Uvulectomy as an epidemiological factor in neonatal tetanus mortality:- observations from a cluster survey.

A total of 2,623 live-births were recorded over a 12-month period during a cluster survey on Neonatal tetanus (NNT) mortality in Kano metropolis, Northern Nigeria. There were 79 neonatal deaths including 54 NNT deaths. NNT mortality was 20.6/1000 live-births. Although there was a male preponderance (55.6%) amongst NNT deaths, the association between sex and NNT death was not significant. Traditional Surgery was performed in over 80% of NNT deaths. The association between NNT death and traditional surgery was highly significant. Uvulectomy was the most frequently performed traditional surgery while circumcision was the least performed. There was also a highly significant association between uvulectomy and NNT death. Indeed, uvulectomy alone had a much stronger association with NNT death than traditional surgeries combined. There was no association between sex and performance of uvulectomy. It is reported that circumcision is not an important epidemiological factor in NNT mortality in this region. Health education is suggested to improve utilization of health facilities and discourage uvulectomy and other traditional surgeries.