Intramuscular injections of quinine and tetanus at the Centre Hospitalier Universitaire of Brazzaville, Congo

Intramuscular injections are known for their iatrogenic complications. IM quinine is a routine procedure in Congo for drug resistant malaria management. In this short note, the authors evaluate tetanus relative to intramuscular injection of quinine among the cases of tetanus treated in the infectious diseases unit of "Centre Hospitalier Universitaire of Brazzaville". This study was conducted from January to December 2005 regarding 18 cases of tetanus among which 5 infected after intramuscular injection of quinine. Their level of seventy was significantly higher with a high mortality rate (post intramuscular: 4 deaths out of 5; other cases: 3 deaths out of 13). Tetanus was generalized in 17 cases. A significant difference between the intramuscular and the non-intramuscular injection was observed regarding the pulse (p<0.05), the level of severity (p<0.005) and deaths (p<0.005). Awareness-raising campaigns with populations and medical staff about the risks of intramuscular injections as well as vaccination schedule should be regularly implemented.