Characteristics and outcome of tetanus in adolescent and adult patients admitted to the Lagos University Teaching Hospital between 2000 and 2009.
This study was a case record review of adult patients with tetanus admitted into Lagos University Teaching Hospital between 2000 and 2009. Of 78,009 adults admitted, 190 had tetanus, constituting 0.25% of admission. Mean age was 30.4 ± 13.8 years. Male to female ratio was 3:1. The commonest occupation was commercial motorcyclists. 96% of the patients were unimmunized and 4% that had partial immunization had localized tetanus. Commonest presentation was trismus (83%). Twenty three patients had complications, 30% had autonomic dysfunction. Mean incubation period was 11.4 ± 4.8 days, and mean duration of onset was 72 ± 45.6h. 31 patients died, case fatality rate was 16.3%. Twelve percent of those with long period of onset died while 43% with short period of onset died (P=0.002). Patients with complications (78%) died of tetanus while only 8% of those without complication died (P<0.0001). Case fatality rate is still unacceptably high for a vaccine preventable disease. Attention to primary prevention of people at risk and active surveillance to prevent complications will further reduce mortality.
Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria. iabankole@yahoo.com
Idowu A
IA
Bankole
Mustapha A
MA
Danesi
Oluwadamilola O
OO
Ojo
Njideka U
NU
Okubadejo
Frank I
FI
Ojini
D000293:Adolescent; D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D002648:Child; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology; D009549:Nigeria / Q000453:epidemiology; D060051:Occupational Injuries / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D012189:Retrospective Studies; D013035:Spasm / Q000453:epidemiology / Q000209:etiology; D015996:Survival Rate; D013742:Tetanus / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D013745:Tetanus Toxoid; D016896:Treatment Outcome; D014313:Trismus / Q000453:epidemiology / Q000209:etiology; D014611:Vaccination / Q000706:statistics & numerical data; D014946:Wound Infection / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control
D013745:Tetanus Toxoid