Abstract

Research Article

Demographic survey and management outcome of Post-Neonatal Tetanus at the Ekiti state university teaching hospital, Ado Ekiti

Ajite AB*, Ogundare EO, Oluwayemi IO, Olatunya OS, Babatola A, Taiwo A, Komolafe A and Fatunla O

Published: 23 April, 2019 | Volume 3 - Issue 1 | Pages: 001-007

Background: Tetanus continues to threaten the survival of children in spite of it being a vaccine preventable disease. The objective of this study was to determine the prevalence of post-neonatal tetanus, review the vaccination of affected children, complications encountered and the outcome among affected children in a tertiary health institution in southwestern Nigeria.

Methods: The study was a retrospective study. Case notes of children outside neonatal life admitted to the Paediatric ward with clinical diagnosis of tetanus between January 2012 and October 2018 were retrieved and evaluated to identify socio-demographic and clinical characteristics. A review of the immunization history and cards was done where the immunization cards were available.

Results: 21children with post-neonatal tetanus were admitted over a period of six years (November 2012 to October 2018) with a prevalence of 0.3%. The M:F was 3.2:1. The mean age in years was 10.14 ±3.44 while the age range of the subjects was 4 to 16years. None of the patients had booster doses of tetanus toxoid (TT) outside the infancy period. Nine (42.9%) subjects had no previous TT vaccination, 2 (9.5%) had 3 doses of TT vaccine in infancy but developed tetanus at age ≥9 years, 1(4.8%) subject had a dose of TT while the remaining 9subjects had no proof of previous TT vaccination. The percentage mortality was 19% (4 out of 21). All the patients that died had no prior record of TT vaccination. Complications identified included laryngeal spasm and autonomic dysfunction.

Conclusion: Post-neonatal tetanus is still common in our locality because booster doses of Tetanus Toxoid are not part of the national immunization schedule. Complete dose of tetanus toxoid vaccination during infancy and booster doses at school entry is necessary and should be part of school health programme to forestall post-neonatal tetanus

Read Full Article HTML DOI: 10.29328/journal.jcavi.1001003 Cite this Article Read Full Article PDF

