Post Neonatal Tetanus as Seen in Rivers State University Teaching Hospital, Nigeria: Prevalence, Clinical Profile and Outcome
Tamunoiyowuna Grace Okari *
Department of Paediatrics, Rivers State University Teaching Hospital, Nigeria and Department of Paediatrics and Child Health, Rivers State University, Nkpolu, Port Harcourt, Nigeria.
Boma Awoala West
Department of Paediatrics, Rivers State University Teaching Hospital, Nigeria. 2Department of Paediatrics and Child Health, Rivers State University, Nkpolu, Port Harcourt, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Post neonatal tetanus, a vaccine preventable disease is a cause of childhood morbidity and mortality in many developing countries including Nigeria. This study was carried out to determine the prevalence, clinical profile and outcome of children with post-neonatal tetanus.
Methods: This prospective observational study carried out over 3years in the Paediatric ward of the Rivers State University Teaching Hospital, was among children older than 28days and up to 16years.
Result: Of 966 children admitted during the period of study, 12 had post-neonatal tetanus giving a prevalence of 1.2%. Six (50%) were > 10years old with a M:F ratio of 5:1, 5(41.7%) resided in rural areas and all (100%) were of low socioeconomic status. Six (50%) did not receive tetanus toxoid vaccine and no child had booster doses. Portal of entry for the infection was majorly via injuries on their limbs, 7(58.3%). The mean incubation period was 10.58±7.39 days while the mean onset interval was 31.58±27.85 hours. Three (25%) children had severe tetanus using Ablett’s classification with spasm 11(91.7%) documented as the commonest symptom. Half, 6(50%) of the children had autonomic complications and an overall case fatality rate of 25%.
Conclusion: The prevalence of post-neonatal tetanus in the Rivers State University Teaching Hospital was low being 1.2%, although unacceptable. The mortality rate of post-neonatal tetanus of 25% was high. Thus, there is a need to strengthen existing immunization program and immediately adopt the commencement of booster doses of tetanus toxoid vaccines for eligible children in Nigeria.
Keywords: Post-neonatal tetanus, prevalence, clinical profile, outcome, teaching hospital, Nigeria