Predictors of Mortality in Neonatal Tetanus: A Retrospective Study From a Medical College in Rural North India

Abstract

Background Studies on factors affecting mortality in neonatal tetanus (NNT) are mostly from other developing countries. Although NNT has been eliminated from India, cases are still occasionally reported from rural areas. Moreover, there is paucity of such studies from India. Hence, this study was aimed to identify risk factors affecting NNT mortality so that case fatality can be minimized especially in resource-limited settings. Methods The records of the 32 neonates diagnosed as NNT over a period of 8 years (2013-2020) were reviewed, and a statistical comparison of various variables between survivors and nonsurvivors was made. Results The overall case fatality rate in our study was 75%. Determinants of mortality in these cases were low birthweight, short incubation period, short period of onset, delay in seeking medical attention, presence of comorbidity, dose of tetanus immunoglobulin < 250 IU, and an unknown entry site of infection. Gender and place of delivery were not associated with increased mortality. Conclusion Improved maternal antenatal care (birthweight and gestation), recognition of the disease at onset of symptoms, and early hospital contact are important, in addition to optimum supportive care, to reduce NNT mortality.