Myanmar achieves maternal and neonatal tetanus elimination
Yangon, 3 June 2010: - Myanmar has achieved maternal and neonatal tetanus elimination (MNTE). The country’s status was confirmed in May 2010 by international experts through a process led by the World Health Organization (WHO).
Myanmar is the second country in East Asia after Vietnam to reach the MNT Elimination status. This achievement followed Myanmar's systematic efforts for several years to reach all pregnant women with tetanus toxoid (TT) vaccines and making provisions for safe and clean deliveries throughout the country, as well as conducting extensive supplemental TT immunization activities with tremendous support from UNICEF since 1999 that targeted women of childbearing age.
“The achievement came as a result of joint efforts of all the partners collaborating with the Ministry of Health, who worked hard for many years to reach this stage,” said Ramesh Shrestha, UNICEF Representative in Myanmar. “But it is also a reminder that the momentum needs to be sustained and routine immunization must be further strengthened to ensure maintenance of the elimination status.”
The validation process included a community based survey of neonatal mortality rate due to tetanus in all children born from April 2009 to April 2010 in the townships selected for survey. The community-based survey used standard WHO methodology and was conducted in the townships of South Okalappa (Yangon Division), Singaing (Mandalay Division) and Saw (Magway Division). These townships were chosen for survey through an extensive review process that indicated they were likely to have the highest NT disease burden. On 18 May, the results of the survey revealed that neonatal tetanus (NT) mortality was reduced to less than 1 case per 1000 live births in the surveyed townships. The survey confirmed that MNT has been eliminated as a public health problem in those townships and therefore in townships that had a lower risk of MNT, as well as Myanmar as a whole.
Neonatal tetanus is a form of generalized tetanus affecting infants during the first month of their life and is estimated to cause approximately 59,000 deaths per year worldwide. Maternal tetanus (MT) has a similar nature and affects women during pregnancy and, more often, following unclean deliveries and abortions. Since both share the same risk factors and means of prevention (such as adequate TT immunization and clean delivery practices), NT elimination acts as proxy for MT elimination.
From 1999 to 2006, 6.7 million women of child-bearing age in Myanmar were targeted and more than 80 per cent were protected with two doses of TT. In 2007, review of relevant health indicators led to the identification of 60 and 27 townships respectively for receiving one and three rounds of intensified TT immunization activities for about 3 million women of child bearing age. In 2008 and 2009, the targeted areas were further narrowed down and corrective supplementary immunization was administered in 7 townships. The final one million eligible women were reached by additional mass TT campaigns.
While the validation of MNT elimination status by WHO experts is an important milestone, the partners will now need to make sure that this status is maintained. The Ministry of Health has already developed plans to sustain the elimination status by maintaining high protection levels against tetanus in mothers and newborns and controlling chances of contracting tetanus during and after delivery and birth.
Despite the progress made since the late 1980s, MNT continues to be a public health problem in many developing countries and can account for a considerable proportion of maternal and neonatal deaths in sub-national areas at high risk. Since 2000, 18 countries have eliminated MNT. Following Myanmar’s achievement of MNTE status, current efforts now focus on the remaining 40 countries.
For more information, please contact:
Sandar Linn, Communication Offficer, UNICEF Myanmar,