Sahel Medical Journal (Jan 2010)
Clinical profile and outcome of adult tetanus in Kano
Abstract
Introduction: Though tetanus is rare in the developed countries of the world, it remains a major public health hazard in the developing world like Nigeria despite availability of inexpensive vaccine. We undertook a 6-year study of all tetanus cases managed at two tertiary centres in Kano. Methodology: Demographic and clinical data of all adult tetanus patients managed at Aminu Kano Teaching Hospital and Murtala Muhammad Specialist Hospital, Kano between January 2004 to December 2009 were collected and analyzed. Results: A total of 146 patients were admitted in the two facilities out of which complete data was obtained from 126 patients. All patients had generalised tetanus. There were 93 (73.8%) males and 33 (26.2%) females. Their age ranges between 17 and 62 years; mean (35.2 ±1.3) years. Majority of the patients were in the age bracket of 21 30 years with most (50.8%) being farmers. The most common portal of entry was leg wound while portal of entry was not identifiable in 37 (29.4%) patients. Incubation period was less than 48 hours in 46 (51.7%) and period of onset was less than 48 hours in 64 (50.8%) patients. Aspiration pneumonitis and laryngospasm were documented complications in 12 (9.5%) and 26 (20.6%) of the patients, respectively. The overall mortality rate was 46%. Conclusion: Tetanus remains an important disease with substantial mortality in Kano. The males and farmers are most frequently affected. The overall mortality rate was 46% with the value being highest among severe (87.2%) and the very severe (92.3%) cases.
