Progress Toward Achieving and Sustaining Maternal and Neonatal Tetanus Elimination - Worldwide, 2000-2022

• Published in: MMWR. Morbidity and mortality weekly report 2024-07, Vol.73 (28), p.614-621
• Main Authors: Jones, Camille E, Yusuf, Nasir, Ahmed, Bilal, Kassogue, Modibo, Wasley, Annemarie, Kanu, Florence A
• Format: Article
• Language: English
• Subjects: Age; Attended births; Births; COVID-19; COVID-19 vaccines; Developing countries; Disease Eradication; DPT vaccine; Female; Full Report; Global Health - statistics & numerical data; Health aspects; Humans; Immunization; Immunization Programs; Infant mortality; Infant Mortality - trends; Infant, Newborn; Infants (Newborn); LDCs; Low income areas; Midwifery; Mortality; Neonates; Pandemics; Pregnancy; Pregnant women; Prenatal care; Public health; Surveillance; Tetanus; Tetanus - epidemiology; Tetanus - mortality; Tetanus - prevention & control; Tetanus antitoxin; Tetanus Toxoid - administration & dosage; Umbilical cord; Vaccines
• ISSN: 0149-2195; 1545-861X; 1545-861X
• DOI: 10.15585/mmwr.mm7328a1

Tetanus remains a considerable cause of mortality among undervaccinated mothers and their infants following unhygienic deliveries, especially in low-income countries. Strategies of the maternal and neonatal tetanus elimination (MNTE) initiative, which targets 59 priority countries, include strengthening antenatal immunization of pregnant women with tetanus toxoid-containing vaccines (TTCVs); conducting TTCV supplementary immunization activities among women of reproductive age in high-risk districts; optimizing access to skilled birth attendants to ensure clean deliveries and umbilical cord care practices; and identifying and investigating suspected neonatal tetanus cases. This report updates a previous report and describes progress toward MNTE during 2000-2022. By December 2022, 47 (80%) of 59 priority countries were validated to have achieved MNTE. In 2022, among the 50 countries that reported coverage with ≥2 doses of TTCV among pregnant women, 16 (32%) reported coverage of ≥80%. In 2022, among 47 validated countries, 26 (55%) reported that ≥70% of births were assisted by skilled birth attendants. Reported neonatal tetanus cases worldwide decreased 89%, from 17,935 in 2000 to 1,995 in 2021; estimated neonatal tetanus deaths decreased 84%, from 46,898 to 7,719. However, the global disruption of routine immunization caused by the COVID-19 pandemic impeded MNTE progress. Since 2020, reported neonatal tetanus cases have increased in 18 (31%) priority countries. Integration of MNTE strategies into priority countries' national postpandemic immunization recovery activities is needed to achieve and sustain global elimination.