Study of clinico-epidemiological factors and outcome of tetanus in a tertiary care hospital

Authors

  • Vikram Singh Sodha Department of Surgery, SMS Medical College and Attached Hospital, Jaipur, Rajasthan, India
  • Shalu Gupta Department of Surgery, SMS Medical College and Attached Hospital, Jaipur, Rajasthan, India
  • Somendra Bansal Department of Surgery, SMS Medical College and Attached Hospital, Jaipur, Rajasthan, India
  • Bhanwar Lal Yadav Department of Surgery, SMS Medical College and Attached Hospital, Jaipur, Rajasthan, India
  • Dinesh Bharti Department of Surgery, SMS Medical College and Attached Hospital, Jaipur, Rajasthan, India
  • Bhanu Kaushik Department of Surgery, SMS Medical College and Attached Hospital, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182765

Keywords:

Mortality, Severity, Tetanus

Abstract

Background: Tetanus is an acute neurological fatal disorder caused by anaerobic spore forming bacillus Clostridium tetani, which produced an exotoxin (Tetanospasmin) in a wound. Purpose of this study was to find out the clinico-epidemiological factors of tetanus and how we can modify or minimize the outcome of this disease.

Methods: This prospective, observational study was conducted in isolation ward in department of general surgery, SMS hospital Jaipur (Rajasthan) from 1 March 2016 to October 2017. Two hundred patients with clinical diagnosis of tetanus, who were admitted in single unit of SMS hospital, recruited in this study. Patients with age less than 1 yr were excluded. After admission, patient’s detailed history and thorough clinical examination done. The day to day progress of the cases was followed till the time of their discharge from the hospital. Outcome variables were age, gender, geographical area, causes of tetanus and site of injury, precipitating factors, role of baclofen, morbidity, cured and mortality.

Results: In this study, mean age of patients were 17 years and male to female ratio was 2.44:1. Most of patients were from rural backgrounds with rural to urban ratio of 6.14:1. Overall mortality in present study was 16.5%. The severity of disease directly related with mortality. The mortality for mild, moderate and severe tetanus was 0%, 1.9% and 68.1% respectively.

Conclusions: Though tetanus is a vaccine preventable illness, its prevalence is high in our country. The incidence of tetanus can be reduced by: strengthening of primary immunization programme; proper wound management and giving prophylactic tetanus immune globulins along with tetanus vaccine.

Metrics

Metrics Loading ...

References

Park K. Park’s textbook of preventive and social medicine. 19th edition. Jabalpur (India): M/s Banarasidas Bhanot Publishers;2007:260-261.

Chavada VK. To study the clinico-epidemiological factors of tetanus cases admitted in a tertiary care hospital for the last 10 years. J Clin Diagn Res. 2010;4:2649-51.

Centers for disease control and prevention, Guidelines for control of Tetanus, Atlanta, GA-CDC, 2000, (CDC. Tetanus surveillance - United States, 2001-2008 MMWR 2011;60:366-69).

Global disease burden.healthgrove.com/I/8386/tetanus in India.

Govt. of India (2016), Annual Report 2015-2016, Ministry of Health and family welfare, New Delhi

Sidhartha SS, Peter JV, Subhash HS, Cherian M, Jeyaseelan L, Cherian AM. A proposed new scoring system for tetanus. Indian J Crit Care Med. 2004;8(3):168-71.

Anuradha S: Tetanus in adults - a continuing problem: An analysis of 217 patients over 3 years from Delhi, India, with special emphasis on predictors of mortality. Med J Malaysia. 2006;61(1):7-14.

Marulappa VG, Manjunath R, Babu NM, Maligegowda I. A ten year retrospective study on adult tetanus at the epidemic disease (ED) hospital, Mysore in Southern India: a Review of 512 Cases. J Clin Diagn Res. 2012;6(8):1377-80.

Younas NJ, Abro AH, Das K, Abdou AM, Ustadi AM, Afzal S. Tetanus: presentation and outcome in adults. Pak J Med Sci. 2009;25(5):760-5.

Kole AK, Roy R, Kole DC. Tetanus: still a public health problem in India - observations in an infectious disease hospital in Kolkata. WHO South-East Asia J Public Health. 2013; 2(3-4):184-6.

Yadav YR, Yadav S, Kala PC. Puerperal tetanus. Journal of the Indian Med Assoc. 1991;89(12):336-7.

Rani KVL, Kalyani D, Shankar K. Assessment of incidence and mortality of tetanus at Sir Ronald Ross Institute of Tropical and Communicable Disease (Govt. Fever Hospital), Hyderabad - Five sear study. IOSR- J Dental Med Sci 2016;15(4):36-40.

Patel JC, Mehta BC. Tetanus: study of 8,697 cases. Indian J Med Sc. 1999;53(9):393-401.

Mukhergee DK. Tetanus and tracheostomy. Ann Otol. 1977;86:67-72.

Downloads

Published

2018-06-25

Issue

Section

Original Research Articles