Tetanus disease and deaths in men reveal need for vaccination

Abstract

With efforts focused on the elimination of maternal and neonatal tetanus, less attention has been given to tetanus incidence and mortality among men. Since 2007 voluntary medical male circumcision has been scaled-up in 14 sub-Saharan African countries as an effective intervention to reduce the risk of human immunodeficiency virus (HIV) acquisition among men. As part of a review of adverse events from these programmes, we identified 13 cases of tetanus from five countries reported to the World Health Organization (WHO) up to March 2016. Eight patients died and only one patient had a known history of tetanus vaccination. Tetanus after voluntary medical male circumcision was rare among more than 11 million procedures conducted. Nevertheless, the cases prompted a review of the evidence on tetanus vaccination coverage and case notifications in sub-Saharan Africa, supplemented by a literature review of non-neonatal tetanus in Africa over the years 2003–2014. The WHO African Region reported the highest number of non-neonatal tetanus cases per million population and lowest historic coverage of tetanus-toxoid-containing vaccine. Coverage of the third dose of diphtheria–tetanus–polio vaccine ranged from 65% to 98% across the 14 countries in 2013. In hospital-based studies, non-neonatal tetanus comprised 0.3–10.7% of admissions, and a median of 71% of patients were men. The identification of tetanus cases following voluntary medical male circumcision highlights a gender gap in tetanus morbidity disproportionately affecting men. Incorporating tetanus vaccination for boys and men into national programmes should be a priority to align with the goal of universal health coverage.

Tetanus Immunity Gaps in Children 5–14 Years and Men ≥ 15 Years of Age Revealed by Integrated Disease Serosurveillance in Kenya, Tanzania, and Mozambique

“…10 During 2012-2016, 12 tetanus cases were determined to be causally associated with VMMC among clients 11-47 years of age in five ESA countries. 2,10,11 Tetanus immunity gaps likely exist due to waning immunity from infant doses, but recent serologic evidence from the region is too limited to inform immunization strategies among VMMC clients.…”

“…2,3 Accurate estimation of tetanus cases and deaths is challenged by underreporting of neonatal cases (occurring within the first 28 days of life) and lack of routine reporting of nonneonatal cases in many countries. 2 Globally, tetanus vaccination started in 1974 as part of the Expanded Program on Immunization (EPI), which was implemented in all countries by the mid-1980s. 3 The programmatic goals of tetanus control are eliminating maternal and neonatal tetanus (MNT; < 1 case per 1,000 live births in every district) and preventing tetanus in all age groups.…”

“…1,2 Case fatality ratios for tetanus vary from 10% to 70%, depending on the treatment and age of the patient. 2,3 Accurate estimation of tetanus cases and deaths is challenged by underreporting of neonatal cases (occurring within the first 28 days of life) and lack of routine reporting of nonneonatal cases in many countries. 2 Globally, tetanus vaccination started in 1974 as part of the Expanded Program on Immunization (EPI), which was implemented in all countries by the mid-1980s.…”

Клінічний Випадок Правця В Споживача Ін’єкційних Наркотичних Речовин

“…На сьогодні в 34 країнах світу правець новонароджених та породіль неелімінований. Щорічно у світі від правця помирають майже 200 000 осіб, із них 50 000 - новона-роджені [4]. Хоча цьому інфекційному захворюванню достатньо легко запобігти завдяки високоефективній вакцині, правець залишається проблемою громадсько-го здоров'я з високим рівнем летальності майже в усіх країнах, що розвиваються.…”

Правець: Огляд Сучасних Рекомендацій З Епідеміології, Етіології, Патогенезу, Клініки, Інтенсивної Терапії У Період Воєн І В Мирний Час

“…Вакцинация против столбняка является частью национальной программы вакци-нации Норвегии. Описан случай столбняка у пожи-лой женщины, не вакцинированной против столб- [3]. Столбняк у беременных протекает, как и у других индивидов, так же про-водится лечение.…”