Trend and Epidemiology of Tetanus in Nasarawa State, Nigeria: A Five Years Review
DOI:
https://doi.org/10.26911/jepublichealth.2023.08.04.09Abstract
Background: Tetanus is a vaccine preventable, non-communicable disease known as lockjaw and characterized by muscle spasm. It is a forgotten disease in the developed world but remained an infection of public health importance in the developing countries. This study aimed to determine the trend in its epidemiology and outcome in Nasarawa state.
Subjects and Method: A retrospective study using secondary data from the medical records of three selected health facilities, one each across the three senatorial zones of the state. All those who had tetanus were included while those with incomplete records, 5 were excluded. Data analysis was done using a statistical package for social sciences version 23. The dependent variable was the outcome of tetanus while the independent variables were incubation period, onset period, type of tetanus, risk factors, vaccination history, and manifestations of tetanus.
Results: The subject consists of 53.8% males and single with age (Mean=15; SD=6.90). Four and 17 days were the shortest and longest incubation periods while one and six days were the shortest and longest onset periods respectively. A total of 24 (93.3%) patients had generalized tetanus. Nail puncture, road traffic accidents, and umbilical infection were the commonest sources of post-neonatal and neonatal tetanus in this study. Spasm is the commonest manifestation, present in 19 (73.1%) of the study population. This is closely followed by trismus in 57.7% of the cases. About half have a positive vaccination history. This study found case fatality of 7.7%.
Conclusion: Generalized tetanus was the commonest type seen in this study, while nail puncture, road traffic accident and umbilical infection were the most common sources of infection. Although, more than half of the study subjects received immunization to prevent tetanus, the case fatality in this study was in one in twelve sufferers.
Keywords: Epidemiology, review, tetanus, trend.
Correspondence:
Bello Surajudeen Oyeleke. Department of Paediatrics Dalhatu Araf Specialist Hospital. Shendam Road, PMB 07, Lafia, Nasarawa State. Email: surajudeenbello4@gmail.com. Mobile: +2347064641540.
References
Alex-Hart B and LongJohn D (2020). Tetanus in school-age children seen at the University of Port-Harcourt Teaching Hospital: A need for booster doses of tetanus vaccine. Archives of Current Research International. 20(2): 1 – 9. doi: 10.9734/ACRI/2020/v20i230172.
Animasahun BA, Gbelee OH, Ogunlana AT, Njokanma OF, Odusanya O (2015). Profile and outcome of patients with post–neonatal tetanus in a tertiary center in Southwest Nigeria: Any remarkable reduction in the scourge? Pan African Medical Journal. 21: 254 – 263. doi: 10.11604/pamj.2015.21.254.6488.
Atkinson W (2012). Tetanus epidemiology and prevention of vaccine-preventable diseases (12th edition). Public Health Foundation.
Bae C, Bourget D (2019). Tetanus. Stat Pearls.
Behrens H, Ochmann S, Roser M (2019). Tetanus. Our World in Data. Accessed from: https://ourworldindata.org/teta-nus#note-1.
Blencowe H, Lawn J, Vandelaer J, Roper M, Cousens S. (2010). Tetanus Toxoid Immunization to Reduce Mortality from Neonatal Tetanus. Int J Epidemiol. 39 (1): i10 –109. doi: 10.1093/ije/dyq027.
CDC (2015). Tetanus Symptoms and Complications. Centers for Disease Control and Prevention
Fatunde OJ and Familusi JB (2001). Post–neonatal tetanus in Nigeria: A need for booster doses of tetanus toxoid. Niger J Paediatr. 28 (2): 35–38.
Federal Ministry of Health Situation Analysis (2005). National child health policy. Nigeria: Federal Ministry of Health.
Felman A (2017). Medicine News Today. Accessed from: https://www.medical-newstoday.com/articles/163063.php.
FMOH and HS Nigeria (1992). Neonatal Tetanus. Nigeria Bulletin of Epidemiology. 2: 13-16.
Galazka A, Gasse F (1995). The Present State of Tetanus and Tetanus Vaccination. Curr Topics Microbiol Immunol. 1995: 31–53. doi: 10.1007/978-3-642-85173-5_2.
Grange AO (1991). Neonatal Tetanus in Lagos Metropolis. Niger J Paediatr. 18:12-22.
Janice L, Kerry H, Brunner, Suddarth's (2003). Textbook of Medical-Surgical Nursing 11th Edition. Jaypee Brothers Medical Publishers Ltd.
Lambo JA and Anokye EA (2013). Prognostic factors for mortality in Neonatal tetanus: A systematic review and Meta–analysis. Int J Infect Dis. 17: 1100 – 1110. doi: 10.1016/j.ijid.2013.05.016.
Lambo JA, Memon MI, Khahro Z.H, Lashari MI (2011). Epidemiology of neonatal tetanus in rural Pakistan. J Pak Med Assoc. 61:99 – 103.
Ogunkeyede SA, Daniel A, Ogundoyin O (2017). Paediatricotogenic tetanus. An evidence of poor immunization in Nigeria. Pan African Medical Journal. 26: 177–181. doi: 10.11604/pamj.2017.26.177.11519.
Ogunrin OA (2009). Tetanus – a review of current concepts in management. J Postgrad Med. 11 (1): 46 – 61.
Orimadegun AE, Adepoju AA, Akinyinka OO (2014). Prevalence and Socio-Demographic Factors Associated with Non-Protective Immunity against Tetanus among High School Adolescents Girls in Nigeria. Ital J Pediatr. 40:29-34. doi: 10.1186/1824-7288-40-29.
Oruamabo RS (2007). Neonatal tetanus in Nigeria: does it still pose a major threat to neonatal survival?. Arch Dis Child. 92: 9 – 10.
Oyedeji OA, Fadero F, Joel-Medewase V, Elemile P, Oyedeji GA (2012). Trends in Neonatal and Post-Neonatal Teta-nus Admissions at a Nigerian Teaching Hospital. J Infect DevCtries. 6:847-853. doi: 10.3855/jidc.2105.
Rodrigo C, Fernando D, Rajapakse S (2014). Pharmacological Management of Tetanus: An Evidence-Based Review. CritCare. 18: 2–17. doi:10.1186/cc13 797.
UNICEF, WHO, UNFPA (2000). Maternal and neonatal tetanus elimination by 2005: Strategies for achieving and maintaining elimination. United Nations Children's Fund.
WHO (2018). Maternal and Neonatal Tetanus Elimination. World Health Organization.
WHO (2019) Maternal and Neonatal Tetanus (MNT) elimination initiative. World Health Organization.
Wilkins CA, Richter MB, Hobbs WB, Whit-comb M, Bergh N, Carstens J (1988). Occurrence of Clostridium tetani in soil and horses. S Afr Med J.3:718-720.
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Published
2023-10-16
Issue
Vol. 8 No. 4 (2023)
Section
Articles