Current Prognostic Factors of Tetanus in Abidjan: 2005-2014

Year 2017, , 125 - 131, 15.09.2017

Aristophane Koffi Tanon Adama Doumbia Patrick Ahuatchi Coffie

https://doi.org/10.5799/jmid.367529

Cited By: 3

Abstract

Objective:
To describe the epidemiological, clinical and prognosis aspects of tetanus in
patients hospitalized at the Infectious and Tropical Diseases Unit of
Treichville Teaching Hospital.

Methods:
A retrospective study of the medical records of all patients hospitalized
between 2005 and 2014. The “Dakar prognosis score” was established on the basis
of six parameters: incubation period, duration of invasion, site of entry,
presence of paroxysms, body temperature and pulse rate. A logistic regression
model was used to identify the factors associated with death.

Results:
Overall, 455 cases of tetanus were included, with a predominance of males
(86%). Most patients lived in Abidjan (77%). A very high proportion of cases
were generalized tetanus (96%), and 137 patients (30%) died. The factors
associated with death were age >60 years (aOR 2.76; 95% CI 1.07 to 9.91),
being a labourer (aOR 2.83 95% CI 1.07-9.39), a severe Dakar prognostic score
(aOR 5.76; 95% CI 2.26-14.72), no intrathecal serotherapy (aOR = 15.6; 95% CI
5.40- 44.84), no penicillin-therapy (aOR 2.33; 95% CI 1.11-4.87) and the
presence of complications (aOR 8.53, 95% CI 4.83-15.09).

Conclusion: This study identifies a
number of factors for a poor prognosis among patients with tetanus admitted to
our hospital, indicating that measures to reduce morbidity and mortality due to
tetanus should be strengthened and prevention improved in resource limited
settings. The prognostic parameters in “the Dakar score” should therefore be
adapted to the current epidemiological and clinical contexts in Côte d’Ivoire. 

Keywords

Prognosis factors, tetanus Côte d’Ivoire, West Africa

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