Conference abstract

Home delivery in Eastern Cameroon 2016: risk factors for the occurrence of neonatal tetanus

Pan African Medical Journal - Conference Proceedings. 2017:3(79).26 Dec 2017.
doi: 10.11604/pamj-cp.2017.3.79.164

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Keywords: Neonatal tetanus (NNT), epidemic, Cameroon
Oral presentation

Home delivery in Eastern Cameroon 2016: risk factors for the occurrence of neonatal tetanus

Céline Mairousgou Tchida1,&, Corlins Ndode1, Gael Kouamen1, Mathieu Els1, Alain Georges Etoundi1

1Cameroon FETP, Yaoundé, Cameroon

&Corresponding author
Céline Mairousgou Tchida, Cameroon FETP, Yaoundé, Cameroon

Abstract

Introduction: neonatal tetanus (NNT) elimination is defined as having an annual rate of < 1 case /1000 live births in each district. Although in Cameroon, NNT was declared eliminated in 2012, several cases were reported in Messamena Health District and neighboring districts in 2016. This led to an investigation to confirm the epidemic and assess risk factors.

Methods: suspected NNT cases notified by health facilities were searched in the communities and validated using the standard NNT case definition. A case was defined as any newborn between 1 January and 30 November 2016, capable of crying and breastfeeding normally during the first 2 days of life and, between the 3rd and the 28th day, cannot suck normally, becomes stiff and / or has seizures. Interviews were carried out with all traditional birth attendants and health personnel to understand the quality of antenatal consultations and delivery methods. To evaluate anti-tetanus toxine (ATT) coverage in women and the use of health services, all women of reproductive age around a case were interviewed. Health personnel and community members were sensitized on NNT during field visits.

Results: five of 10 notified cases of NNT were validated. The median onset of disease was 5 days (3 to 7 days). All lived in rural areas. All cases were delivered at home; 4(80%) by a recognized traditional birth attendant and 1 case by a family member. Only 1(20%) of mothers of cases attended one antenatal consultation and none received 2nd dose of ATT. For all cases, the umbilical cord was cut with razor blades and cauterized with charcoal. Fifteen out of 43 (35%) of women interviewed used health services.

Conclusion: the possible risk factors identified were low utilization of health services by women, low ATT coverage and home deliveries (poor umbilical cord care and the use of non-medical equipment). The effective community sensitization on the use of health services (ANC, deliveries, immunization) will foster the elimination of NNT.