A survey of neonatal tetanus and perinatal mortality in southern Muslim communities in Thailand.

The objective was to obtain the incidence rate of neonatal tetanus, perinatal mortality rate, and the coverage of health care utilization in the rural Muslim in the lower part of southern Thailand. In a retrospective field study, the rural populations of Narathiwat, Yala and Pattani provinces were studied by cluster sampling technique. The still birth rate and early neonatal mortality rate were 15.3 per 1,000 births and 11.2 per 1,000 live births, respectively. The maternal mortality rate was 1.7 per 1,000 live births. 55% of all pregnancies received 2 injections of tetanus toxoid, 80% of deliveries were performed by traditional birth attendants. The incidence rate of neonatal tetanus was 0.9 per 1,000 live births. The coverage of health service for prevention of perinatal mortality was low and these perinatal and maternal mortality rates were unacceptably high. In contrast, the incidence of neonatal tetanus was not particularly high for unknown reasons.

Effect of passive immunity to tetanus in DTP vaccinated infants.

Tetanus antitoxin levels in DTP unvaccinated and vaccinated infants whose mothers had either received no dose or two doses of absorbed tetanus toxoid at present pregnancy were determined by the enzyme immunosorbent assay (EIA). It was found that the percentage of protective infants born from non-immunized and immunized mothers were 95.4 and 100 respectively. The transplacental tetanus immunity in infants of immunized mothers was higher than those of non-immunized mothers, however, it was significantly reduced in both groups of infants within two months. After the first dose of DTP vaccine, infants born from non-immunized mothers were able to respond well in producing antibody whereas the infants from immunized mothers were not. In the second and third dose of DTP vaccine both groups of infants had a similar range of tetanus antitoxin.