A 30-cluster survey was carried out in order to estimate the incidence of neonatal tetanus in rural Côte d'Ivoire. Births in the 19 months preceding the survey were enumerated by interviewers in house-to-house visits. If a child born in that period had died, the interviewer asked a series of questions to establish a presumptive diagnosis of neonatal tetanus. A total of 41 deaths from neonatal tetanus was found in the study area among 2324 live births that occurred from 1 January 1981 to 31 July 1982. This gives a neonatal tetanus mortality rate of about 2%. Most deliveries and almost all deaths occurred at home, and only about 2% of neonatal tetanus cases were reported through the routine health information system. Birth in a clinic and antiseptic care of the umbilical cord protected infants from neonatal tetanus. Tetanus immunization of all women of child-bearing age is recommended as a preventive measure
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