title: Tetanus in Ethiopia: unveiling the blight of an entirely vaccine-preventable disease.
abstract: Today, tetanus exacts its toll only in resource-poor countries like Ethiopia. Agrarian rural life with limited vaccine typifies tetanus risk in Ethiopia where current tetanus control trends on expanding infant immunization and eliminating highly prevalent maternal and neonatal tetanus (MNT). Protection by infant tetanus immunization primers disappears within an average of 3 years, if not followed by boosters. Second-year of life, school-based, and universal 10-yearly tetanus immunizations need to be supplemented. Facility-based reviews in Ethiopia reveal a continued burden of tetanus at tertiary-level hospitals where ICU care is suboptimal. Quality of medical care for tetanus is low - reflected by high case-fatality-rates. Opportunities at primary-health-care-units (antenatal-care, family planning, abortion, wound-care, tetanus-survivors) need to be fully-utilized to expand tetanus immunization. Prompt wound-care with post-exposure prophylaxis and proper footwear must be promoted. Standard ICU care needs to exist. Realization of cold-chain-flexible, needle-less and mono-dose vaccine programs allow avoiding boosters, vaccine-refrigeration, and improve compliance.
authors.affiliation: Anaesthetics, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital, Imperial College London, 369 Fulham Road, London SW10 9NH, UK. yohannes2005@gmail.com
authors.forename: Yohannes Woubishet
authors.initials: YW
authors.lastname: Woldeamanuel
mesh_terms: D003695:Delivery of Health Care / Q000379:methods; D019468:Disease Management; D005002:Ethiopia; D006801:Humans; D012424:Rural Population; D013742:Tetanus / Q000517:prevention & control* / Q000628:therapy*; D013745:Tetanus Toxoid / Q000627:therapeutic use*; D014611:Vaccination / Q000379:methods*
chemical_list: D013745:Tetanus Toxoid