A 12-year review of cases of adult tetanus managed at the University College Hospital, Ibadan, Nigeria

Abstract

In this review, hospital case records of 202 adult tetanus managed between January 1990 and December 2001 in a tertiary institution in Southwestern Nigeria were reviewed. The mean age of the patients was 36.1+/-17.8 years with male:female ratio of 2.2:1 and an overall mortality rate of 64%. Patients with unfavourable outcomes spent 4.5+/-0.41 days compared with 16.6+/-1.2 days by those who survived. Factors associated with poor prognosis are age >60 years (P=0.029), incubation period <7 days (P=0.007), period of onset <48 h (P=0.0001), tachycardia with pulse rate >120/min (P=0.001) and spasm (P=0.002). Gender (P=0.11), post-injury vaccination (P=0.48) and types of antibiotics administered (P=0.49) were not significantly associated with increased mortality. The three most common complications were aspiration pneumonitis, sepsis and urinary bladder obstruction while complications with highest mortality (100%) were sepsis and cardiac arrest.

Tetanus in adults: Clinical presentation, treatment and predictors of mortality in a tertiary hospital in Ethiopia

“…In contrast to our finding, both lower (15% to 27%) [3,12,15,16,18,23,24] and higher (55% to 72.7%) [9,10,13,17,21] casefatalities were observed. The case-fatality of tetanus observed in previous studies from Addis Ababa [14,15] was 35.9% and 27%, respectively.…”

“…Majority of patients were males (77.9%) in keeping with most other studies [2,3,10,12,13,21]. The mean age was 33.8 years similar to studies done in other developing countries [15,21] but in contrary to older adult dominance in high-income countries [2,3]. Women were older than men in this study.…”

“…Lack of clean delivery is an important risk factor for neonatal tetanus. Tetanus is a severe disease associated with a high mortality which varies from 15% to 72.2% [3,4,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] depending on the available treatment facilities. Treating tetanus patients in intensive care unit (ICU) improves the survival rate [23].…”

Characteristics and outcome of tetanus in adolescent and adult patients admitted to the Lagos University Teaching Hospital between 2000 and 2009

“…This is consistent with previous studies [3,15]. Therefore, prevention and early treatment of complications will reduce mortality.…”

“…The shorter the period of onset, the worse the outcome and this is similar to previous studies [8,15].…”