Dispute over vaccine aside, we really do need to tackle tetanus to save our babies
What you need to know:
- The 2008/9 Kenya Demographics and Health Survey recorded a low of 63 per cent coverage against neonatal tetanus among pregnant women in these high-risk districts, which are now the target of the current vaccination campaign.
- Maternal and neonatal tetanus are common in marginalised, illiterate communities with limited access to health facilities. Thus, babies infected with tetanus die even before they are named and they are buried without a conclusive hospital diagnosis.
- The Ministry of Health, in collaboration with Unicef and WHO and in an effort to push Kenya into the category of those countries that have eliminated this disease, has been carrying out campaigns in the high-risk districts.
I listened carefully to the Catholic Church’s submission on its claim that the tetanus toxoid being given to girls and women in the reproductive age bracket was laced with a family planning agent.
The church explained that one of the reasons it is suspicious is that there is no epidemic to warrant such a campaign. Neonatal and maternal tetanus is one of the neglected diseases.
Others include rabies and sleeping sickness. These diseases continue to claim millions of lives despite the fact that they are either preventable through vaccination or treatable.
Maternal and neonatal tetanus are common in marginalised, illiterate communities with limited access to health facilities. Thus, babies infected with tetanus die even before they are named and they are buried without a conclusive hospital diagnosis.
Most deaths arising from neonatal tetanus are never recorded and easily miss the eye of policy makers’ prioritisation lists. In the at-risk populations tetanus is shrouded in myths and stigma. Therefore, it is not surprising that the Catholic church can claim that there is no tetanus outbreak and hence a vaccination campaign is unwarranted.
TETANUS IS DEADLY
According to the World Health Organisation (WHO), tetanus kills millions of children globally early in life. Infected children from unvaccinated mothers hardly make it past 14 days of life.
Most deaths from maternal and neonatal tetanus occur in remote areas that have limited access to health facilities and high illiteracy levels, with most deliveries being carried out by untrained traditional birth attendants.
The umbilical cord wound, which was a source of life for these newborns in the womb, becomes a route for bacterial infection through unclean deliveries.
It is a common practice in rural areas for the umbilical wounds to be smeared with ashes, soil, and cow dung or tied with dirty thread, effectively infecting the fragile newborns.
Countries that have managed to eradicate tetanus have combined routine ante-natal and supplementary national immunisation campaigns, promotion of clean delivery practices, and awareness creation on the disease burden.
The church, civil society, and ministries of health and education have played key roles in these countries. In some of them, tetanus vaccination is enshrined in the law and done in schools to ensure that every girl gets life immunity.
HIGH-RISK DISTRICTS
Sadly, Kenya is among the countries that have yet to attain maternal and neonatal tetanus elimination status.
The 2008/9 Kenya Demographics and Health Survey recorded a low of 63 per cent coverage against neonatal tetanus among pregnant women in these high-risk districts, which are now the target of the current vaccination campaign.
Neonatal and maternal tetanus incidences are higher in poor countries because of low vaccine coverage and high incidences of unclean birth procedures. When a mother is fully vaccinated, the immunity she gets protects her and her baby at birth.
The Ministry of Health, in collaboration with Unicef and WHO and in an effort to push Kenya into the category of those countries that have eliminated this disease, has been carrying out campaigns in the high-risk districts.
The target is to vaccinate the women with three rounds of the tetanus toxoid, although five jabs are required for lifelong protection.
The tetanus vaccine is among the oldest and is, therefore, well researched. It is one of the safest vaccines in the world and there is no documented evidence of its use as a family planning method. The Catholic Church, to which I subscribe, is entitled to its opinion, but I feel compelled to ask the following questions:
If it is a family planning method, why give it to pregnant women? And if the government is using it to reduce the population, why does the campaign target sparsely populated districts? Does the church have any documented cases of miscarriage or infertility among those who were vaccinated earlier in the year?
The Catholic Church is strongly rooted in the pro-life principle. Should it turn out that the results of the laboratory analysis for the presence of the hCG hormone were false positives, as one major laboratory has alluded, where will this leave the church?
Dr Othieno teaches agricultural information and communication management at the University of Nairobi. ([email protected]).
