Tetanus – still a scourge in the 21st century: a paediatric hospital-based study in India

Mishra, Kirtisudha; Basu, Srikanta; Kumar, Devendra; Dutta, A. K.; Kumar, Praveen; Rath, Bimbadhar

doi:10.1258/td.2012.110445

Cited by 9 publications

(18 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, Mishra et al too found sepsis to be strongly associated with mortality. 12 Many studies have found pneumonia (aspiration or ventilator associated) to be a risk factor for mortality. 12 However, our study did not conclude the same.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical features seen (trismus, spasms, hypertonia, and fever) in our study (as described in ►Table 3) are comparable to other similar studies. 4,9,10,12 All our patients received HTIG (6,000 IU), complete course of tetanus toxoid immunization, metronidazole, and amoxycillin-clavulanate. Some patients required higher antibiotics, while some required inotropes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Profile and Outcome of Pediatric Tetanus at a Tertiary Care Center

Mondkar

Tullu

Deshmukh

et al. 2020

J Pediatr Intensive Care

View full text Add to dashboard Cite

The aims and objectives of this study are to study clinical profile and factors affecting mortality in tetanus. This was a retrospective study of 25 tetanus patients (aged 6 months–12 years) admitted to pediatric intensive care unit of a tertiary center (over 3 years). In this study, 25 tetanus cases (mean age 6.6 years) were analyzed; 16 were males and 9 were females. Incubation period ranged from 2 to 30 days (mean 8.2 days), period of onset from 11 to 120 hours (mean 42.8 hours), and duration of spasms from 4 to 26 days (mean 14 days). The commonest portal of entry was posttrauma (52%), followed by otogenic (40%). Eighteen patients had moderate and 7 had severe tetanus. Fifteen were unimmunized and 10 were partially immunized. The commonest complaints were trismus and spasms (100%), hypertonia (72%), fever (60%), dysphagia (48%), and neck stiffness (44%). Eight patients required primary tracheostomy and 11 required primary endotracheal intubation. Complications encountered were pneumonia (58%), conjunctivitis (41%), gastrointestinal bleed (37.5%), urinary infection (33%), acute kidney injury (AKI) following rhabdomyolysis (33%), sepsis (29%), disseminated intravascular coagulation (DIC) (25%), bedsores (25%), and acute respiratory distress syndrome (ARDS) (20%). Oral diazepam was most commonly used, followed by midazolam, vecuronium, and magnesium sulfate. Mortality rate was 32% (five moderate and three severe cases died). Short period of onset (less than 48 hours), AKI following rhabdomyolysis, sepsis, DIC, ARDS, and inotrope need were significantly associated with higher mortality. It is concluded that the commonest portal of entry was posttrauma. None of the patients was completely immunized. Short period of onset, AKI, sepsis, DIC, ARDS, and inotrope need predicted a higher mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Outcome of Pediatric Tetanus at a Tertiary Care Center

Mondkar

Tullu

Deshmukh

et al. 2020

J Pediatr Intensive Care

View full text Add to dashboard Cite

show abstract

“…Most tetanus occurs in rural areas. Mortality is highest in patients not admitted to hospital, and delayed admission to hospital is associated with worse outcomes in neonatal tetanus 62–64. Facilities for ventilation and intensive care are associated with improved outcome in both neonatal and non-neonatal tetanus 45,65,66.…”

Section: Clinical Featuresmentioning

confidence: 99%

Maternal and neonatal tetanus

2015

View full text Add to dashboard Cite

Maternal and neonatal tetanus are important causes of maternal and neonatal mortality, claiming about 180 000 lives worldwide every year, almost exclusively in developing countries. Although easily prevented by maternal immunisation with tetanus toxoid vaccine, and aseptic obstetric and postnatal umbilical-cord care practices, maternal and neonatal tetanus persist as public-health problems in 48 countries, mainly in Asia and Africa. Survival of tetanus patients has improved substantially for those treated in hospitals with modern intensive-care facilities; however, such facilities are often unavailable where the tetanus burden is highest. The Maternal and Neonatal Tetanus Elimination Initiative assists countries in which maternal and neonatal tetanus has not been eliminated to provide immunisation with tetanus toxoid to women of childbearing age. The ultimate goal of this initiative is the worldwide elimination of maternal and neonatal tetanus. Since tetanus spores cannot be removed from the environment, sustaining elimination will require improvements to presently inadequate immunisation and health-service infrastructures, and universal access to those services. The renewed worldwide commitment to the reduction of maternal and child mortality, if translated into effective action, could help to provide the systemic changes needed for long-term elimination of maternal and neonatal tetanus. Tetanus in the first 28 days of life (neonatal tetanus) was long recognised by clinicians in resource-poor settings as an important cause of neonatal death. However, since babies affected by this disease usually are born at home and die there without registration of either event, the true burden was unknown. In the 1970s and 1980s, community-based surveys about neonatal tetanus from more than 40 countries showed that fewer than 10% of tetanus-related cases and deaths were routinely reported in most countries: in some regions, the reporting fraction was as low as 2-5%.

show abstract

“…Severe advanced tetanus cases call forcare with sedation, airway protection and well-ordered ventilation. 10,11 Autonomic dysfunction is common with events of tachycardia, raised blood pressure and sweating. 12 nervoussystem variability are recognized to be the roots of death with tetanus.…”

Section: Introductionmentioning

confidence: 99%

Five years study of mortality and morbidity patterns of Tetanus cases in a Tertiary Care PICU (Pediatric Intensive Care Unit), Multan Pakistan.

Khurshid¹,

Amin²,

Aziz³

et al. 2020

TPMJ

View full text Add to dashboard Cite

Objectives: Tetanus is an avoidable disease. Significant reduction in the incidence of tetanus is observed around the globe but in Pakistan, its incidence is still high. The objective of current study was to determine the demographic, clinical features, outcome and complications of tetanus patients admitted in Pediatric Intensive Care Unit (PICU). Study Design: This Descriptive-observational study. Setting: At PICU of The Children Hospital & ICH Multan Pakistan. Periods: 1st January 2013 to 31st December 2017. Material and Methods: A total of 77 tetanus cases admit through the study period in PICU. Clinical features, complications, duration of stay and outcome of 77 tetanus cases during study period were noted. Results: Amongst a total of 77 cases, 62 were male (80.6%) and 15(19.4%) female. Most (57.1%) were between 2 to 7 years. Twenty five (32.4%) were unvaccinated, 52 (67.6%) partially vaccinated. According to the grade of severity (Ablett classification), majority (40) were of grade-III. Regarding the outcome, 15 (19.5%) expired. Conclusion: Tetanus is a fatal disease with high mortality rate. Vaccination and right management of the disease are the best options to minimize the load of tetanus in our country.

show abstract

Tetanus – still a scourge in the 21st century: a paediatric hospital-based study in India

Cited by 9 publications

References 2 publications

Clinical Profile and Outcome of Pediatric Tetanus at a Tertiary Care Center

Clinical Profile and Outcome of Pediatric Tetanus at a Tertiary Care Center

Maternal and neonatal tetanus

Five years study of mortality and morbidity patterns of Tetanus cases in a Tertiary Care PICU (Pediatric Intensive Care Unit), Multan Pakistan.

Contact Info

Product

Resources

About