References

  1. Stephen S Aron. Tetanus (Clostridium tetani); Nelson Textbook of Pediatrics. Berman RE, Kliegman RM, Jenson HB, Stanton BF. 18th ed. Philadephia, 2007. Ref.: https://tinyurl.com/y5tpobpq
  2. Brook I. Current concepts in the management of Clostridium tetani infection. Expert Rev Anti Infect Ther. 2008; 6: 327-336. Ref.: https://tinyurl.com/y5otqum9
  3. TETANUS. 2018; Ref.: https://tinyurl.com/y5jeph9o
  4. Gonçalves G, Santos MA, Frade JG, Cunha JS. Levels of diphtheria and tetanus specific IgG of Portuguese adult women, before and after vaccination with adult type Td. Duration of immunity following vaccination. BMC Public Health. 2007; 7: 109. Ref.: https://tinyurl.com/yxv4fxkb
  5. Ölander RM, Auranen K, Härkänen T, Leino T. High tetanus and diphtheria antitoxin concentrations in Finnish adults; Time for new booster recommendations? Vaccine. 2009; 27: 5295–8298. Ref.: https://tinyurl.com/y6ch2t87
  6. Animasahun BA1, Gbelee OH1, Ogunlana AT2, Njokanma OF1, Odusanya O. Profile and outcome of patients with post-neonatal tetanus in a tertiary centre in south west Nigeria: any remarkable reduction in the scourge? Pan Afr Med J. 2015; 21: 254. Ref.: https://tinyurl.com/y2josntk
  7. Adegboye OA, Adeboye MAN, Anoba S. Childhood tetanus; Still a public health concern: A review of 95 case. Savannah Journal of Medical Research and Practice. 2012; 1. Ref.: https://tinyurl.com/y2lqvekv
  8. Mondal T, Aneja S, Tyagi A, Kumar P, Sharma D. A study of childhood tetanus in post-neonatal age group in Delhi. Indian Pediatr. 1994; 31: 1369-1372. Ref.: https://tinyurl.com/y6oonnrz
  9. Faulkner AE, MPH, Tejpratap SP, Tiwari. CDC; Manual for the Surveillance of vaccine preventable diseases: Tetanus, chapter 14. Ref.: https://tinyurl.com/y4fnphuv
  10. Wassilak SGF, Roper MH, Kretsinger K, Orenstein WA. Tetanus toxoid. In: Plotkin SA, Orenstein WA, Offit PA, eds. Vaccines fifth edition. Philadelphia: Saunders. 2012; 746-772.
  11. Final 2015 reports of nationally notifiable infectious diseases and conditions. MMWR Morb Mortal Wkly Rep. 2016; 65: 1306-1321. Ref.: https://tinyurl.com/y3awd2sp
  12. Public health reporting and national notification for tetanus. CSTE position statements 09-ID-63. Atlanta, GA: CSTE; 2010. 1-8. Ref.: https://tinyurl.com/y69vslvj
  13. Oyedeji GA. Socio-economic and cultural background of hospitalised children in Ilesha. Nig J Paediatr. 1985; 12: 111-117. Ref.: https://tinyurl.com/y3wrx9rf
  14. Oyedeji OA, Fadero F, Joel-Medewase F, Elemile P, Oyedeji GA. Trends in neonatal and post-neonatal tetanus admissions at a Nigerian teaching hospital. J Infect Dev Ctries. 2012; 6: 847-853. Ref.: https://tinyurl.com/y6g2kp2a
  15. Anah MU, Etuk IS, Ikpeme OE, Ntia HU, Ineji EO, et al. Post Neonatal Tetanus in Calabar, Nigeria: A 10 Year Review. Nigerian Medical Practitioner.2009; 54. Ref.: https://tinyurl.com/y4p6yuxf
  16. Alhaji MA, Akuhwa RT, Mustapha MG, Ashir GM, Mava Y, et al. Post-neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria. Nig J Paediatr. 2013; 40: 154-157. Ref.: https://tinyurl.com/y34kzoft
  17. Fatunde OJ, Familusi JB. Post-neonatal tetanus in Nigeria: The need for booster doses of tetanus toxoid. Nig J Paediatr. 2001; 28: 35-38. Ref.: https://tinyurl.com/y3g3lt54
  18. Fortium M, Maine N, Mendy M, Hall A, George M, et al. Measles, polio and tetanus toxoid antibody levels in Gambian children aged 3-4years following routine vaccination. Trans R Soc Trop Med Hyg. 1995; 89: 326-329. Ref.: https://tinyurl.com/y3bdun6r
  19. Cilia FG, Spenz DJR, Urbieta EM, Carcedo MA, Perez TE. Immunity against tetanus in Childhood. An Esp Pediatr. 1993: 38; 499-502. Ref.: https://tinyurl.com/yxeeatlp
  20. Aboud S, Matre R, Lyamuya EF, Kristoffersen EK. Levels and avidity of antibodies to tetanus toxoid in children aged 1-15 years in Dar es Salaam and Bagamoyo, Tanzania. Ann Trop Paediatr. 2000; 20: 313-322. Ref.: https://tinyurl.com/yxeeatlp
  21. Yaguo ILE, Uchenwa-Onyenegecha TA. Tetanus in Nigeria: Is the end in sight? Greener Journal of Medical Sciences. 2015; 5: 053-057. Ref.: https://tinyurl.com/y6lejyc8
  22. Akuhwa RT, Alhaji MA, Bello MA, Bulus SG. Post-neonatal tetanus in Nguru, Yobe State, North-eastern Nigeria. Nig Med Pract. 2010; 57: 40-42. Ref.: https://tinyurl.com/yy8t29ze
  23. Nte AR, Mayuku A, Oruamobo RS. Neonatal and post neonatal tetanus: the time to act is now. Nig J Paediatr. 2002; 29: 85.
  24. Lambo JA, Anokye EA. Prognostic factors for mortality in neonatal tetanus: a systematic review and meta-analysis. Int J Infect Dis. 2013; 17: 1100-1110. Ref.: https://tinyurl.com/y6axfz5r
  25. Gbadegesin RA, Adeyemo AA, Osinusi K. Childhood post-neonatal tetanus. Nig J Paediatr. 1996; 23: 11-15. Ref.: https://tinyurl.com/y2l877kg

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