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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Tetanus in adults: Clinical presentation, treatment and predictors of mortality in a tertiary hospital in Ethiopia
Journal of the Neurological Sciences, Volume 317, No. 1-2, Year 2012
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Description
Background: Tetanus remains a major health problem in the developing world. The aim of this study was to evaluate the clinical presentation, risk factors, complications, treatment, outcome and predictors of death in patients with tetanus. Methods: Patients aged ≥ 13 years admitted to Tikur Anbessa Hospital from June 2001 to May 2009 with the diagnosis of tetanus were included in this retrospective study. Results: Data from 68 patients were analyzed; majority (77.9%) were males, the mean age was 33.8 years. None of them was vaccinated for tetanus. The types were: generalized (91.2%), cephalic (7.4%), localized (1.5%), severe (72.1%), moderate (19.1%) and mild (8.8%). One or more complication(s) occurred in 75%; dysautonomia (58.8%), pneumonia (44.1%) and hypoxemia (41.2%). Tracheostomy and mechanical ventilation was used in 45.6% and 11.8%, respectively. Case-fatality was 35.3%. Predictors of mortality were age ≥ 40 years, duration of symptoms prior to presentation < 4 days, severe tetanus, incubation period < 7 days, period of onset < 3 days and dysautonomia. The cause of death was early acute respiratory failure due to uncontrolled spasms in 87.5%. Conclusions: Most tetanus patients were young males and there was high case fatality due to acute respiratory failure. Age ≥ 40 years and dysautonomia were independent predictors of mortality. Preventing tetanus by vaccination and treating patients in a well equipped ICU is recommended. © 2012 Elsevier B.V. All rights reserved.
Authors & Co-Authors
Amare, Amanuel
Ethiopia, Addis Ababa
School of Medicine
Melkamu, Yilma
Ethiopia, Addis Ababa
Addis Ababa University
Mekonnen, Desalew
Ethiopia, Addis Ababa
School of Medicine
Statistics
Citations: 30
Authors: 3
Affiliations: 2
Identifiers
Doi:
10.1016/j.jns.2012.02.028
ISSN:
0022510X
e-ISSN:
18785883
Research Areas
Health System And Policy
Study Design
Cohort Study
Study Locations
Ethiopia