Changing Incidence of Fatal Tetanus of the Newborn

A Retrospective Study in a Defined Rural Haitian Population

Warren L. Berggren Department of Community Health, Hôpital Albert Schweitzer, Departments of Tropical Public Health and Population Sciences, Harvard School of Public Health, Haiti, W. I.

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Gretchen M. Berggren Department of Community Health, Hôpital Albert Schweitzer, Departments of Tropical Public Health and Population Sciences, Harvard School of Public Health, Haiti, W. I.

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In a geographically defined population of 1,629 women between the ages of 15 and 60 years, tetanus of the newborn was determined retrospectively to have caused the death of 1,143 of their 7,248 live-born children. Analyzing the data by age cohorts of mothers, we showed that, whereas losing a child due to tetanus was relatively infrequent among the younger mothers, over half the older mothers had endured this experience. When the data were analyzed according to birth cohorts of children, they showed the frequency of death due to tetanus of the newborn to have diminished over a 30-year period from 25% of live births to 0% of live births. Declines in frequency could be directly related to a succession of preventive programs. A program that immunized all women with tetanus toxoid, whether or not they were pregnant, provided the means of eliminating tetanus of the newborn as a public health problem.

Author Notes

Present address: Albert Schweitzer Hospital, P. O. Box 2213-B, Port-au-Prince, Haiti, W. I.

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