Does Pre-Hospital Care Affect the Outcome of Tetanus Patients? - An Analysis of cases Seen At a Tertiary Hospital in Nigeria.

Abstract

Tetanus remains one of the major public health hazards of the developing world. It is an infective, but potentially preventable, disease caused by Clostridium tetani. Majority of affected persons in developing countries commonly seek medical attention with "first care providers" before coming to the secondary or tertiary health institutions. This is particularly prevalent in Africa, and Nigeria is not an exemption. We sought to determine the effect of the care given to tetanus patients on their outcome, prior to their presentation at our Teaching Hospital. The data for all tetanus cases seen between 1990 and 2000 were collected prospectively. Forty-eight (82.8%) of the 66 patients received one form of care before presenting to us. Most of the patients were first seen at private clinics and these cases were noted to be severe, with an attending higher mortality. All cases seen at the traditional homes were mild. We recommend the introduction of health education seminars on wound care and prevention of tetanus for the different cadres of personnel involved in the primary health care delivery.


Key Words: Tetanus, Outcome, Mortality, Pre-Hospital, Care.


Nigerian Medical Practitioner Vol.44(1) 2003: 19-21