Adult tetanus at the University of Port Harcourt Teaching Hospital: An analysis of 42 cases

ABSTRACT

Background: Adult tetanus is still common in Nigeria as in other developing countries where immunization programmes are poor. Recently; fee for service was introduced in tertiary medical institutions. Type of Study Retrospective. Aim: To define the characteristics of cases of tetanus in adults admitted to the University of Port Harcourt Teaching Hospital (UPTH) from 1991 to 1995. Methods: Patients with features of tetanus were identified from ward records and the Medical Records Department. The case note were examined and analysed. The management was carried out in the general medical wards and consisted of anti-tetanus serum (ATS); crystalline penicillin; dextrose infusion; diazepam and metho carbarmol provided for by patients. Results: There were 42 patients 26 males and 16 females. The ages ranged from 15 to 60 years (mean 29 years). The immunization history was poor. The commonest portal of entry was the lower limb (47.6). The predominant social groups were students and fishermen. There was delay in the treatment of some of the patients as a result of which 25 cases had complications such as tachycardia; pneumonia and hypertension. Nine patients had multiple complications. Twenty-one patients died on admission. Eighteen deaths occurred within the first week of admission. Conclusion: The high mortality may reflect treatment delays and lack of intensive care unit facilities. Adequate campaign for anti-tetanus immunization should be embarked upon especially for the high risk students and fishermen