A 6-year review of post-neonatal tetanus at Usmanu Danfodiyo University Teaching Hospital, Sokoto

Background: Tetanus is a vaccine-preventable disease but its incidence has remained unacceptably high in developing countries. Objective: To determine the prevalence, risk factors and outcome of post-neonatal tetanus at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Methods: A retrospective descriptive study from 1st January 2010 to 31st December 2015. Children aged 1 month to 15 years diagnosed with post-neonatal tetanus were studied. Information from the admission files was extracted. Data was analysed using SPSS version 20. Results: Total admissions during the study period were 14,458; 61 had post-neonatal tetanus, giving a prevalence of 0.4%. The M: F ratio was 1.5:1. The mean age was 7.4±3.2 years. Fifty-nine (96.7%) were not immunised against tetanus. Portal of entry for the organism was trauma injuries to the foot in 33(54.1%). Thirty-one (50.8%) were discharged, 5(8.2%) DAMA, while 25(41.0%) died, and case fatality was 41.0%. Conclusion: Post-neonatal tetanus is a major cause of morbidity and mortality in Sokoto. There is need for improved health education, sustainability of immunisation programmes and coverage to eradicate this scourge

A 10-year review of outcome of management of tetanus in adults at a Nigerian Tertiary Hospital

Background : Tetanus remains one of the major public health hazards of the developing world. Previous studies in Nigeria indicate that mortality ranged from 26to 60. Mortality is much lower in the developed world because of the availability of facilities for intensive care of cases; unlike in most developing countries. Aim : To report our experience with the management of adult tetanus at the University of Port Harcourt Teaching Hospital over the past 10 years (1996-2005). Methods : Data of all patients aged 16 years and above managed for tetanus in the medical wards between January 1996 and December 2005 were retrieved from their case records and analyzed. Results : Eighty-six patients were managed for tetanus (50 males and 36 females); constituting about 1of all medical admissions over the 10-year period. Students; civil servants and commercial motorcyclists formed the major groups at risk. The commonest portal of entry was lower limb injuries (54). Case fatality rate (CFR) was 42.9; with a statistically significant higher CFR found among patients above 40 years of age (P= .000); patients with incubation period shorter than 7 days (P= .04); those with a shorter duration of hospitalization (P= .000) and those administered higher average daily diazepam doses (P= .044). Complications such as aspiration pneumonitis; laryngospasm and respiratory failure were major causes of mortality. Conclusion : Case fatality rate of tetanus has remained consistently high at our center. Factors that were significantly associated with high mortality included older age; age above 40 years ; incubation period of less than 7 days and higher degree of sedation with diazepam. It is recommended that preventive immunization against tetanus be given to all Nigerians with secondary vaccination at adulthood

Les manifestations cliniques du tetanos

Le tetanos est une affection grave car responsable d'une mortalite estimee a 25 pour cent dans le meilleur des cas. Chaque annee une centaine de cas de tetanos sont hospitalises dans le service des maladies infectieuses du CHU de Treichville qui recoit les adultes et les grands enfants avec un taux de letalite de 31 pour cent. Il se manifeste sous la forme de contractures avec plusieurs caracteristiques