[Mortality and morbidity of tetanus in the infectious diseases department, Point G teaching hospital, in Bamako, Mali (2004-2009)].
Our study objectives were to determine annual cases of the tetanus and to describe its clinical, evolutionary and prognostic aspects. It was a transverse study from data records and medical records of patients aged 15 years and above hospitalized for tetanus in the service of infectious diseases of the Point G CHU from January 1, 2004 to December 31, 2009. The tetanus was diagnosed based on clinical (trismus, dysphagia, seizures and point consecutive to an injury) and epidemiological arguments (absence of a correct tetanus immunization, entry way). We collected a total of 119 cases of tetanus out of 1,839 hospitalizations making a prevalence of 6.5%. The hospitalization period was 5 days (73%) for most of the patients. Unskilled laborer and farmers were the most frequent with respectively 30.2 and 21.8% of cases. Tetanus occurred in the course of a traumatic road accident (16%) and from other traumatic causes (48.7%). The clinical form was a generalized type for 94.4% of the cases. A wound was the entry way for 64.7% of the patients. The entry way was located on the lower members 49.6% of the time. The co-morbidity was recorded with infection by Plasmodium falciparum (15 cases, 12.6%) and HIV (1 case). Hospital lethality was 46.2%. The death was statistically linked to clinical severity according to the Dakar score (P = 0.0005) and the Mollaret stage (P = 0.0001). A need for strengthening communication for behaviour change for the gaining of a correct and sustained immunization exists. A strategy based on the capacity building for a rapid tetanus diagnosis and a combined co-morbidities care may reduce the lethality in the context of our limited technical environment.
Service de maladies infectieuses et de médecine interne, CHU du Point G, Bamako, Mali. minta_daouda@yahoo.fr
D K
DK
Minta
A M
AM
Traoré
A K
AK
Soucko
M
M
Dembélé
Y
Y
Coulibaly
M S
MS
Dicko
I
I
Coulibaly
N
N
Diany
N G E
NG
Maboune
B
B
Ba-Sall
A K
AK
Traoré
N
N
Koné
H A
HA
Traoré
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D055552:Infectious Disease Medicine / Q000706:statistics & numerical data; D008297:Male; D008302:Mali / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity; D011247:Pregnancy; D015995:Prevalence; D013742:Tetanus / Q000453:epidemiology* / Q000401:mortality* / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult