慈溪市1996-2008年新生儿破伤风监测分析

Neonatal tetanus in Cixi city during 1996～2008

目的：了解慈溪市新生儿破伤风（Neonatal Tetanus,NT）流行病学特征,讨论消除NT策略。方法：利用描述流行病学分析方法,对1996-2008年NT监测资料进行分析。结果：全市共报告NT确诊病例57例,年平均发病率波动在0.11/‰~1.01/‰之间,病死率为15.79%。流动人口病例占98.25%（56/57）,男女性别比为3.75∶1。病例平均日龄6.5天,所有病例均采用土法接生且无新生儿破伤风类毒素（TT）免疫史。结论：旧法接生和产前未注射破伤风类毒素及人口流动是NT发病的主要因素。提高孕妇自我保健意识,推广住院分娩,对高危人群接种TT,加强新法接生培训是消除NT的基本措施。

Objective To understand the epidemiological characters of neonatal tetanus（NT）in Cixi city,and to discuss strategies for eliminating NT.Methods Data of NT surveillance system during 1996～2008 were analyzed by descriptive epidemiological method.Results Altogether 57 NT cases were reported in 13 years.The incidence of neonatal tetanus was between 0.11/‰～1.01/‰ while the mortality was 15.79%.Cases among transient population accounting for 98.25%（56/57） and the ratio of boy to girl was 3.75：1.The onset of the disease was averagely on 6.5 day after birth,all NT cases delivered at home and all the midwives lack of training.None of the mothers had been vaccinated with tetanus toxin.Conclusion The dominant factors contributing to NT involve old midwifery,lack of tetanus toxin injection before labor and delivery,and population floating.It is believed that eradication of NT can be achieved through improving self-care among pregnant women,promoting hospital delivery,inoculating high risk groups with TT and strengthening training of new midwifery.