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Maternal and Neonatal Tetanus Eliminated in the Region of the Americas

According to a joint announcement from the Pan American Health Organization (PAHO) and the United Nations International Children's Emergency Fund (UNICEF), maternal and neonatal tetanus (MNT) has been eliminated from the Region of the Americas as a result of a widespread vaccination campaign and methods to ensure clean birthing practices.

The World Health Organization (WHO) reports that MNT was responsible for the deaths of 34,000 newborn children in 2015, a 96% reduction from 1988, when an estimated 787,000 newborn babies died of tetanus within their first month of life, according to the statement. The infection occurs neonatally when a newborn’s unhealed umbilical stump is infected with Clostridium tetani, the bacterium that causes tetanus. This can happen for multiple reasons, including the application of potentially contaminated traditional substances to the stump, the baby being born on a contaminated surface, unsterile equipment being used to cut the stump, or if the hands of the person who delivers the baby are unclean. Paralysis can occur because of the infection and it is often fatal as the infant is unable to breathe and breastfeed. Administration of the diphtheria toxoid (DT) or monovalent tetanus toxoid (TT) vaccines during pregnancy, as well as ensuring that babies are delivered and handled post-delivery in clean areas, are methods to prevent infection.

On a country-level, PAHO/WHO recommended the following 4 lines of action to eliminate MNT:
  1. Carry out routine immunization of pregnant women against tetanus
  2. Conduct supplemental immunization activities for women of childbearing age so each woman receives at least 2 doses of the vaccine
  3. Reinforce surveillance of neonatal tetanus cases
  4. Promote clean delivery services
Because C. tetani live in the soil and feces of animals, it cannot be completely eradicated; however, MNT can be considered eliminated if a region sees “an annual rate of <1 case of neonatal tetanus per 1000 live births at the district level,” according to the statement. This is the case in the Region of the Americas.

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