ABSTRACT
Background:Tetanus is caused by a potent toxin produced by anaerobic bacilli clostritiumtetani. Though it’s a completely vaccine preventable disease its incidence is still high in developing countries including in India. Tetanus is a disease of poor and developing countries of the world. Its incidence chiefly depends on economic, demographic and environmental factors. Since it carries a high morbidity and mortality despite advanced medical care the emphasis should be on complete immunization of children. We conducted this prospective study to analyze clinical features and complication in children with tetanus. Aims and Objectives: To study clinical presentation and complications of tetanus in children.Methods: After obtaining approval from institutional ethical committee we conducted a prospective study of 12 pediatric patients diagnosed with tetanus. The study was a prospective cohort study conducted in the department of pediatrics of a tertiary care hospital situated in a metropolitan area. Patients were included in this study on the basis of predefined inclusion criteria. Patients having any exclusion criteria were excluded from the study. The data was tabulated and analyzed using SPSS 16.0 version software.Results:The study comprised of 12 pediatric patients admitted with tetanus. Out of these 12 patients there were 6 males and 6 females with a M: F ratio of 1:1. 6 patients belonged to age group of 0-5 years and 6 patients were more than 5 years of age. Majority of the patients belonged to urban area (66.66%) while 4 patients (33.33%) belonged to rural area. The analysis of probable mechanism of infection showed that most of the patients acquired infection through injuries (41.66%) followed by ear infections (25%), wounds (16.66%) and burns (16.66%). Trismus (33.33%), hypertonicity in legs (25%), dysphagia (16.66%), stiffness (16.66%) and fever (8.33%) were the common presenting complaints in the studied cases. Clinical signs seen in the studied cases included tachycardia (66.66%), tachypnea (33.33%) and autonomic disturbances (8.33%). The study of immunity status showed that 6 children (50%) were partially immunized while 5 (41.66%) and 1 (8.33%) children were completely unimmunized and completely immunized. Complications were seen in 10 (83.33 %) children and were more common in the age group of 0-5 years in which all patients developed complications. Common complications seen in treated children included Pneumonia (33.33%), ARDS (16.66%), congestive cardiac failure (16.66%), Renal Failure (16.66%), DIC (8.33%), sepsis (8.33%) and bedsores (8.33%). Mortality was found to be 41.66%.Conclusion: Though being a vaccine preventable disease incidence of tetanus is still high in developing countries.Unimmunized children are susceptible to this dreadful disease after trauma, ear infections and burns. Since it carries a high morbidity and mortality the emphasis should be given in immunization of all children.