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新生儿破伤风是一种可避免的重要发病和死亡原因,过去被许多发展中国家的卫生服务忽视。最近在发展中国家,新生儿破伤风的影响程度越更显示出它是一个重要的卫生问题。社区调查结果表明:新生儿破伤风死亡率在5以下至60以上/每1000名活产;占整个新生儿死的23—72%。迄今结果表明,它每年夺去五千万新生儿的生命。事实上在许多国家,各种破伤风,尤其是新生儿破伤风是不作疫情报告的。常规的疫情报告系统仅确定大约2—5%的估计发病率,我们需要更准确、可靠的估计发病率和估计死亡率。消灭新生儿破伤风是一项根本的,且是可以实现的目标。可通过两方面的途径来完成:(1)增加育龄妇女的免疫复盖面,尤其是用破伤风类毒素免疫妊娠妇女;(2)改善产期保健,特别强调增加新法接生的比例。应把新生儿破伤风死亡率看作妇女保健设施利用的质量和程度、免疫规划的成效和实现“2000年人人享有保健”取得进展的指标。新生儿破伤风的消灭需要政府和妇幼保健机构的完全承诺。因它的预防可通过卫生人员与母亲的接触来完成,哪怕发生一例病人,也是卫生体系失败的证明。
Neonatal tetanus, a preventable cause of morbidity and mortality, was neglected in the past by health services in many developing countries. The more recent impact of tetanus in developing countries shows that it is an important health issue. Community surveys showed that the neonatal tetanus mortality rate was below 5 and above 60 per 1000 live births, and 23 to 72% of all neonatal deaths. The results so far show that it claims 50 million newborns each year. In fact, in many countries, all kinds of tetanus, especially neonatal tetanus, are not reported as epidemics. Conventional outbreak reporting systems only determine estimated morbidity rates of about 2-5%, and we need more accurate and reliable estimates of morbidity and estimated mortality. The elimination of neonatal tetanus is a fundamental and achievable goal. There are two ways to accomplish this: (1) to increase the immunization coverage of women of childbearing age, especially pregnant women who are immunized with tetanus toxoid; (2) to improve maternity health with a special emphasis on increasing the proportion of new births to be delivered. The neonatal tetanus mortality rate should be considered as the quality and extent of utilization of women’s health facilities, the effectiveness of immunization programs and the achievement of progress towards achieving health for all by the year 2000. The elimination of neonatal tetanus requires full commitment from the government and MCH institutions. Because its prevention can be done through the contact of health personnel with the mother, even a single patient is evidence of the failure of the health system.