title: Neonatal tetanus: the Massey Street Children's Hospital experience.
abstract: BACKGROUND
  Neonatal tetanus (NNT), a major cause of neonatal deaths in the developing world appears to be on the downward trend in recent years. At the Massey Street Children's Hospital (MSCH), a foremost paediatric centre in Lagos an unpublished review revealed that NNT constituted 15-20% of the neonatal admissions in the period 2003-2005.
  
  
  OBJECTIVE
  The aim of this study was to determine the current prevalence of the disease, describe the clinical characteristics of NNT cases seen at the hospital and proffer solutions that would contribute to the elimination of the disease.
  
  
  METHODS
  This was a retrospective study. The clinical record of 66 patients with NNT admitted during a 2 year period (2006-2008) was reviewed. The clinical characteristic of the patients, co-morbidities/complications and mortality in the children was determined. The immunization status, facility used for Antenatal care and delivery by the mothers was also noted.
  
  
  RESULTS
  NNT constituted 2.5% of neonatal admissions in the 2 year period. The mean age of the patients was 8.8 +/- 3.29 days. 36 (54.5%) of the patients died while 25 (37.9%) were discharged home. The overall case fatality rate (CFR) was 54.5%. Recurrent apnea was the commonest complication seen. 27 (40.9%) and 37 (56.1%) of the mothers had ANC and delivered at the TBA clinics respectively. Only 2 (3%) of the mothers attended government hospitals.
  
  
  CONCLUSIONS
  Though there is a reduction in the number of cases of NNT over the years (15-20% prevalence to 2.5%) the CFR at the secondary health facility still remains unacceptably high. The preference of mothers for TBA clinics rather than government hospitals is a major concern which needs to be addressed.
authors.affiliation: Department of Paediatrics, Massey Street Children's Hospital, Lagos, Nigeria.
authors.forename: O F
authors.initials: OF
authors.lastname: Adeniyi
authors.forename: C A
authors.initials: CA
authors.lastname: Mabogunje
authors.forename: C N
authors.initials: CN
authors.lastname: Okoromah
authors.forename: J K
authors.initials: JK
authors.lastname: Renner
mesh_terms: D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D013742:Tetanus / Q000401:mortality* / Q000628:therapy*