Tetanus: study of 8,697 cases.

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Public Health

Background:

• Tetanus remains a significant global health concern, characterized by high mortality rates.
• Understanding risk factors and outcomes is crucial for improving patient management and prevention strategies.

Purpose of the Study:

• To analyze a large cohort of tetanus cases to identify key epidemiological features and prognostic factors.
• To determine the overall mortality and factors influencing survival in tetanus patients.

Main Methods:

• Retrospective analysis of 8,697 tetanus cases over 14 years.
• Stratification of data by age group (neonatal vs. non-neonatal), incubation period, presence of spasms, site of infection, and treatment received.
• Comparison of mortality rates across different subgroups and severity grades.

Main Results:

• Overall mortality was 48.0%, with neonatal tetanus having a significantly higher rate (86.38%) compared to non-neonatal (40.18%).
• Shorter incubation periods, presence of spasms, higher fever on admission, and specific infection sites (trunk, post-abortion, post-injection) were associated with increased mortality.
• Absence of spasms was linked to very low mortality (2.14%).
• Appropriate administration of antitoxin serum (A.T.S.) or tetanus immune globulin correlated with lower mortality compared to no treatment or incorrect dosage.

Conclusions:

• Tetanus poses a severe threat, particularly to neonates, necessitating targeted interventions.
• Incubation period, clinical presentation (spasms), and infection source are critical determinants of tetanus prognosis.
• Effective management involves prompt antitoxin administration and supportive care, with respiratory and circulatory failure being primary causes of death.