A review of 207 newborn with tetanus

In this study, 207 patients with neonatal tetanus admitted to Erciyes University, Faculty of Medicine, Unit of Neonatology between 1976 and 1994 were investigated retrospectively. One hundred and sixty-seven (80.6%) patients had non-hygienic home deliveries and none of the mothers of the children had been immunised with tetanus toxoid. Of the 207 patients, 161 (77.8%) were males, 46 (22.2%) were females. Failure to suck and twitching were the most frequent symptoms. The mean age of patients who died or survived was 6.9 and 8.8 days respectively (p > 0.05). Mean birth weight was 3092 g for the fatal cases and 3317 g for the survivors (p < 0.05). Mean age of onset of symptoms was 5.5 days for the fatal cases and 6.5 days for the survivors (p < 0.05). Mean period between onset of symptoms and hospital admission was 1.5 days for the fatal cases and 2.1 days for the survivors (p > 0.05). Ninety-seven (46.8%) of the 207 patients died. Mean age of death was 9.3 days and most of the patients died at the fifth day of admission to hospital. Sex, age on admission and duration of symptoms did not affect the prognosis. In addition, the efficacy of the diazepam, phenobarbital sodium and chlorpromazine used for sedation in neonatal tetanus was investigated. Of 207 patients, 43 patients were treated with diazepam, 33 patients with phenobarbital sodium, another 33 patients with phenobarbital sodium + chlorpromazine and 94 patients were treated with diazepam + phenobarbital sodium +/- chlorpromazine called as "combined therapy". The least mortality rate was found in the group treated with "combined therapy" and the highest mortality rate in the group treated with phenobarbital sodium + chlorpromazine (p < 0.001). The most frequent cause of death was apnea in the first week and sepsis in the later period.