Tetanus; Risk Factors and Management

Sohail Sardar

Abstract


Objectives:  Our objective was to study tetanus disease risk factors and modes of management and its recovery.

Design & Duration:  It is a prospective type of cohort study. Completed in six months from January 2019 to June 2019.

Setting:  This study was done in Nishter Hospital Multan

Subjects and Methods: Total 90 patients were studied which were admitted in medical unit of the hospital via OPD or emergency ward. Their age range was 15-30 years. A predesigned proforma was used to document data of each individual patient. A proper written consent was taken from the patients or their attendants for including patient in the study. Consent was also taken from the medical superintendant of the hospital for conducting study. Data was analyzed using Microsoft office (version 20) and results were expressed in the form of tables and charts. Confidence interval was 95% and margin of error was 5%. P-value less than 0.05 was taken significant and more than 0.05 taken non-significant. Frequency and percentages and means calculated. Sample size was determined through WHO software.  

Results There were 90 patients studied including 50 males and 40 females. Total mortality rate was 33%, its mean 30 patients out of 90 died. These cases were admitted in ICU under continuous monitoring. Which patients experienced respiratory distress they underwent intubation and mechanical ventilation started. Risk factors in these cases were septic abortion, thorn prick, road traffic accident, household trauma, abscess, ulcer or burn, farm injuries and history of surgical intervention in previous two weeks. Among 40 females 24(60%) were high risk and presented in critical condition despite all measures and ventilator support 16(40%) died. Similarly out of 50 males 14(28%) were high risk patients and among them 13(28.2%) cases died despite all measures taken.

Conclusion: Tetanus is a life taking disease most common in underdeveloped and developing countries. In south asia it has high frequency.  In this study mortality rate was more in females than males. All these cases were non-immunized against tetanus previously. Hence proper immunization and early diagnosis of the disease may decrease mortality and morbidity to much extent. Early diagnosis and quick management with ICU care and ventilator support are main components of management.


Keywords


Tetanus, risk factors, mortality rate, outcome

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