Neonatal tetanus in Casablanca

Neonatal tetanus (NT) remains common in developing countries. Its poor prognosis is characterized by a high mortality rate. Patients and methods – Our retrospective review concerned 50 cases of NT admitted to the intensive care and neonatology units in the Casablanca Children's Hospital between 1990 and 1999. The diagnosis was made on clinical signs and gravity was evaluated with the Dakar score. Results – NT accounts for 0.5% of cases admitted in our service. A low socio-economical level, and home delivery without asepsis were found in 90%. 80% of patients were of rural origin. A Dakar score ⩾4/6 was noted in 76%. Since 1994 therapeutic management has improved but with heavier costs and longer hospitalization. Nevertheless, the mortality rate reached 66%. Conclusion – Prevention based on vaccination, easier access to healthcare, or education of the population will help to solve this problem.