Sensitivity of neonatal tetanus surveillance system in India.

OBJECTIVE To estimate the sensitivity of neonatal tetanus (NNT) surveillance in India. DESIGN A comparison of two sets of data obtained from NNT mortality surveys and routine surveillance system. METHODS NNT mortality surveys were undertaken in 1981, 1989 and 1992 using 30 cluster sampling technique. The data on reported incidence of NNT through routine surveillance system was taken from the published documents of Health Ministry and WHO. RESULTS In 1981, the incidence of disease in a national survey was estimated to be 4 and 16.4 per 1000 live births in urban and rural areas, respectively. Follow up surveys in 1989 and 1992 estimated the overall incidence as 4 and 1.74 per 1000 live births, respectively. Comparing the reported and estimated by surveys, around 10% of NNT cases were reported. CONCLUSIONS There is an urgent need to strengthen the routine surveillance system which at present grossly under-reports the NNT incidence in India.