Would save many lives in the developing world

Time and again tetanus has been described as a neglected disease.1 An estimated 8 million babies and 2 million children and adults may die from tetanus during the 1990s, mostly in developing countries--despite the World Health Organisation's call to eliminate the disease by this year. Vaccination to prevent post-abortal and maternal tetanus has been largely ignored. The primary aim of prevention programmes has been to eliminate neonatal tetanus2; the two commonest prevention programmes--immunisation of preschool children and of pregnant women--have omitted adolescent girls.

Fauveau and colleagues collected data on 1101 cases of maternal tetanus in developing countries published between 1958 and 1990: 27% were attributed to post abortal and 67% to post partum sepsis.3 One third of all cases described were from Nigeria, which has a high rate of induced abortion, many of them performed under septic conditions. In …