Post-neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Abstract

Background: Tetanus is a public health problem in Nigeria. This study examines the demographic and clinical profile of postneonatal tetanus (PNT) seen in University of Maiduguri Teaching Hospital (UMTH), North- eastern Nigeria. Methods: This is a hospital-based prospective study of PNT. All children beyond the neonatal period to 14 years of age admitted into the Paediatrics unit of UMTH, Maiduguri from June 2009 to July 2011 with the diagnosis of PNT were studied. Results: A total of 39 cases of PNT were admitted over the period under review. The male: female ratio was 2.3:1.0. Their ages at presentation ranged between 16 months and 14 years, with mean +SD of 6.9+ 3.87 years. Over 90 percent of the children were either not immunized against tetanus or their immunization status was unknown and only two of the children were fully immunized. No booster immunization was received by any of the eligible children. The portal of entry of the infection was injury to the lower limbs and otogenic route in 53.9% and 33.3% respectively. Majority of patients were of low socioeconomic status. The duration of hospital stay ranged between 1-50 days with mean + SD (18.68+ 11.51).The mortality rate was (7)18 %. Conclusion: Tetanus still remains a major cause of childhood morbidity and mortality in Nigeria. Severe disease and the first one week of admission are the main variables identified to influence outcome. Therefore, there is need to strengthen routine immunization and booster doses of tetanus toxoid (TT) should be mandatory at primary and secondary school entry. Close monitoring of patients with severe tetanus during the critical period is imperative for successful management.