Tétanos de l'enfant au Centre Hospitalier Universitaire Mère­Enfant de Libreville, Gabon / Child tetanus at the Mother and Child University Hospital Center, Libreville, Gabon

L'objectif de cette étude était de déterminer les aspects épidémiologique, clinique, thérapeutique et évolutif du tétanos de l'enfant au service de réanimation du Centre Hospitalier Universitaire Mère-Enfant de Libreville, au Gabon. Méthodes : Etude rétrospective de type descriptif menée du 1er janvier 2019 au 31 décembre 2022. Les dossiers des enfants âgés de 0 à 16 ans, admis en réanimation pour tétanos, ont constitué la base des données. Les variables étudiées étaient épidémiologiques, cliniques, thérapeutiques et évolutives. Résultats : Parmi les 561 enfants hospitalisés en réanimation durant la période, il y'avait 12 cas de tétanos, soit une prévalence de 2,1%. Le sexe ratio était de 2. Les enfants âgés de 10 ans et plus représentaient la moitié de l'effectif (n=6). La porte d'entrée la plus retrouvée était une plaie du pied soit 50%, suivie d'une plaie céphalique dans 25% des cas. Tous les enfants avaient un état vaccinal incorrect, un trismus et des troubles d'alimentation. Le score pronostique de Dakar était à 2 chez six enfants (50%) et de 3 chez les 6 autres. Les molécules les plus utilisées étaient le Midazolam (92%), le Métronidazole (100%), le sérum et vaccin antitétanique (100%). Cinq patients (42%) ont bénéficié d'une ventilation assistée. La durée moyenne de séjour était de 13,6 jours ±9,9 et la létalité de 42%. Conclusion : le tétanos prédomine chez le grand enfant n'ayant pas de couverture vaccinale. Des mesures de sensibilisation des populations sur la vaccination antitétanique sont indispensables pour baisser la létalité.

Morbidity and mortality of tetanus at Kenyatta National Hospital: a ten-year case audit

Introduction: Tetanus is a major health problem in developing countries, and is associated with high a morbidity and mortality. There are no recent local data in Kenya on the impact of the disease in terms of morbidity and mortality. The objective of this study was to describe the type, severity, risk factors, immunization history and outcome of tetanus patients at Kenyatta National Hospital (KNH). Method: This was a retrospective descriptive study of patients with a clinical diagnosis of tetanus admitted to KNH over ten years, who were aged 13 years and above. All available files with tetanus diagnosis were selected, and the patients' data were retrieved and analysed using SPSS Software version 21.0. Results: Out of 53 patients with tetanus, 50 (94.3%) were males and 3 (5.7%) were females. The mean age at presentation was 33.2 years (SD= 15.6). Only 4 (7.5%) patients had prior tetanus immunization. The commonest risk factor was acute injury - seen in 37 (69.8%) patients. The common site of injury was the lower limb - seen in 26 (49.1%) patients. The incubation period ranged from 3 to 90 days (IQR 7-17). Generalized tetanus was the commonest form found in 50 (94.3%) patients. Only 16 (30.2%) patients were managed in the Intensive Care Unit (ICU). The overall mortality was 49.1%. Conclusion: Tetanus mortality is still high as reported in many other studies. Most patients were males without prior immunization history. Only few patients were managed in Intensive Care Unit. We recommend advocacy on tetanus immunization and booster dosing

Incidence et facteurs de risque du tétanos néonatal en milieu rural centrafricain

Objectif : Décrire le profil épidémiologique et clinique du tétanos néonatal et identifier les facteurs de risque.Méthodologie : Il s'agissait d'une étude cas-témoins portant sur les nouveau-nés atteints du tétanos ou non (témoins), réalisée entre 2012 et 2017 à l'hôpital de district de Carnot. Un questionnaire a permis de collecter les données sociodémographiques et cliniques qui ont été saisies et analysées sur Epi info. Le test de chi-carré a servi à comparer les proportions au seuil de significativité 5%.Résultats : Au total,332 nouveau-nés ont été inclus dont 166 cas de TN et 166 témoins. L'âge moyen était de 7,8 ±3,6jours. L'incidence du TN était de 2,7 à 5,2 cas pour 1000 naissances vivantes. La fréquence hospitalière était de 7,5% et celle du tétanos de classe 3 selon le score de Dakar a été de 62,4%, le taux de létalité de 54%. Les facteurs de risque de TN étaient: le sexe masculin (p=0,00), le bas niveau d'instruction des mères (p=0,001),l'éloignement de l'hôpital (p=0,000), la primiparité (p=0,000), un faible nombre de consultations prénatales (p=0,000)et de doses de vaccin antitétanique (p=0,000), l'accouchement à domicile (p=0,000), l'accouchement par un personnel non qualifié (p=0,000),la section septique du cordon ombilical (p=0,000), l'absence de pansement du cordon (p=0,000) et un pansement septique (p=0,024).Conclusion : En Centrafrique, l'incidence du tétanos néonatal reste élevée et les facteurs de risque multiples. Des mesures efficaces de promotion de la santé peuvent contribuer à l'élimination de cette maladie

