By Alfred Nyakinda

In a meeting held by the immunization stakeholders in Nairobi, Kenya received certification for maternal and neonatal tetanus elimination (MNTE) from the World Health Organization (WHO).

Dr. Collins Tabu, head of National Immunization and Vaccines programme showing MNTE certificate

While applauding the Kenyan government for attaining the elimination status, Dr. Rudi Eggers, WHO representative to Kenya, noted the danger posed by the disease.

“Neonatal tetanus is a fatal disease particularly in difficult to reach and rural areas where deliveries take place at home without adequate sterile procedures and in unclean environment,” he said while delivering his keynote speech during the ceremony, “WHO estimates a 94 percent reduction in neonatal deaths from 1988 when an estimated 787,000 newborn babies died of tetanus within their first month of life. “

The occasion marked Kenya’s removal from the global list of countries that have yet to achieve MNTE, reducing the number to 14. The certification confirms the country has achieved its goal of reducing the number of cases to less than one per 1000 live births annually in every district.

Kenya’s validation comes after a 2018 survey in Narok County, which has the highest risk of neonatal tetanus. The risk was considered high due to its poor performance in vaccinating with tetanus-containing vaccine, antenatal visits, delivery by skilled attendants, health staffing, poverty and other human development indices.

“Kenya among other countries that have eliminated MNT need to maintain the elimination status by vaccinating women of reproductive age with tetanus-toxoid-containing vaccines (TTCV) and implementing clean practices during delivery,” Eggers urged.

Other recommendations by the WHO include: planning outreach activities for remote places, promoting delivery in health facilities and strengthening knowledge of health workers on the immunization schedule.

Tetanus occurs when a bacteria enters the body through an open wound or puncture. The bacteria spores live in the soil, animal dung and in faeces, making everybody susceptible to the disease. The bacteria produces a poison that attacks the central nervous system.

The disease has an incubation period of 3-21 days after infection, with symptoms ranging from the inability to open the mouth, muscle spasms often in the back, abdomen and extremities, sudden painful muscle spasms often triggered by sudden noises, trouble swallowing, seizures, headache, fever and sweating as well as changes in blood pressure or fast heart rate.

Though the disease-causing bacteria are present in the environment globally, there are no hospital lab tests that can confirm tetanus instead diagnosis is done through clinical observation. Tetanus is referred to as silent killer because so many of these women and newborns die at home and both the births and the deaths go unreported.

Neonatal tetanus can be prevented by immunizing women of reproductive age either during or outside of pregnancy, protecting the mother and through a transfer of antibodies to the fetus. Kenya initiated the MNTE process in 2001, conducting nationwide tetanus vaccination campaigns in 2003, 2006, 2009 and 2013/2014 and 2017. contact: mwakishaj@who.int

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