Tetanus: A 10-year review of cases in a teaching hospital in northwestern Nigeria

Abstract

Aim/Objectives: The objective of this study was to present the descriptive characteristics of non-neonatal tetanus cases seen in a teaching hospital in Northwestern Nigeria over a 10-year period and to discuss the implications of the study findings for anti-tetanus vaccination policy and implementation in developing countries.
Methodology: Fifty-nine records of non-neonatal tetanus cases were reviewed. The socio- demographic characteristics of the patients, the source of infection, seasonal distribution and outcome of cases were investigated. The data obtained was compared for differences in proportions and case fatality rates between groups.
Results: The annual prevalence of cases in this study was 5.9 per year. Most (82.7%) cases were aged <40 years while mortality was higher in patients >40 years. More males (76.9%) were affected but case fatality ratio was higher in females. The Hausa/Fulani ethnic group (88.1%) predominated. Majority (63.5%) of cases were from the rural area. Case fatality rates for the urban and rural areas were 26.3% and 72.7%, respectively. (p =0.0016)
Farmers (30.5%), housewives and students (18.6% each) were most affected. Portal of entry of infection was mostly through injury wounds (49.1%), puerperal sepsis (8.5%) and post-surgery infection (3.4%). Only one (2.1%) of the cases was immunized. The overall case fatality rate was 52.5% while 44.1% survived.
Conclusion: In view of the study findings, it is opined and hypothesized that a policy to expand and implement anti-tetanus vaccination campaign beyond maternal and childhood immunoprophylaxis, to cover the entire rural and farming populations, and school children will help to reduce considerably the burden of tetanus in Nigeria and other developing countries.


Sahel Medical Journal Vol. 10 (1) 2007: pp. 1-5