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

La morbimortalité du tétanos à l'hôpital Sominé Dolo de Mopti

Introduction. Le tétanos est un problème de santé publique. La létalité qui lui est associée est très élevée. L'objectif de ce travail était de décrire les aspects cliniques, thérapeutiques et évolutifs du tétanos chez l'adulte. Méthodes. Il s'agissait d'une étude rétrospective des cas de tétanos à l'hôpital Sominé Dolo de Mopti. Les données ont été collectées à partir des dossiers des malades et portaient sur le nom, le sexe, l'âge, la profession, la provenance, le statut vaccinal, la porte d'entrée. Le score de Dakar a été utilisé pour évaluer le pronostic des patients. Résultats. Nous avons colligé 11 cas dont un tétanos obstétrical. La prévalence hospitalière était de 1,03% ; l'âge moyen de 41ans avec des extrêmes de 21 et 70 ans. La tranche d'âge de 20 - 30 ans était la plus affectée avec 36,36%. Aucun des patients n'avait été antérieurement vacciné contre le tétanos. La durée moyenne d'hospitalisation a été de 11,36 jours. Tous les patients ont présenté le trismus, dans plus de 50% des cas, la fièvre était associée aux paroxysmes. Nous rapportons un taux de létalité de 54,54% dont 83,33% sont survenus dans les quatre jours qui ont suivi l'hospitalisation. Le délai moyen de survenu du décès était de 4 jours. Conclusion. Le tétanos continue d'être une menace à l'atteinte de l'objectif de la couverture sanitaire universelle. Des efforts de sensibilisation et des programmes de vaccination plus inclusifs devraient permettre d'en réduire la morbimortalité

Aspects épidémiologiques, cliniques et évolutifs du tétanos au CHR de Maradi au Niger

Introduction : Le tétanos est caractérisé par un tableau clinique fait des spasmes musculaires sévères faisant suite à des blessures. La bactérie en cause, Clostridium tétani, a été découverte en 1884 et mise en culture pour la première fois en 1889. C'est une maladie totalement évitable et d'ailleurs quasiment éliminée des pays développés grâce à la vaccination généralisée et à une rigoureuse prophylaxie post-exposition, toutes deux parfaitement codifiées. Objectif : Cette étude rétrospective avait pour but de décrire les aspects épidémiologiques, cliniques et évolutifs du tétanos au CHR de Maradi au Niger. Matériel et méthodes : Les dossiers de malades hospitalisés au service des maladies contagieuses du CHR de janvier 2011 à aout 2018 ont été évalués. Résultats : Nous avions colligé 49 cas de tétanos sur un total de 2930 malades hospitalisés dans le service soit un taux de prévalence de 1,67 %; 32,65 % des patients étaient âgés de 0 à 15 ans. La porte d'entrée tégumentaire a été la plus fréquemment retrouvée (vingt huit cas). D'autres portes d'entrée ont été notées : fracture ouverte (5 cas), injection intramusculaire (1 cas), ombilicale (2 cas), brulure corporelle (2cas). 57,14% des malades étaient au stade II de la classification de Mollaret. On a enregistré 19 décès sous traitement, soit un taux de létalité de 38,78 %. Le stade clinique des patients à l'admission a été associé au décès avec une P = 0,0030.Conclusion: La sensibilisation des populations, le renforcement du programme élargi de vaccination et l'amélioration de la prise en charge des malades devraient permettre de réduire encore davantage la mortalité liée au tétanos

Placental malaria and neonatal anti-tetanus antibody status: any association?

