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 7-year retrospective study of diabetesrelated deaths in a Nigerian tertiary hospital

A total of 362 diabetics were admitted over a 7-year period (January 1995 to December 2002) to a Nigerian tertiary hospital. Forty (40) of these (8.8%) died as in-patients. Twenty-six (26) were male and 14 were female. Thirteen (32%) were newly diagnosed with diabetes. Seventy percent (70%) of deaths occurred within 1 week of admission. A case-controlled study of the diabetic deaths revealed that presentation with any of the following were associated with in-patient death: diabetic emergencies (p<0.001), infective process (p<0.001), fever (p<0.001), systolic hypertension (p=0.001), and short duration of hospitalisation (p=0.001). It is suggested that greater awareness of diabetes and education of newly diagnosed cases may reduce this high mortality. In addition, the national health insurance system should cover all disease care, including diabetes