Case series report of neonatal tetanus in the southern region, 2023

Abstract

Despite Vietnam’s achievement in eliminating neonatal tetanus (NNT) since 2005, sporadic cases are still being recorded. In July and August 2023, four cases were demerged in Binh Phuoc (three cases) and Ba Ria-Vung Tau (one case), posing a threat to this public health milestone. This study describes the epidemiological characteristics of NNT cases, identifies risk factors, and assesses vaccination practices and responses in areas with reported cases. Medical records, interviewing mothers, and surveying community vaccination coverage for children ≤ 4 years old, pregnant women, or mothers of children under two years old in affected areas were conducted. All mọthers were ethnic minorities (H’Mong and S’tieng), working as rubber-tapping laborers, living far from community health centers, and had not registered for antenatal care or received tetanus toxoid (TT) vaccines during pregnancy. Three of four mothers had migrated from the North, and all deliveries occurred at home, assisted by relatives using unsterile tools for cord-cutting. In the two affected communes of Binh Phuoc, institutional delivery rates were 61,5% and 64,7%, while the TT vaccine coverage (two doses) among pregnant women was only 33,3% and 60,0%. A comprehensive assessment of vaccination coverage and risk factors for NNT is essential to implement more effective interventions.