Background. Neonatal tetanus(NT) has remained an important cause of neonatal morbidity and mortality in the tropics where high prevalence of placental malaria coexists. The current strategy for the control of NT involves stimulating production of protective level of anti-tetanus antibody in the mother, through tetanus toxoid immunization, and transferring same through the placental to the foetus. Placental malaria is known to alter the morphology and functions of the placenta, but the effect on transfer of anti-tetanus antibody specifically, remains unsettled. We studied the influence of placental malaria on transplacental transfer of anti-tetanus antibodies among mother-infant pairs at the University of Maiduguri Teaching Hospital North-Eastern Nigeria.Method. Maternal and cord blood samples were collected from 162 mother-baby pair and analysed for anti-tetanus antibody levels using ELISA. Placental biopsy was also taken from each mother-baby pair and placental malaria diagnosed histologically.Results. One hundred and sixteen (71.6%) of the 162 mother-infant pairs were positive for placental malaria out of which 59(50.9%) had chronic-active, 44 (37.9%) acute and 13 (11.2%) had past placental malaria. Forty-one (25.3%) babies were classified as seronegative for tetanus antibodies of whom 32 were delivered to mothers who were positive for placental malaria. Fifty-six (34.5%) mother-infant pairs had poor placental transfer for tetanus antibodies as signified by cord-maternal ratio of < 1.0 antibodies, out of these, 40 (24.7%) were positive for placental malaria. There was statistically significant association between type of placental malaria and serostatus (p = 0.0009) and efficiency of placental transfer (p = 0.0340). Mothers with chronic-active malaria were 7.4 times more likely to deliver a seronegative infant compared to mothers with acute malaria (p = 0.0002, OR =7.353, 95% CI = 2.327 -23.25). Similarly, maternal-infant pair with chronic-active malaria were 2.9 times more likely to have inefficient placental transfer (p = 0.0221, OR = 2.859, 95% CI = 1.200 ­ 6,859).Conclusion. Placental malaria has remained a very common medical condition in Maiduguri among pregnant women and may partly account for the high level of neonatal tetanus prevalent in the area

Strategies to increase immunization coverage of tetanus vaccine among women in Sub Saharan Africa: a systematic review

World Health Organization (WHO) estimated in 2013 that 49,000 deaths all over the world were caused by neonatal tetanus. Only as recently as the year 2000, neonatal tetanus was a public health problem in 59 countries, but since then it has been eliminated in 36 of the countries concerned. The objective of this piece of work, therefore, was to investigate which strategies intended to increase demand for vaccination are effective in increasing anti-tetanus vaccination coverage of women in Sub Saharan Africa. We searched the following electronic databases from January 1989 to July 2016: Medline, EMBASE (Excerpta Medica Database), The Cochrane Library, Google Scholar, CINAHL (Cumulative Index to Nursing and Allied Health Literature), WHOLIS (World Health Organization Library Database), LILACS (Latin American and Caribbean Literature on Health Sciences) and contacted experts in the field. There were no restrictions to language or publication status. All study designs that could provide the information we sought were eligible, provided the studies were conducted in sub-Saharan Africa. Critical appraisal of all identified citations was done independently by two authors to establish the possible relevance of the articles for inclusion in the review. Our search strategy yielded 191 records and after assessment for eligibility, 6 papers met the criteria for inclusion. In Ivory Coast, after reorganization, health workers said they were satisfied with the work environment and the care provided in 91% and 96% of cases, respectively. In Kenya, the main factors contributing to having sufficiently immunized part of the population against tetanus are lower birth order, higher household wealth index, women's employment, making joint health-related decisions with a partner, and higher number of antenatal care visits. Particularly in Ethiopia, compared with other member countries, the size of the unimmunized population, reporting quality, fragileness of the health system, , resource limitation, and others deserve further concerted attention. In Nigeria, the prevalence of missed opportunities was 66%. The factors responsible for missed opportunities were; poor history taking, lack of knowledge of the current immunization schedule, dependence on physician referral for immunization and inefficient immunization records keeping system. In Nigeria, socio-logistic variables found to be important in Expanded Programme on Immunization implementations included scheduling, health staff attitude, intersectoral collaboration, and health education. Lack of community participation was also found to be a crucial constraining factor. There are many challenges to increase immunization coverage of tetanus vaccine for women. So far very few interventions addressing these challenges have been evaluated scientifically. Community mobilization interventions to change or impact beliefs and attitudes of women are absolutely needed. Additionally, improving accessibility, affordability, availability and accommodation of vaccination service venues will make them more attractive

