title: [Elimination of maternal and neonatal tetanus in Senegal: evolution of survey indicators of 2003-2009].
abstract: OBJECTIVE
  This study aimed to estimate the evolution of the maternal and neonatal tetanus in Senegal from the tetanus vaccination coverage among pregnant women, the proportion of deliveries attended by trained medical personnel and the number of cases of tetanus declared by respective districts, helping to identify districts at high risk of neonatal tetanus (NNT).
  
  
  METHODS
  Data analysis of the epidemiological surveillance realized from 2003 to 2009 in 65 districts of Senegal. Data were collected from the reports of vaccination usage and from the Statistical Directories of the National Health Information Services of the Ministry of Health & Prevention. A district is at high risk when the incidence of NNT is ≥1 case per 1 000 Live births (LB).
  
  
  RESULTS
  There were 153 reported cases of NNT in Senegal between 2003 and 2009. National incidence decreased from 0.08 to 0.03 case per 1 000 LB (p = 0,0008). The vaccination coverage of the pregnant women by at least two doses of tetanus vaccine (VAT2+) increased from 66% in 2003 to 78% in 2009. The percentage of districts that had reached a vaccination coverage ≥80% was 20% in 2003 compared to 60% in 2009 (p = 0.009). The proportion of deliveries attended by qualified medical staff evolved from 53% in 2003 to 67% in 2009 (p = 0,02). By 2009, the incidence of NNT was less than 1 case per 1,000 LBs in all districts.
  
  
  CONCLUSIONS
  Assessing the elimination of maternal and neonatal tetanus in Senegal shows that progress has been made from 2003 to 2009. This was made possible through the organization of vaccination campaigns for women of childbearing age and the improvements in the conditions of deliveries.
authors.affiliation: Service des maladies infectieuses, CHNU de Fann-Dakar, avenue Cheikh-Anta-Diop, 5035 Dakar, Sénégal. louisefortes@yahoo.fr
authors.forename: L
authors.initials: L
authors.lastname: Fortes Déguénonvo
authors.forename: S A
authors.initials: SA
authors.lastname: Diop
authors.forename: A
authors.initials: A
authors.lastname: Diouf
authors.forename: N M
authors.initials: NM
authors.lastname: Dia Badiane
authors.forename: I O
authors.initials: IO
authors.lastname: Ba
authors.forename: N M
authors.initials: NM
authors.lastname: Manga
authors.forename: M
authors.initials: M
authors.lastname: Seydi
authors.forename: C T
authors.initials: CT
authors.lastname: Ndour
authors.forename: M
authors.initials: M
authors.lastname: Soumaré
authors.forename: B M
authors.initials: BM
authors.lastname: Diop
authors.forename: P S
authors.initials: PS
authors.lastname: Sow
mesh_terms: D000465:Algorithms; D062665:Epidemiological Monitoring; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D012675:Senegal / Q000453:epidemiology; D013742:Tetanus / Q000453:epidemiology / Q000517:prevention & control*; D013745:Tetanus Toxoid; D013997:Time Factors
chemical_list: D013745:Tetanus Toxoid
keywords: Senegal; elimination; neonatal tetanus