A study of clinical profile of childhood tetanus in south Gujarat area

Abstract

Introduction: Despite the availability of cheap, safe and effective vaccine, tetanus is still a serious health problem worldwide and rural India, and a common cause of death in the new born. Community surveys have shown that only a small proportion of neonatal tetanus (NT) cases are routinely reported and under – reporting is often highest in areas at highest risk of NT. So, the objective of the study was to find out the epidemiological factors, clinical profile and outcome of childhood tetanus. Also to find out the preventable factors and prognostic factors in childhood tetanus.

Methods: It was a prospective observational study. Legal guardians of all children less than 12 years old including neonates with diagnosis of tetanus admitted in pediatric department were inquired for detailed history regarding the present complaint, history of sources of infection, history of antenatal care, immunization status and detailed labor history. Grading of tetanus was done after detailed general and systemic examination.

Result: Total 35 cases were included in the study with Male: Female ratio of 1.7:1. Among them 28.57% were neonatal tetanus and 28.57% were traumatic case. Among 10 neonatal tetanus cases 9 mothers were not immunized and among 25 non-neonatal cases 19 were unimmunized. Mortality was 90% in NT cases and 36% in Non-Neonatal Tetanus (NNT) cases. Common complication were septicemia [9 (25.71%)], Disseminated Intravascular Coagulation (DIC) [8 (22.85%)], Hyperpyrexia [7 (17.14%)], Pneumonia [5 (14.28%)], Bed sore [3 (8.5%)], and thrombo phlebitis [1(2.8%)] of cases.

Conclusion: Although incidence of childhood tetanus has been reduced over the years, but still tetanus is more common in rural population due to illiteracy, poor socioeconomic status, poor vaccination and superstitions. The mortality by tetanus can be reduced by improving routine immunization specifically in rural and low socioeconomic population, by recognition of disease severity and providing proper management with intensive care as early as possible.