Full Project – Prevalence of neonatal tetanus among children attending University Teaching Hospital

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CHAPTER ONE

1.0       INTRODUCTION

Neonatal tetanus is the disease of the nervous system. Tetanus or lock jaw is an infection caused by Clostridium tetani which is a spore bearing anaerobic gram positive bacillus (CDC, 2012). The organism produce a soluble exotoxin which is neurotoxin.(Eregie et al., 1995 ). The spores are resistance to heal and many antiseptic (cracken et al., 1971). Tetanus is a natural harmless inhabitant of the intestinal tract of many animals including man (WHO, 2014). It is commonly found in the soil and mostly rusted metal like nails. The bacillus not invasive but it produces exotoxins which are of two types:

1. Tetano spasm
2. Tetano lysine (Mustapha et al., 1999).

Tetano spasm is a potent toxin which affect the Central Nervous System, thus produces the characteristics feature of the disease while the exact function of tetano lysine is not known (Ross willson, 2000) The exotoxin gets to Central Nervous System by way of either through neuron axon or vascular system. Once it reaches the Central Nervous System, it becomes fixed to the nerve cell of the anterior horn in the spinal cord and the brain cells, the synaptic inhabition between the neural and plates and the anterior horn all in the spinal cord and motor neurons in the brain (Rahman et al., 1998). This lowers the reflex excitability resulting in stiffness of the muscles (High jolly 1976). The exotoxin cannot be dislodged but can be neutralized by tetanus anti-toxins while it is in circulation. (Abdulkarim et al., 2011)

Neonatal tetanus is now confined in areas where there is ignorance of the normal method of infant and children hygiene (Jalan et al., 2010).the organism usually enters the body through the umbilical cord of an infant, either because the cord has been cut with a dirty instrument, or because of a dirty dressing that have been applied (Mustapha et al., 1999).

The onset of symptoms is usually in the second week, the earlier the onset, the worse the prognosis. The infant becomes rigid and unable to feed because of intense trimus (Azubuke et al., 1999). There are repeated spasms of the whole body which are more on the outlook (Cracken et al., 1971). If available, human Tetanus Immune Globulin(TIG) should be given (Ide et al., 2009).

Neonatal tetanus is a disease caused by Clostridium tetani in a new born baby and other older children (Zafar et al., 2012). It is anaerobic and found in cultivated soils and manure and therefore likely to infect accidental wounds (UNICEF, 2009).

The incubation period is within 3 to 10 days but may be much longer (Surabaya et al., 1973).some signs are:

1. stiffness of the muscles around the wound
2. followed by rigidity of face and neck hence lock jaw (Hlady et al., 1998).

All muscles are the affected and opisthotomos may occur. Tetanus vaccine or toxoid will give an active immunity. Tetanus antitoxin is a serum that gives a short term passive immunity and may be used for treatment of a case of tetanus (Barbara et al., 1968).

1.1 Statement of the Problem

  There has been an increased case of neonatal tetanus infection among new born babies that were born before arrival to the hospital in the year 2001. In the year 2016, there were increased in the number of babies that were born with neonatal tetanus infection.

1.2 Justification

 The study is necessary so as to determine the current rate of neonatal tetanus infection and suggest ways to reduce or completely eradicate it. Therefore, there is a need for a research work like   this in order to find a lasting solution to the high cause of neonatal tetanus infection in ABUTH Zaria.

1.3 Aim and Objectives

1.3.1 Aim of the Study

The aim of this project is to determine the prevalence of neonatal tetanus related to cultural practices despite anti natal clinic care within children attending Ahmadu Bello University Teaching Hospital in Zaria Local Government Area.

1.3.2 Objectives of the Study

1. To isolate neonatal tetanus among children attending Ahmadu Bello University Teaching Hospital
2. To determine the prevalence of neonatal tetanus among children.

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Full Project – Prevalence of neonatal tetanus among children attending University Teaching Hospital