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

Tetanus in a rural setting of south-western Nigeria: a ten-year retrospective study

ABSTRACT: We review the records of 79 tetanus patients in two hospitals (one tertiary and one secondary level) in Owo, Ondo state, Nigeria from 1997 to 2006. The male: female ratio was 3:1. Ages were 14-70 years (mean 33.25 years, SD ±16.76). The overall case fatality rate (CFR), 32.91%, did was not significantly different in the two hospitals. CFR for men was 32.10% and for women 35.29%. The main factor indicative of bad prognosis was a short hospitalization period. It was observed that 30.38% of our patients were discharged against medical advice (DAMA), that financial constraint was the underlying problem in 50% of cases, and that the trend of DAMA occurred at the two study sites. This DAMA phenomenon could pose a great danger to the eradication of this vaccine preventable disease in rural areas

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

Experience with Tetanus in a Tertiary Hospital in South East Nigeria

Background: Tetanus has for long been an avoidable source of morbidity and mortality particularly in developing countries. The aim of this study was to review the experience with managing tetanus in a regional tertiary hospital in Nigeria. Methods: A retrospective study of patients who were admitted with a clinical diagnosis of tetanus between January 1999 and December 2003 was done. Relevant data were extracted from the patients' case records. Results: A total of 12 patients were identified within the time frame with a diagnosis of tetanus. There were more male than female patients (ratio 1.4:1) with city dwellers constituting a small majority. The mean age of the patients was 29.8 years. Lower limb injuries accounted for the portal of entry in 75of cases while one case followed a practice of oral sex. All patients were managed in the general ward and no mortality was recorded despite the presence of dysautonomia in some patients. Conclusion: Despite the high rate of morbidity and mortality associated with tetanus in developing countries and despite some regional differences in presentation; careful clinical management even in resource poor countries can result in very good outcomes

Facteurs determinants [sic] la morbidite et la mortalite dues au tetanos neonatal : a propos de 43 cas observes a l'hopital Sendwe (Zaire)

Dans une etude portant sur 43 cas de tetanos neonatal; les auteurs analysent les facteurs intervenant dans la mortalite et la morbidite dues au tetanos neonatal. Ces facteurs sont notamment une absence de vaccination de la mere; un environnement insalubre; un accouchement a domicile; un traitement septique du cordon ombilical; une situation materielle deplorable et l'apparition des premieres crises dans la premiere semaine de vie

Est-ce bien le tetanos qui fait mourir le nouveau-ne?

Il s'agit d'un theme qui est assez peu aborde par les anthropologues; celui d'un mal qui tue le nouveau-ne; que les medecins nomment tetanos et qui est designe de diverses manieres dans les cultures africaines. Il s'agit cependant d'un exemple de probleme de sante; a propos duquel les certitudes du medecin sont tres fortes (il sait comment faire pour eviter le tetanos); les constats de l'epidemiologue sont clairs ; mais ou par contre les representations et les pratiques sociales existantes sont mal connues; suscitant parfois de simples reactions d'ignorance ou de rejet

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

Le tetanos chez l'enfant : aspects epidemiologique; clinique et therapeutique : a propos de 784 cas

Toxi-infection tres meurtriere; le tetanos demeure une calamite chez l'enfant dans les pays en voie de developpement. A partir de 784 cas observes sur 10 ans a la clinique de pediatrie de Cotonou; les auteurs font le point sur l'epidemiologie; les aspects cliniques et therapeutiques du tetanos. La frequence est de 2;36 pour cent des hospitalisations. Le tetanos atteint surtout les nouveau-nes et les enfants de 5 a 10 ans provenant des milieux socio-economiques defavorises. A defaut de l'arsenal therapeutique moderne rencontre dans les pays developpes la seule solution pour les pays en developpement pour reduire l'incidence du tetanos est la vaccination. Ceci explique la baisse reguliere de la prevalence du tetanos depuis l'institution du programme elargi de vaccination

Hospital-based study on neonatal tetanus; Buluba Hospital; 1985-1989

Neonatal tetanus is a major cause of morbidity and mortality among neonates in Uganda. A retrospective study has been made of 228 cases of neonatal tetanus seen in Buluba Hospital over the 5-year period of 1985-1989. The number of cases of neonatal tetanus admitted per year to the hospital did not decrease significantly during that period suggesting that the immunization programme aimed at immunization of pregnant women with tetanus toxoid has not had a clear impact. Over 40pc of neonatal tetanus cases came from the two nearest subcounties: Waina and Imanyiro. Over 75pc of admitted cases of neonatal tetanus accounted for 23pc of all deaths among child admissions. More than 90pc of neonatal tetanus cases showed the first symptoms of the illness within the first 14 days of life; the shortest incubation period was 2 days. The average age at onset was 5.6 days and the average age at death was 9.9 days. The need for a more effective immunization programme and more intensified activities to increase the proportion of deliveries attended by trained personnel and improve hygienic conditions during and after deliveries is emphasized