{"tags": [{"id": 12, "search": null, "name": "vaccines", "code": ""}], "categories": [{"hasContent": true, "id": 25, "search": null, "name": "Immunity and Immunization", "code": "280"}], "versions": [{"publisher": {"id": 19, "search": null, "name": "Unit of Vaccines and immunization services, Ministry of Health", "contact": ""}, "authors": [{"id": 29, "search": null, "name": "Unit of Vaccines and immunization services, Ministry of Health", "contact": ""}], "collaborators": [{"id": 30, "search": null, "name": "UNICEF", "contact": ""}, {"id": 9, "search": null, "name": "WHO", "contact": ""}], "fileUrl": "media/5TT_SHEDULE.pdf", "id": 23, "search": null, "name": " 5-T.T. Schedule Handbook for health care providers", "description": "", "edition": "Second", "state": "CURRENT", "upload": "./5TT_SHEDULE.pdf", "datePublished": "2013-05-01"}], "relatedGuidelines": [{"summary": "The brief provides a summary of issues at hand, the current trends in immunization coverage and its Financing", "id": 473, "categories": [23], "name": "NHA POLICY BRIEF VACCINE FINANCING "}, {"summary": "This training guide is intended to equip health managers and service providers at all levels with sufficient information for smooth integration of the new PCV10 vaccine into the routine infant immunization schedule. This training guide will first be used during the training sessions for the introduction of the PCV10 vaccine but will subsequently serve as a reference point for all health workers and managers involved in providing immunization services. It contains general information on best practices of managing immunization services and specific information for the handling of PCV10.", "id": 75, "categories": [25], "name": "Introduction of Pneumococcal Conjugate Vaccine (PCV10) in Kenya"}, {"summary": "This training guide has been developed primarily for health workers involved in immunization services delivery in Kenya to prepare them for the introduction of the Rotavirus vaccine that will be introduced into the national infant immunization schedule from July 2014. \r\nIt is intended to equip health workers at all levels with sufficient information to ensure smooth integration of the new Rotavirus vaccine into the routine infant immunization schedule.\r\n", "id": 26, "categories": [25, 13], "name": "Introduction of Rotavirus Vaccine into routine Immunization in Kenya: A guide for health workers"}, {"summary": "A  guide for health workers to address key technical issues concerning the introduction of the second dose. It is meant to empower the health workers with knowledge and skills to adequately respond to questions or concerns that the guardians may raise regarding the vaccine\r\n", "id": 25, "categories": [25], "name": "Measles vaccine second dose introduction in routine immunization: A guide for healthcare workers"}, {"summary": "These National policy guidelines for immunization seek to comprehensively guide health workers on vaccination priorities and acceptable practices for the overall good of all Kenyans. \r\n\r\nIt summarizes immunological and epidemiological information on target vaccine preventable diseases of public health importance in Kenya (including those in the EPI schedule) and presents recommendations on priority vaccines for Kenya, including vaccination schedules. In addition, it provides technical reference and guidelines for health workers who are involved in managing and monitoring immunization service delivery at all levels of the health care system.", "id": 78, "categories": [25], "name": "National Policy Guidelines of Immunization 2013"}], "lastUpdated": "", "id": 23, "search": null, "name": " 5-T.T. Schedule Handbook for health care providers", "summary": " A guideline to harmonize the practice of tetanus toxoid vaccine administration through out the country among health care workers. It is intended to show how five appropriately spaced doses of tetanus toxoid vaccine can be used to provide up to 20 years of protection", "description": "Tetanus is a  known to affect all age groups and both sexes. In Kiswahili it is known as \u201cpepo-punda\u201d and is also named in many of the Kenyan languages. Tetanus is caused by an anaerobic spore-forming bacterium known as Clostridium tetani.\r\nInfection occurs when tetanus spores enter the body through a contaminated wound. The spores germinate inside the body and release a powerful toxin. This toxin enters the blood stream and attacks the nervous system, irritating the motor neurons. The irritated nerves become hypersensitive and react to any stimulus with strong contractions of all skeletal muscles. \r\n\r\nTetanus can appear anytime from 3 days to 3 weeks after exposure to the bacteria. These periodic strong muscular contractions or spasms throw the body into an arch described as \u201cophisthotonus\u201d. The facial muscle contractions pull the cheek muscles outwards giving the impression of a grimace or \u201crisus sardonicus\u201d. Both these features are the hallmark of tetanus disease. Muscular spasms are provoked by a variety of stimulus such as bright or flickering light, sudden loud noise, simple touch etc.\r\nTreatment for tetanus is mainly supportive I.e. isolation of the patient to a quiet stress free environment, minimizing the number of visitors, sedating the patient, and providing naso-gastric or parenteral feeding. However where possible, surgical toileting of the wound should be done together with the administration of suitable antibiotics & antisera to reduce the bacterial and toxin load. \r\n\r\nSevere cases may require I.C.U facilities especially where the spasms are so frequent or severe that they affect respiration. With all this hospital management recovery from tetanus can still take about two weeks and mortality is about 40% in\r\nKenya. Maternal or neo-natal tetanus occur at the time of delivery if the perineum or cord are cut with contaminated instruments or treated with contaminated material. Neo-natal tetanus usually sets in between the third to the fifth day after birth. Characteristically the baby is described to have been fine after delivery but suddenly stopped breastfeeding about two days later. This is followed by progressive lethargy, convulsions and death by the fifth to seventh day. Neo-natal tetanus mortality is 100% in the absence of I.C.U facilities. This is because the spasms are so exhausting to the neo-nate that it literally gives up breathing\u2014therefore assisted respiration is vital for survival. Again the child is unable to accept any feeds because of the mouth spasms and therefore needs specialized feeding.\r\n\r\nPrevention of tetanus is through the administration of a series of well spaced doses of the tetanus toxoid vaccine. Each dose from the second onward confers an increasing duration of immunity. \r\n\r\n", "guidelineType": "CLINICAL", "datePublished": "2013-05-01"}