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Pakistan is failing in maternal and neonatal tetanus elimination

Nature Medicine volume 30, page 615 (2024)Cite this article

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The recent World View article by Seth Berkley highlighted the urgent need to improve the vaccination status of children1. We concur with the author’s concerns, and are particularly worried about the low tetanus vaccination coverage in the remote and war-affected regions of the Federally Administered Tribal Areas in Pakistan.

In 1988, the World Health Assembly initiated a global campaign to eradicate neonatal tetanus2, a major cause of high neonatal mortality affecting 6–7 deaths per 1000 live births3. The World Health Organization’s Maternal and Neonatal Tetanus Elimination (MNTE) effort was relaunched in 1999 to target 59 countries with high tetanus prevalence. After three decades, 49 out of 59 high-risk countries have successfully achieved the eradication target of 1 case per 1000 live births in every district. Most have successfully eliminated neonatal tetanus, with zero incidence per 1000 live births (country-wide); Pakistan is the only South Asian country that has failed to achieve the target. The high country-wide incidence rate (0.1 cases per 1,000 live births) in Pakistan is due to low tetanus-toxoid-containing vaccine (TTCV2+) coverage4.

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References

  1. Berkley, S. Nat. Med. 29, 1596 (2023).

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Authors and Affiliations

  1. Medical Research Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Suliman Khan & Usman Ayub Awan

  2. Department of Medical Laboratory Technology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan

    Suliman Khan & Usman Ayub Awan

  3. Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA

    Xingyi Guo

  4. Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA

    Xingyi Guo

  5. Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Usman Ayub Awan

Authors
  1. Suliman Khan
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  2. Xingyi Guo
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  3. Usman Ayub Awan
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Corresponding authors

Correspondence to Suliman Khan or Usman Ayub Awan.

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The authors declare no competing interests.

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Khan, S., Guo, X. & Awan, U.A. Pakistan is failing in maternal and neonatal tetanus elimination. Nat Med 30, 615 (2024). https://doi.org/10.1038/s41591-023-02762-1

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  • DOI: https://doi.org/10.1038/s41591-023-02762-1

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