vaccine and by adhering to aseptic precautions during childbirth or umbilical cord practices, it still remains an important public health concern.[2] In fact, the estimates suggest that in the absence of appropriate interventions, almost 80% of the cases of neonatal tetanus eventually die and is extremely common in poor, remote, and isolated settings with substandard childbirth and postnatal practices or even limited access to health services.[1]

Realizing the high fatality associated with the disease, a special initiative was launched for the elimination of the MNT by the World Health Organization and other stakeholders.[1] Since then, a significant progress has been achieved and in the global mission to eliminate MNT, the vaccine has been introduced in excess of 100 nations and almost 90% of new borns have been immunized with three doses of diphtheria–pertussis–tetanus vaccine by the end of 2014.[1] Nevertheless, close to 58 000 neonates and an unknown number of mothers die every year from the disease and it still persist as a public health concern in 24 nations, especially in African and Asian region.[1],[3]

In an historical achievement, the South-east Asian region became the second region after European region to eliminate MNT cases from all districts across all the nations in the region, with Indonesia being the last nation eliminating the disease in the region.[3] This has been the result of the commitment of the program managers, support from the international agencies, and the extensive efforts of the health personnel to reach remote areas and improve the reach of maternal and child health services, especially immunization coverage.[3],[4]

However, it is very much important to understand that as tetanus spores are widely present in the environment the disease cannot be eradicated, and hence the efforts do not end here.[2],[3] At the same time, there is a need to address the existing challenges of competing health priorities, lack of constant funding, poor accessibility, suboptimal surveillance, resource constraints, and poor monitoring and supervision.[2],[4],[5] The need of the hour is to maintain elimination, which will require conducting periodic review with stakeholders, strengthening of the routine immunization activities for both pregnant women and children, enhancing access to clean deliveries by ensuring the presence of skilled birth attendants, reliable surveillance of neonatal tetanus, and introducing school-based immunization activities.[1],[3] In addition, strengthening of the public health infrastructure and giving extra attention to the high-risk areas will also play a crucial role in reducing the incidence of the disease.[1],[2],[3]

To conclude, the elimination of maternal and neonatal tetanus from the South-east Asian region is a remarkable achievement for the health sector and the program managers. However, the real need is to strengthen the existing immunization activities to ensure that the disease no longer emerge once again as a public health problem.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health OrganizationImmunization coverage - Fact sheet; 2016. Available from: http://www.who.int/mediacentre/factsheets/fs378/en/. [Accessed 2016 May 19].   Back to cited text no. 1
    
2.
World Health OrganizationMaternal and neonatal tetanus elimination: validation survey in 4 States and 2 union territories in India, May 2015. Wkly Epidemiol Rec 2015;90:589-608.  Back to cited text no. 2
    
3.
World Health OrganizationWHO South-East Asia Region eliminates maternal and neonatal tetanus; 2016. Available from: http://www.searo.who.int/mediacentre/releases/2016/1625/en/. [Accessed 2016 May 19].  Back to cited text no. 3
    
4.
Thwaites CL, Beeching NJ, Newton CR. Maternal and neonatal tetanus. Lancet 2015;385:362-70.  Back to cited text no. 4
[PUBMED]    
5.
Khan R, Vandelaer J, Yakubu A, Raza AA, Zulu F. Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all. Int J Womens Health 2015;7:171-80.  Back to cited text no. 5
[PUBMED]    

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Correspondence Address:
Dr. Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur Guduvanchery Main Road, Sembakkam Post, Kanchipuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.205581

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