Maternal and Neonatal Tetanus Elimination: Where are We Now?

Shashi Kant Dhir,1 Pooja Dewan,2 Piyush Gupta2 1Department of Pediatrics, Guru Gobind Singh Medical College, Punjab, India; 2Department of Pediatrics, University College of Medical Sciences, Delhi, IndiaCorrespondence: Piyush GuptaDepartment of Pediatrics, University College of Medical Sciences, Del...

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Autores principales:	Dhir SK, Dewan P, Gupta P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	tetanus toxoid containing vaccines clean delivery maternal tetanus neonatal tetanus strategy tetanus immunization mnte validation Arctic medicine. Tropical medicine RC955-962
Acceso en línea:	https://doaj.org/article/dcf2656dc4114e019b2115c6bb5d717c
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spelling	oai:doaj.org-article:dcf2656dc4114e019b2115c6bb5d717c2021-11-23T18:43:02ZMaternal and Neonatal Tetanus Elimination: Where are We Now?1179-7282https://doaj.org/article/dcf2656dc4114e019b2115c6bb5d717c2021-11-01T00:00:00Zhttps://www.dovepress.com/maternal-and-neonatal-tetanus-elimination-where-are-we-now-peer-reviewed-fulltext-article-RRTMhttps://doaj.org/toc/1179-7282Shashi Kant Dhir,1 Pooja Dewan,2 Piyush Gupta2 1Department of Pediatrics, Guru Gobind Singh Medical College, Punjab, India; 2Department of Pediatrics, University College of Medical Sciences, Delhi, IndiaCorrespondence: Piyush GuptaDepartment of Pediatrics, University College of Medical Sciences, Delhi, IndiaTel +919811597172Fax +91-11-22590495Email piyush.gupta@gmail.comAbstract: The maternal and neonatal tetanus elimination (MNTE) program was envisaged by the World Health Organization to overcome the mortality and morbidity caused by maternal and neonatal tetanus (MNT). Although preventable by simple cost-effective practices like universal immunization, clean delivery practices, and healthy umbilical cord care, as of date MNT is still prevalent in 12 developing countries of Asia and Africa. Definitive approaches need to be microplanned by these countries to successfully accomplish the three stages of MNTE, ie, achieving, validating, and sustaining. Once a country achieves MNTE, this status is required to be validated and sustained according to the high-risk and low-risk categorization of the districts. The three-pronged strategies for achieving and sustaining MNTE include (a) rigorous immunization of women of reproductive age with tetanus toxoid-containing vaccines, (b) strengthening of clean delivery services for pregnant women, and (c) effective surveillance for MNT. Although the deadlines for achieving MNTE globally have been missed many times, yet there has been a significant progress to date as evident by 80% reduction in countries requiring validation for MNTE (59 countries in 1999 to 12 countries in 2020). Huge strides have been made in the overall coverage of two doses of tetanus toxoid (13.79% to 65.27%), neonates being protected at birth (12% to 88%), global coverage of third-dose DPT (more than doubled), and reduction of 88% estimated deaths due to NT in the last four decades. Identification of the most vulnerable populations, systematic planning at all levels of health care, involvement of local community support, tackling the implementation gap, strong political will, good financial support, and continued robust surveillance will go a long way in achieving MNTE.Keywords: tetanus toxoid containing vaccines, clean delivery, maternal tetanus, neonatal tetanus, strategy, tetanus immunization, MNTE validationDhir SKDewan PGupta PDove Medical Pressarticletetanus toxoid containing vaccinesclean deliverymaternal tetanusneonatal tetanusstrategytetanus immunizationmnte validationArctic medicine. Tropical medicineRC955-962ENResearch and Reports in Tropical Medicine, Vol Volume 12, Pp 247-261 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tetanus toxoid containing vaccines clean delivery maternal tetanus neonatal tetanus strategy tetanus immunization mnte validation Arctic medicine. Tropical medicine RC955-962
spellingShingle	tetanus toxoid containing vaccines clean delivery maternal tetanus neonatal tetanus strategy tetanus immunization mnte validation Arctic medicine. Tropical medicine RC955-962 Dhir SK Dewan P Gupta P Maternal and Neonatal Tetanus Elimination: Where are We Now?
description	Shashi Kant Dhir,1 Pooja Dewan,2 Piyush Gupta2 1Department of Pediatrics, Guru Gobind Singh Medical College, Punjab, India; 2Department of Pediatrics, University College of Medical Sciences, Delhi, IndiaCorrespondence: Piyush GuptaDepartment of Pediatrics, University College of Medical Sciences, Delhi, IndiaTel +919811597172Fax +91-11-22590495Email piyush.gupta@gmail.comAbstract: The maternal and neonatal tetanus elimination (MNTE) program was envisaged by the World Health Organization to overcome the mortality and morbidity caused by maternal and neonatal tetanus (MNT). Although preventable by simple cost-effective practices like universal immunization, clean delivery practices, and healthy umbilical cord care, as of date MNT is still prevalent in 12 developing countries of Asia and Africa. Definitive approaches need to be microplanned by these countries to successfully accomplish the three stages of MNTE, ie, achieving, validating, and sustaining. Once a country achieves MNTE, this status is required to be validated and sustained according to the high-risk and low-risk categorization of the districts. The three-pronged strategies for achieving and sustaining MNTE include (a) rigorous immunization of women of reproductive age with tetanus toxoid-containing vaccines, (b) strengthening of clean delivery services for pregnant women, and (c) effective surveillance for MNT. Although the deadlines for achieving MNTE globally have been missed many times, yet there has been a significant progress to date as evident by 80% reduction in countries requiring validation for MNTE (59 countries in 1999 to 12 countries in 2020). Huge strides have been made in the overall coverage of two doses of tetanus toxoid (13.79% to 65.27%), neonates being protected at birth (12% to 88%), global coverage of third-dose DPT (more than doubled), and reduction of 88% estimated deaths due to NT in the last four decades. Identification of the most vulnerable populations, systematic planning at all levels of health care, involvement of local community support, tackling the implementation gap, strong political will, good financial support, and continued robust surveillance will go a long way in achieving MNTE.Keywords: tetanus toxoid containing vaccines, clean delivery, maternal tetanus, neonatal tetanus, strategy, tetanus immunization, MNTE validation
format	article
author	Dhir SK Dewan P Gupta P
author_facet	Dhir SK Dewan P Gupta P
author_sort	Dhir SK
title	Maternal and Neonatal Tetanus Elimination: Where are We Now?
title_short	Maternal and Neonatal Tetanus Elimination: Where are We Now?
title_full	Maternal and Neonatal Tetanus Elimination: Where are We Now?
title_fullStr	Maternal and Neonatal Tetanus Elimination: Where are We Now?
title_full_unstemmed	Maternal and Neonatal Tetanus Elimination: Where are We Now?
title_sort	maternal and neonatal tetanus elimination: where are we now?
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/dcf2656dc4114e019b2115c6bb5d717c
work_keys_str_mv	AT dhirsk maternalandneonataltetanuseliminationwherearewenow AT dewanp maternalandneonataltetanuseliminationwherearewenow AT guptap maternalandneonataltetanuseliminationwherearewenow
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Maternal and Neonatal Tetanus Elimination: Where are We Now?

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