Strategies for the Control of Neonatal Tetanus

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Abstract
This paper describes strategies for the control of neonatal tetanus. The natural history of the disease, the immunological effects of tetanus toxoid immunization and programmatic opportunities for providing these immunizations are considered. A formula for calculating the cost per prevented neonatal tetanus death is suggested and its use illustrated for preschool, school age and antenatal immunization programs in communities with high and intermediate levels of neonatal tetanus. While antenatal tetanus immunization can give early reduction in the incidence of neonatal tetanus, preschool and school age immunizations appear to be an economical long-run strategy to complement antenatal and infant immunizations for control of neonatal tetanus.

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