Progress towards the Elimination of Maternal and Neonatal Tetanus

Over the last 25 years impressive progress has been made on the elimination of maternal and neonatal tetanus worldwide including in the African Region. In 1999 a global initiative was launched to eliminate it completely with a global target date of 2015. This article looks at the progress made across the African Region and the challenges remaining and strategies being implemented for those countries yet to achieve the goal

Tetanus nearly Eliminated after 40 Years of Vaccination in Rural Sengerema District; Tanzania

Objective: To study the incidence of tetanus during the last 50 years in Sengerema; Tanzania. Design: Analysing the annual reports in the only district hospital; focusing on the number of admissions and mortality for tetanus and malaria. Setting: Sengerema Hospital; Sengerema district; Tanzania. Subject: Number of admissions and mortality in Sengerema Hospital due to tetanus. Interventions: In the seventies and eighties a vaccination campaign was started end organised in order to cover the whole district and to provide immunity for tetanus. Main outcome measures: From 1962 to 2012; we analysed the incidence and fatality rate of tetanus. Result: One hundred and fifteen admissions in the sixties; increasing to 183 in the seventies; dropping to 30 in the nineties. For the last ten years 18 patients with tetanus were seen in the only district hospital. Then last year no admissions for tetanus were registered. The number of deaths due to tetanus decreased simultaneously; during the last decade a single fatality case was reported. Conclusion: During the last decades; we have witnessed the disappearing of tetanus in Sengerema Hospital. The incidence of tetanus can be reduced significantly or eliminated by an effective immunisation programme; even in rural Tanzania

Le tetanos chez le grand enfant dans un hopital pediatrique a Yaounde; Cameroun

Le tetanos est evitable par la vaccination; mais peut survenir en cas d'une immunisation incomplete. Nous avons mene une etude sur les dossiers medicaux des enfants admis pour tetanos entre 2008-2009 au Centre Mere et Enfant de la Fondation Chantal BIYA a Yaounde. Le but etait d'analyser les circonstances de survenue et les manifestations cliniques du tetanos chez le grand enfant; afin de proposer des strategies de prevention adaptees au contexte camerounais. Le statut vaccinal etait inconnu chez un patient; les autres (80) n'avaient pas recu de rappel vaccinal. Les portes d'entree etaient les plaies aux membres; l'une etait secondaire a une injection medicamenteuse. Tous ont presente le tetanos generalise. Le deces etait survenu chez un patient. Le tetanos n'est pas rare chez le grand enfant au Cameroun. Il se degage ainsi la problematique des rappels vaccinaux

Trends in Neonatal and Post-Neonatal Tetanus Admissions at a Nigerian Teaching Hospital

Introduction: Tetanus accounts for high morbidity and case fatality rates in developing countries. This study therefore aimed to identify reasons for the persistence of this disease. Methodology: Paediatric admissions at Ladoke Akintola University Teaching Hospital between 1 January 2006 and 31 December 2008 diagnosed with tetanus were studied. Data was analyzed with SPSS 18 and statistical significance was set at p 0.05. Results: Of the total 1;681 paediatric admissions; 30 (1.8) had tetanus. Of the 878 neonatal admissions; 8 (0.9) had tetanus; while 22 (2.7) of the total 803 post-neonatal admissions had tetanus. Neonatal tetanus admissions were significantly higher in 2006 compared to 2007 and 2008 (7 [2.3] versus 1 [0.2] [?2

Tetanus - a Review of Current Concepts in Management

Tetanus is a vaccine preventable disease that yearly causes a total of 309;000 deaths. Reports showed up to 1 million cases annually; mostly in underdeveloped countries. Clostridium tetani; the causative organism; is widespread in the faeces of domestic animals and humans; while spores of C. tetani are abundant in soil and in the environment surrounding the habitation of humans and animals. In developing countries; mortality rates are as high as 28 per 100;000; in North America the rate is less than 0.1 per 100;000. Immunization programs clearly decreased neonatal tetanus deaths; and some recent evidence suggests progress in prevention throughout the World. Tetanus remains a great public health problem in developing countries such as Nigeria and it is associated with high mortality; but the understanding of the epidemiological aspects of this disease forms the basis of preventive strategies in any community. This paper reviewed the history; epidemiology and clinical diagnosis of tetanus and emphasized the current opinions in the management of tetanus outlining the various suggested treatment plans from experts in developing countries which form the basis for World Health Organization recommendations

