title: Tetanus - still a scourge in the 21st century: a paediatric hospital-based study in India.
abstract: Tetanus remains endemic in India. A retrospective hospital-based study was conducted to review the profile of all children admitted with diagnosis of tetanus between January 2009 and December 2010. A total of 140 cases of tetanus were admitted; 45 cases of neonatal tetanus (NT) and 77 cases of post-neonatal tetanus (PNT) were studied. Age of presentation of NT was 9.4 ± 1.2 days. Home-delivered children accounted for 86.7% of cases, with 77.8% being attended by untrained birth attendants. Unimmunized mothers accounted for 93.4%. In PNT, otogenic route of infection and trauma were present in 58.4% and 23.3% of cases, respectively. The rate of hospital admission of tetanus remains high. Unlike previously published reports, otogenic route is the most common mode of PNT infection in this study. Improving immunization, increasing deliveries by skilled birth attendants and prompt treatment of suppurative otitis media are the main areas in which public health initiatives need to be focused.
authors.affiliation: Department of Pediatrics, Kalawati Saran Children’s Hospital, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Kirtisudha
authors.initials: K
authors.lastname: Mishra
authors.forename: Srikanta
authors.initials: S
authors.lastname: Basu
authors.forename: Dipti
authors.initials: D
authors.lastname: Kumar
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Dutta
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.forename: Bimbadhar
authors.initials: B
authors.lastname: Rath
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003975:Diazepam / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007136:Immunoglobulins / Q000627:therapeutic use; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010035:Otitis Media, Suppurative / Q000150:complications / Q000188:drug therapy; D010406:Penicillins / Q000627:therapeutic use; D011295:Prenatal Care; D013742:Tetanus / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D013745:Tetanus Toxoid / Q000008:administration & dosage
chemical_list: D007136:Immunoglobulins; D010406:Penicillins; D013745:Tetanus Toxoid; D003975:Diazepam