[Pediatric tetanus continues to be a current issue: 14 cases encountered in the CHUP-CDG pediatric hospital of Ouagadougou, Burkina Faso]

[Tetanus, an infectious disease still topical in Lome (Togo)]

Introduction

Tetanus still remains a public health problem in Togo despite the existence of the Expanded Program on Immunization.

Patients and method

A retrospective and descriptive cohort study was performed from January 1, 2008 to December 31, 2018 in the infectious and tropical diseases department of Sylvanus Olympio teaching hospital of Lome (Togo) on tetanus cases.

Results

We included 208 tetanus cases accounting for 6.5% of the whole hospitalizations in the infectious and tropical diseases department at this hospital. The median age of the patients was 23 [13-38 years] with male predominance (81.2%). The patients were workers (63.5%) and came mainly from urban areas (65.9%). Tetanus vaccination was only up to date in 9.3% of patients. Gateways were dominated by skin wounds (66.8%). Antitetanus serum was administered in 191 patients (91.8%) mainly through intrathecal route (189 patients (91.1%)). Complications were marked by superinfection of the wound (n=8), septic shock (n=3), acute respiratory failure and skin necrosis in 1 case respectively. The lethality was 27.4%.

Conclusion

The morbidity of tetanus, in particular juvenile morbidity, remains high with significant lethality. It is therefore important to place particular emphasis on the vaccine booster component.

[Neonatal and child tetanus morbidity and mortality in the University hospitals of Abidjan, Côte d'Ivoire (2001-2010)]

The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.