Neonatal tetanus in Sagamu, Nigeria during the Expanded Programme on Immunization and the National Programme on Immunization eras: A comparative analysis.

Background: It is essential to continually study the pattern of occurrence of neonatal tetanus (NNT) for better control measures. Objective: To compare the prevalence rates and outcome of NNT in a Nigerian tertiary hospital over two periods characterized by different national immunization programmes the Expanded Programme on Immunization (EPI) and the National Programme on Immunization (NPI). Methods: The records of babies hospitalized with NNT between 1991 and 1996 (EPI period) and between 1997 and 2005 (NPI period) were studied. Results: The prevalence rates for the EPI and NPI periods were 6.4 percent and 2.9 percent respectively. Most of the mothers did not receive ante-natal care (81.4 percent for EPI and 75.6 percent for NPI), did not take anti-tetanus vaccines in pregnancy (87.7 percent for EPI and 88.4 percent for NPI) and delivered their babies outside the health facilities (86.6 percent for EPI and 83.3 percent for NPI). The Case Fatality Rate was 49.5 percent and 61.5 percent for the EPI and NPI periods respectively. Conclusion: The prevalence and mortality of NNT remains high in Nigeria despite a change in immunization programme.