The presentation of tetanus in a tertiary health centre in Abakaliki, South- East Nigeria

Abstract

Background: The presentation and prognosis of tetanus varies amongst different regions of the world and this depends on many factors including the herd immunity and hygienic practices in the regions. Tetanus may be categorized into 4 clinical types: generalized tetanus, localized tetanus, cephalic tetanus and neonatal tetanus.
Objectives: To study the presentation and prognosis of tetanus in a tertiary health centre in Abakaliki, South-East Nigeria, and to compare it with that from other parts of the world.
Methodology: A review of the case notes of tetanus patients managed in the isolation wards of the Federal Teaching Hospital Abakaliki, South- East Nigeria, from June 2013 to May 2015 was done.
Results: The total number of tetanus cases seen over the period was 16, with an age range of 16 to 52years and mean age of 28.07±5.34years. All the patients had generalized tetanus. There were 15(93.75%) males and 1 (6.25%) female. The mean incubation and onset periods were 12.6 days and 2 days respectively. They were treated with intravenous diazepam, metronidazole, tetanus toxoid and anti-tetanus serum. The mean duration of admission was 12.5days and mortality rate was 18.8%. Presence of co-morbid medical conditions was associated with mortality.
Conclusion: The study showed that tetanus affects predominantly young men in their productive years, and the mortality rate is rather high for a potentially preventable disease. More efforts should be put in achieving universal immunization coverage for children less than 5years of age, with regular booster doses for the whole population.

Keywords: Diazepam, emergency, fatal, preventable, young males