Neonatal tetanus prevention programme in Kenya: Successes and controversies
AbstractObjective: To review the disease process, and success and controversies associated with neonatal tetanus control in Kenya.
Data sources: Medline search on published articles in journals, books and national/ international agency reports.
Data selection: Relevant literature from peer-reviewed scientific papers, international and Kenyan reports and topical articles were reviewed.
Data extraction: Information was reviewed on: disease process, national and global disease epidemiology and prevention strategies used, and successes and challenges faced in Kenya.
Data synthesis: The literature was read, relevant information extracted, reviewed and analysed to synthesise the conclusions.
Conclusions: Tetanus results from infection by highly resistant spores of Clostridium tetani and mainly affects newborns, usually resulting from unsafe deliveries particularly in developing countries. Neonatal tetanus affects children without passive immunity due to the mothers not having been vaccinated, and has a high fatality rate. The lack of natural immunity, and the achievement of 80% protection levels after two vaccine doses supports vaccination as an effective and cost-effective tool towards elimination of the disease. Kenya has implemented various strategies targeting women of reproductive age in an attempt to achieve the target of eliminating neonatal tetanus. Kenya's neonatal tetanus control programme has achieved successes, with high immunisation coverage and reduction in number of reported cases. Confidence in the vaccination programme however needs to be re-built following the doubts recently introduced by claims that it is being utilized for fertility control.