Demographic survey and management outcome of Post-Neonatal Tetanus at the Ekiti state university teaching hospital, Ado Ekiti

Abstract

Background: Tetanus continues to threaten the survival of children in spite of it being a vaccine preventable disease. The objective of this study was to determine the prevalence of post-neonatal tetanus, review the vaccination of affected children, complications encountered and the outcome among affected children in a tertiary health institution in southwestern Nigeria. Methods: The study was a retrospective study. Case notes of children outside neonatal life admitted to the Paediatric ward with clinical diagnosis of tetanus between January 2012 and October 2018 were retrieved and evaluated to identify socio-demographic and clinical characteristics. A review of the immunization history and cards was done where the immunization cards were available. Results: 21children with post-neonatal tetanus were admitted over a period of six years (November 2012 to October 2018) with a prevalence of 0.3%. The M:F was 3.2:1. The mean age in years was 10.14 ±3.44 while the age range of the subjects was 4 to 16years. None of the patients had booster doses of tetanus toxoid (TT) outside the infancy period. Nine (42.9%) subjects had no previous TT vaccination, 2 (9.5%) had 3 doses of TT vaccine in infancy but developed tetanus at age ≥9 years, 1(4.8%) subject had a dose of TT while the remaining 9subjects had no proof of previous TT vaccination. The percentage mortality was 19% (4 out of 21). All the patients that died had no prior record of TT vaccination. Complications identifi ed included laryngeal spasm and autonomic dysfunction. Conclusion: Post-neonatal tetanus is still common in our locality because booster doses of Tetanus Toxoid are not part of the national immunization schedule. Complete dose of tetanus toxoid vaccination during infancy and booster doses at school entry is necessary and should be part of school health programme to forestall post-neonatal tetanus.

Post Neonatal Tetanus as Seen in Rivers State University Teaching Hospital, Nigeria: Prevalence, Clinical Profile and Outcome

“…The parents/caregivers of all the children with PNT in this study were from low socio-economic class as also reported by Ajite et al in Ekiti. [32] In other studies in Nigeria, majority of children treated for PNT were also from families with low socio-economic class. [27,31] The exact reason for this observation is not known, it has however been attributed to the fact that these children are more exposed to poor hygienic environments, have risky behaviours like playing barefoot and unsupervised outdoor play.…”