Mortality and Associated Factors Among Adult Tetanus Patients Admitted at Public Hospitals in Bahir Dar City,...

Tetanus, caused by Clostridium tetani, results in rigor spasms and remains as major cause of mortality in areas with poor vaccination and sanitation. Mortality has been cited to be 20%-55% in Ethiopia, possibly due to variation in healthcare, immunization, and intensive care access. However, there is limited data at the local level. This study was conducted to determine Tetanus mortality and identify determinants among adults in the Bahir Dar public hospitals.

A multicenter, hospital-based cross-sectional study was conducted using medical records of 251 patients admitted between January 1, 2019, and December 2024. Data were collected using Kobo Collect software and entered into EpiData 4.6, where they were cleaned and checked for completeness. Analysis was performed using SPSS version 27. Binary logistic regression was performed to identify significant factors. A p-value of < 0.05 in the multivariable model was considered statistically significant.

The mortality rate for tetanus was 32.27% (95% CI: 26.75%, 38.33%). Several factors were significantly associated with tetanus mortality, including coexisting diseases (AOR = 2.12; 95% CI: 1.65, 6.30), onset of symptoms within 2 days (AOR = 4.10; 95% CI: 1.84, 8.16), generalized tetanus type (AOR = 6.5; 95% CI: 2.05, 11.42), failure to receive tetanus antitoxin (AOR = 2.51; 95% CI: 1.04, 10.43), and undergoing a tracheostomy procedure (AOR = 2.3; 95% CI: 2.3 (1.32, 5.81).

The mortality rate among tetanus patients was found to be high. Key factors include coexisting diseases, acute onset (within 2 days), generalized tetanus, failure to administer Tetanus Antitoxin, and the performance of tracheostomy. Hence, the study highlights the importance of early diagnosis and treatment, advocating for the use of antitoxin, providing special care for patients with generalized tetanus, and reconsidering the effectiveness of tracheostomy as a treatment option.