Review of tetanus admissions to a rural Ugandan hospital

Tetanus; which can be eliminated through an effective immunization programme; remains a significant cause of morbidity and mortality in Uganda with a high case fatality rate. This study was carried out in St Francis Hospital Buluba (SFHB) after observing that the hospital was registering an abnormally high number of tetanus patients. Its aim was to retrospectively establish the socio-demographic characteristics of the patients and determine the case-fatality rate among tetanus patients admitted between 2005- 2008. Records of all patients registered and treated for tetanus up to the time of death or discharge on the Medical and Pediatric wards were evaluated. Case notes of 71 patients were retrieved and analyzed for clinical characteristics. During the three-year period under study; 163 patients (0.65of all admissions) were managed for tetanus. Analysis was done for only 154 (94.5) patients because records of the others lacked basic data. The majority of the patients (67) were males and most were young (81were below 13 years of age). Forty two percent (42) came from areas outside Mayuge district. The registered case-fatality rate was 47; with mortality being highest in the extremes of age. This paper recommends scaling up and sustaining immunization service to the whole population. Presentation of an immunization certificate should be made compulsory for all children joining school at all levels. Finally; programmes that help the population to access booster doses later in life should also be implemented

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

Tétanos en milieu hospitalier à Bamako, Mali

RÉSUMÉ â€¢ Objectif. Le but de cette étude était de décrire le profil épidémiologique, clinique et évolutif du tétanos au service des maladies infectieuses de l'hôpital du Point G de Bamako au Mali. Malades et méthodes. Il s'agissait d'une étude rétrospective descriptive de juillet 2001 à août 2004. Ont été recueillis : l'âge, le sexe, la porte d'entrée, les signes cliniques, le délai d'hospitalisation ainsi que l'évolution. Résultats. Cinquante quatre patients hospitalisés pour tétanos ont été inclus. Le sexe masculin était le plus représenté avec 68,5% des cas. Les patients étaient âgés de 15 à 66 ans avec une moyenne d'âge de 39 ans. La profession paysanne dominait avec 27,8%. La porte d'entrée était présente dans 87% des cas. Sa nature était une plaie dans 46,3%,siégeant aux membresinférieurs dans 42,6%. Le tétanos généralisé paroxystique avec attitude en opisthotonos était le plusfréquent avec 18,5%, et le tétanoslocalisé avec 12,9% des cas. Le pronostic a été mauvais avec une létalité de 38,9%. Tous les décès étaient survenus pendant la première semaine d'hospitalisation. Conclusion. Pour réduire la morbidité et la mortalité liées au tétanos à l'image des pays développés, la vaccination de masse devrait être une priorité nationale au Mali

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

National EPI coverage survey report in Ethiopia, 2006

Background: Routine EPI reports have shown an upward trend in immunization coverage in recent years in Ethiopia; however; regional disparities exist. Objective: To determine regional coverage of child and TT immunization and assess reasons for not utilizing immunization services. Methods: The revised 2005 WHO-EPI regional coverage cluster survey method was used to determine the sample size for the study. Regional immunization status of 12-23 months of children and mothers with 0-11 months of infants forchild immunization and TT immunization respectively were taken as the unit of analysis. A sample of 6;903 children between 12-23 months and 6;952 mothers with infants between 0-11 months from 468 clusters in 11 regions of the country were surveyed in June 2006. Results: The weighted national immunization coverage assessed by card plus history for children aged 12-23 months vaccinated before the age of one year was BCG 83.4; DPT1 84.3; DPT3 66.0; measles 54.3; and fully immunized children 49.9. The weighted national TT2+ coverage and rate of Protection at Birth (PAB) assessed by card plus history was 75.6and 63.0respectively. Conclusion: The survey showed a 10 percentage point of increment in DPT3 coverage compared to 2001 survey coverage. However; progress was not uniform in all regions of the country. Despite the improve-ment in the access to immunization in the country; DPT3 coverage was less than 30and dropout rate remained very high in three emerging regions. Effective behavioral change communication (BCC) strategies need to be designed and implemented to tackle high dropout rate in the program. Besides; health workers training program on interpersonal communication and Reaching Every District (RED) approach should be fully implemented to increase and sustain high level of immunization coverage in Ethiopia

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