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Tetanus: A clinical review.

J M Al-Kaabi1, E M Scrimgeour, A Louon

  • 1Department of Medicine, Sultan Qaboos University Hospital, PO Box 35, Al-Khod 123, Muscat, Oman. Tel. +968 513355 ext. 3404. Fax. +968 513419.

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Tetanus, though rare in Oman, requires intensive care and multidisciplinary management. Early diagnosis and aggressive treatment led to a 10% mortality rate in this study, lower than global averages.

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Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Public Health

Background:

  • Tetanus remains a significant global health concern with high mortality rates, despite widespread immunization programs.
  • In Oman, tetanus is infrequent but necessitates prolonged Intensive Care Unit (ICU) stays and comprehensive management.
  • This study evaluates the outcomes of tetanus patients at Sultan Qaboos University Hospital over a ten-year period.

Purpose of the Study:

  • To assess the clinical characteristics and treatment outcomes of tetanus patients admitted to Sultan Qaboos University Hospital.
  • To evaluate the effectiveness of early diagnosis, aggressive ICU treatment, and multidisciplinary management in reducing tetanus mortality.
  • To provide insights into the management of tetanus in a healthcare setting where the disease is uncommon.

Main Methods:

  • A retrospective review of all tetanus cases admitted to Sultan Qaboos University Hospital between 1991 and 1999.
  • Inclusion criteria encompassed all diagnosed tetanus patients, with a focus on treatment protocols and patient outcomes.
  • Data collection involved reviewing patient records for demographics, clinical presentation, ICU stay duration, treatment interventions, and mortality.

Main Results:

  • Ten cases of tetanus were identified, including nine adults and one infant, with adult patients averaging 59 years old.
  • All patients presented with severe generalized tetanus, requiring early tracheostomy, assisted ventilation, and sedation.
  • The study observed a 10% mortality rate, with survivors experiencing an average ICU stay of 5.5 weeks.

Conclusions:

  • Tetanus in Oman, while infrequent, presents a substantial clinical challenge requiring intensive and prolonged care.
  • The observed 10% mortality rate is attributed to early diagnosis, aggressive treatment strategies, and coordinated multidisciplinary management.
  • Effective management protocols are crucial for improving outcomes in tetanus patients, even in low-incidence settings.