Childhood Post-neonatal Tetanus.

Abstract

Summary: A review of postneonatal tetanus in 42 patients aged between two months and 14 years admitted to the University College Hospital, Ibadan, between January 1989 and June 1992, is reported. The major portals of entry identified in 38 cases were wounds following trauma (50.0 percent) and chronic otitis media (34.2 percent). Six (14.3 percent) of the cases had received three doses of DPT vaccine during infancy, while another one had pro phylactic anti-tetanus serum following trauma. Most of the patients attended the hospital long after the onset of spontaneous spasms and 71 percent after develop ment of opisthotonus. The commonest associated morbidity was pneumonia which occurred in 19 percent of the cases and the case mortality was 20.0 percent. It is suggested that improved immunization coverage, pre-school booster dose of tetanus toxoid, education of health workers on the proper management of otitis media and judicious use of prophylactic antitetanus serum will help in reducing the incidence of the disease.