[Tetanus in neonates and women of child-bearing age in the Dakar hospital infectious diseases unit].
OBJECTIVE
This study had for aim to describe and compare the epidemiological, clinical and outcome features of tetanus in neonates (NT) and women of child bearing age (WCBAT) in Dakar.


METHODS
This retrospective study was made on NT (3 to 28 days of age) and WCBAT (15 to 49 years of age) patient files, admitted in the Fann University Hospital Infectious Diseases Clinic from 2000 to 2007.


RESULTS
One hundred and thirty-eight WCBAT (11.9%) and 103 NT (8.9%), for a total of 1156 cases of tetanus were admitted. A decrease of the annual rate of these populations was noted over this 8 year period. The majority (59.4%) of WCBAT was between 15 and 25 years of age and the mean age of NT was 9.3 days. Most of the patients in both groups came from suburban areas (78%). The tetanus immunization status was not updated for 92% of WCBAT. The most frequent portals of entry were cutaneous wounds for WCBAT (77.4%) and umbilical stumps for NT (85.4%). On admission, 64% of NT presented with severe tetanus (stage III on the Mollaret scale) compared to 11.6% for WCBAT. The death rate was significantly higher in NT (48.5%) than in WCBAT (26.8%); p=0.0005.


CONCLUSIONS
To eliminate neonatal tetanus, the prognosis of which is worse in Dakar, an intensification of the large vaccination program is needed with supplementary vaccination campaigns including women of child bearing age in areas of risk.
Manga
N M
NM
Clinique des maladies infectieuses et tropicales, Ibrahima Diop Mar, CHNU Fann, BP 5035, avenue Cheikh-Anta-Diop, Dakar, Sénégal. nmmanga@hotmail.com
Dia
N M
NM
Ndour
C T
CT
Diop
S A
SA
Fortes
L
L
Mbaye
M
M
Diop
B M
BM
Sow
P S
PS
D000293:Adolescent; D000328:Adult; D005260:Female; D006293:Health Promotion; D006301:Health Services Needs and Demand; D017052:Hospital Mortality; D006753:Hospital Records; D006757:Hospital Units / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D055552:Infectious Disease Medicine; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011379:Prognosis; D011644:Puerperal Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D012675:Senegal / Q000453:epidemiology; D013742:Tetanus / Q000453:epidemiology*; D013745:Tetanus Toxoid; D014611:Vaccination / Q000706:statistics & numerical data; D035862:Vulnerable Populations; D055815:Young Adult
D013745:Tetanus Toxoid