Revista da Sociedade Brasileira de Medicina Tropical (Aug 2007)
Tétano acidental no Estado do Ceará, entre 2002 e 2005 Accidental tetanus in the State of Ceará, between 2002 and 2005
Abstract
Descrevem-se as características demográficas e clínicas de indivíduos com tétano acidental no Ceará. Analisou-se, retrospectivamente, 131 casos de tétano acidental notificados em hospital de referência estadual entre 2002 e 2005. Destes, a maioria (84,8%) ocorreu entre homens e em moradores da zona urbana (93,2%). A faixa etária com maior incidência foi a de 35 a 49 anos (35,2%). História vacinal completa esteve relatada em quatro (3%) casos, sendo ferimento perfurocortante o mais observado, e os membros inferiores os mais acometidos. O trismo esteve relacionado a 86,2% dos casos, seguido por contraturas (54,1%). Entre os notificados houve 95,5% confirmados, cujo óbito incidiu em 33 (26,4%) pacientes. Conclui-se que o tétano acidental no Ceará atinge a população de maneira expressiva, apesar de ser uma doença imunoprevinível. Urge autoridades e órgãos gestores da saúde programarem estratégias que visem mudanças de políticas públicas relacionadas à cobertura vacinal dos susceptíveis, principalmente adultos.The demographic and clinical characteristics of individuals with accidental tetanus in Ceará are described. This was retrospective analysis of 131 cases of accidental tetanus notified in a state referral hospital between 2002 and 2005. Most of these cases (84. 8%) occurred among men and among people living in the urban zone (93. 2%). The age group with highest incidence was between 35 and 49 years old (35. 2%). A complete vaccination history was reported in four (3%) cases. Puncturing/cutting wounds were the cause most commonly observed and the legs were the area most affected. Trismus (lockjaw) was reported in 86. 2% of the cases, followed by muscle contractions (54. 1%). Among the notified cases, 95. 5% were confirmed and 33 patients (26. 4%) died. We conclude that accidental tetanus in Ceará significantly affects the population, in spite of being a disease that is preventable by immunization. The health authorities and health administration entities are urged to program strategies that aim towards changes in public policies concerning the vaccination coverage for susceptible individuals, particularly adults.
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