{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T02:57:11Z","timestamp":1774666631706,"version":"3.50.1"},"reference-count":18,"publisher":"American Public Health Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1992,10]]},"abstract":"<jats:p> OBJECTIVES. Tetanus continues to be a leading cause of neonatal death in Bangladesh as in other developing countries, yet little is known about risk factors or the efficacy of tetanus toxoid in this setting. METHODS. In May 1990, mothers of 6148 infants born alive between March 15, 1989, and March 14, 1990, in 30 rural unions of Rajshahi Division in Bangladesh were interviewed. Three surviving controls for each neonatal tetanus death were matched for sex, residence, and date of birth. RESULTS. Of 330 neonatal deaths, 112 met the case definition for tetanus. Risk was increased with a history of neonatal tetanus in a previous child, application of coconut oil to the vagina, and use of multiple ties on the umbilical cord. Risk was reduced by the birth attendant washing hands and using a cleaned cord-cutting tool. Risk was not reduced by a maternal history of two doses of tetanus toxoid (TT2), although estimated efficacy of TT2 was 45% (95% confidence interval = 16% to 64%). Subsequent to the survey, a reference laboratory reported to potency in three consecutive lots of tetanus vaccine from the production laboratory in Bangladesh. CONCLUSIONS. These findings identify high-risk mothers, stress the importance of washing hands and cleaning the cord-cutting tool, and demand improved quality control of tetanus vaccine production. <\/jats:p>","DOI":"10.2105\/ajph.82.10.1365","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:17:08Z","timestamp":1227964628000},"page":"1365-1369","source":"Crossref","is-referenced-by-count":36,"title":["Neonatal tetanus in rural Bangladesh: risk factors and toxoid efficacy."],"prefix":"10.2105","volume":"82","author":[{"given":"W G","family":"Hlady","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J V","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A R","family":"Samadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Begum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Hafez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A I","family":"Tarafdar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J R","family":"Boring","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"p_1","unstructured":"Gasse F. Neonatal tetanus elimination initiative: progress report and recommendations. Geneva, Switzerland: World Health Organization; 1990. WHO Document EPIV MCH\/NNT\/GEN\/90.1."},{"key":"p_2","first-page":"46","volume":"1","author":"Traverso HP","year":"1989","journal-title":"Lancet."},{"key":"p_3","unstructured":"1989 Statistical Yea,bo of Bangladesh. Dhaka, Bangladesh: Bangladesh Bureau of Statistics; 1989."},{"key":"p_4","unstructured":"Galazka A, Stroh G. Neonatal tetanus guidelines on the community-based survey on neonatal tetanus mortality. Geneva, Switzerland: World Health Organization; 1986. WHO Document EPI\/ GEN\/86\/8."},{"key":"p_5","unstructured":"Dean AD, Dean JA, Burton AH, Dicker RC. Epi Info, Version S:A Wont Processun& Database and Statisics Progran for Epidem ogy on M zcoconputes. Stone Mountain, Ga: USD, Inc, 1990."},{"key":"p_6","doi-asserted-by":"crossref","unstructured":"Robins JM, Greenland S, Breslow NE. A general estimator for the variance of the Mantel-Haenszel odds ratio. Am J EpidemioL 1986;124:719-723.","DOI":"10.1093\/oxfordjournals.aje.a114447"},{"key":"p_7","unstructured":"EGRET Manual Addend, Revso 1. Seattle, Wash: Statistics and Epidemiology Research Corporation; 1990."},{"key":"p_8","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/6.5.589"},{"key":"p_9","unstructured":"Lemeshow S, Strob G. Sampling Technius for Evalating Health Pammeters inDevelopingCotiies. Washington, DC: National Academy Press; 1988:11. Monograph."},{"key":"p_10","unstructured":"Chwwdhury MK, Karim MR, Mostafa G, Sarder AM, D'Sousa S. Dem 1gphic Surveiknce System-Matab. Vol 11. Dhaka, Bangladeh: International Centre for Diarrhoeal Dse Research; 1983. B Scientific Report No. 59."},{"key":"p_11","first-page":"177","volume":"3","author":"Jaffari SMH","year":"1966","journal-title":"Indian Pediatr."},{"key":"p_12","doi-asserted-by":"publisher","DOI":"10.1007\/BF02829205"},{"key":"p_13","unstructured":"Laha PN, Vaishya PD. A study of the incidence of 1000 cases of tetanus in Gwalior and its neighboring districts. JIndian Med Assoc. 1965;44:422436."},{"key":"p_14","doi-asserted-by":"publisher","DOI":"10.2307\/1966568"},{"key":"p_15","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/28.6.299"},{"key":"p_16","doi-asserted-by":"crossref","unstructured":"Chen LC, Rahman M, Sarder AM. Epidemiology and causes of death in a rural area Of B adesh. IntJEpdeL 1980,9:25-33.","DOI":"10.1093\/ije\/9.1.25"},{"key":"p_17","doi-asserted-by":"crossref","unstructured":"Kalter HD, Gray RH, Black RE, Gultiano SA. Validation of post mortem interviews to ascertain selected causes of death in children. Int JEpidemioL 1990,19:380-386.","DOI":"10.1093\/ije\/19.2.380"},{"key":"p_18","unstructured":"Basu RN. Neonatal tetanus in Bangladesh. In Touch (Voluntary Health Services Society newsletter, Dhaka, Bangladesh). 1989;13:3-5."}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.82.10.1365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T19:48:32Z","timestamp":1652125712000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.82.10.1365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,10]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[1992,10]]}},"alternative-id":["10.2105\/AJPH.82.10.1365"],"URL":"https:\/\/doi.org\/10.2105\/ajph.82.10.1365","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,10]]}}}