Neonatal tetanus in Awassa: retrospective analysis of patients admitted over 5 years

Neonatal tetanus is a significant health problem worldwide, with an estimated 500,000 deaths per year. Retrospective analysis of medical records of neonates admitted to Bushulo Major Health Center with the diagnosis of tetanus neonatorum over 5 years period (1994/98) was made to describe the clinical profile and management out come. There were a total of 43 neonates admitted with a diagnosis of tetanus during the study period. Male to Female ratio was 2:1. Mean age at presentation (incubation period) was 9.5 days (range; 4-20 days). Most patients were brought within 3 days of the onset of symptoms. Common presenting complaints were; rigidity, spasm, failure to suck, trismus, fever and seizure. The overall case fatality was 29/42 (69%). All patients with severe classification and 23/32 (72%) of patients with moderate severity died. Most deaths occurred during the first two days of hospitalization (20/29 died within 2 days), and survivors stayed in hospital for a long period (8-26 days). Improved immunization coverage, clean delivery and clean cord care are recommended to reduce morbidity and mortality of neonatal tetanus.