A Primordial Killer Still on the Prowl: A Short Report on Paediatric Tetanus in North-Eastern Nigeria

Aims: To examine the clinical profiles and outcomes of neonatal and post-neonatal tetanus as seen at the Federal Medical Centre Azare, North-Eastern Nigeria.

Study Design: The study was cross-sectional retrospective.

Place and Duration of Study: Department of Paediatrics, Federal Medical Centre, Azare, Nigeria from 1st January to 31st December 2013.

Methodology: Hospital records of patients managed for neonatal and post-neonatal tetanus during the study period were retrieved and analysed. Information obtained included, history, physical examination findings, complications and outcome. SPSS version 17.0 was used for data analysis.

Results: A total of 19 cases were admitted during this period, 6 (31.6%) had neonatal tetanus, while 13 (68.4%) had post-neonatal tetanus. The male: female ratio for neonatal tetanus was 1:1, that of post-neonatal tetanus was 1.6:1. The case fatality rate of neonatal tetanus was 50% and 61.5% for post-neonatal tetanus. The mean age of the neonates who survived the disease differed significantly from that of those who did not survive the disease (P=.03). This was also true for incubation period (P= .01). Mean incubation period and onset time for post-neonatal tetanus was longer in survivors than non-survivors. However, these differences did not reach statistical significance (P= .59, .50 respectively). The portal of entry of post neonatal tetanus had a statistically significant relationship with the outcome (P= .02).

Conclusion: Mortality from tetanus remains high, the importance of preventive strategies in its management cannot be overemphasized in our environment.