Neonatal Tetanus at Pediatric Teaching Hospital in Bangui

Background: Despite the Maternal and Neonatal Tetanus (MNT) elimination initiative, neonatal tetanus still persists in some parts of the world. Objectives: To determine hospital prevalence and describe epidemiological, clinical, therapeutic and outcome aspects of neonatal tetanus at the Pediatric Teaching Hospital in Bangui. Methodology: It was the review of hospitalized newborns’ files in the neonatal unit at Pediatric Teaching Hospital in Bangui between January 2016 and December 2019. Newborns discharged with tetanus diagnosis, and whose files were usable were included. The variables studied were: for the newborn: age, sex, birth weight, the reason for transfer, diagnosis, cause and time of death, place and method of delivery; for the mother: age, antenatal care, tetanus vaccine status, parity and geographical provenance. Epi Info 7 software, version 7.1.3.3 was used for data analysis. The chi2 test with the significance level set at p < 0.05 and the odds ratio were used. Résultats: Forty-eight (48) out of 5796 newborns had neonatal tetanus (0.8%). They were newborns to mothers with an average age of 18.8 years of which 68.8% (n = 33) were primipara and 87.5% (n = 42) not vaccinated against tetanus. Childbirth happened at home in 91.7% (n = 44), and the blade was used for sectioning the umbilical cord in 39.6% (n = 19). Newborns were referred from rural area in 47.9% (n = 23). A single antenatal care contact was done in 68.7% (n = 33). Tetanus was classified as severe according to the Dakar prognosis score between 4 and 6 in 89.6% of cases (n = 43). The death occurred in 58.3% (n = 28). Conclusion: The high frequency of neonatal tetanus as well as its severity requires pregnancy follow-up strengthening and childbirth monitoring in order to its elimination. But primary prevention relies on improving individual and general hygiene conditions.