[Tetanus in women of childbearing age at the infectious diseases clinic in Dakar].
The objective of this article was to describe the epidemiological and outcome features of tetanus in the woman of childbearing age (WCBAT) and compare them with neonatal tetanus (NT) and other tetanus cases in a hospital department in Dakar from 1998 to 2007. A retrospective study was conducted using the files of WCBAT (15 to 49 years old), NT (3 to 28 days old) and other tetanus cases admitted at the Infectious Diseases Clinic, in Fann University Hospital, from 1998 to 2007. 1484 cases of tetanus were admitted in 10 years, with 176 cases of tetanus of WCBAT (11.8%) and 178 cases of NT (11.9%). In comparison with WCBAT the NT annual hospital rate significantly decreased during the study period whereas other tetanus cases rate remained stable. The average age of WCBAT was 26.1 year old and 57.9% were between 15 and 25 years old. The geographical origin was identical for all patients, with more than 71% coming from suburban areas. Most of the WCBAT cases were housewives (50.9%), single women (75%) without updated tetanus immunization (92%). The main portals of entry of WCBAT were injuries and wounds (67.4%) and maternal tetanus cases were rare (8%), mainly post-abortum. At admission, WCBAT cases were less severe than NT cases but more severe than other tetanus cases. The lethality rate of WCBAT cases (28.4%) was significantly lower than NT cases (50%, p = 0.00003), but higher than the other tetanus cases (22.2%; NS). Prognostic factors were: non-identified or intramuscular injection portal of entry and a Mollaret state III at admission. An intensification of the extended immunization program associated with supplementary immunization campaigns targeting women of child bearing age in high risk districts, are necessary to eradicate neonatal and maternal tetanus in Dakar.
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
Ndour
C T
CT
Fortes
L
L
Diop
S A
SA
Dia
N M
NM
Mbaye
M
M
Ndiaye
E H M
EH
Diop
B M
BM
Sow
P S
PS
D000293:Adolescent; D000328:Adult; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007231:Infant, Newborn; D055552:Infectious Disease Medicine; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011379:Prognosis; D011644:Puerperal Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D012675:Senegal / Q000453:epidemiology; D013742:Tetanus / Q000151:congenital / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D013745:Tetanus Toxoid; D014946:Wound Infection / Q000453:epidemiology; D055815:Young Adult
D013745:Tetanus Toxoid