Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital

Post-Neonatal Tetanus in an Intensive Care Unit

  • Nighat Sultana
  • Attia Bari The Children's Hospital & The Institute of Child Health Lahore
  • Mehwish Faizan
  • Muhammad Sarwar
Keywords: Tetanus, Autonomic instability, Children, Neurological, Outcome, Ventilation

Abstract

Objective: To determine the prognostic factors and outcome of tetanus in children of post-neonatal age admitted in the intensive care unit (ICU) of a tertiary care hospital.

Methods: This prospective cross sectional study, carried out in the Pediatric ICU of The Children’s Hospital Lahore from Jan 2013 to March 2017. Children of both genders with age range of two months to 16 years diagnosed clinically as tetanus were included. All 132 patients were scrutinized for all possible risk factors, need for mechanical ventilation and outcome. Data was analyzed by SPSS version 20.

Results: Mean age of children was 7.5±3.4 years with male predominance (70.5%). Only (38.6%) received three doses of vaccination but none had booster dose. Trauma (43.2%) encompassed maximum predisposing factor followed by ear or nose prick and ear discharge. Mean duration of ICU stay was 20±13.3 days. Mortality rate was (17.4%). Ventilator support was given to (78.8%). Neurological outcome was normal in (82.6%). Trauma, ear or nose prick in girls and ear discharge were significantly associated with poor outcome and death with p-value of <0.001, 0.011 and <0.001 respectively. Other factors associated with poor outcome were need for mechanical ventilation and neurological impairment with p-value of 0.001 and <0.001 respectively.

Conclusion: Tetanus is causing our children to suffer from devastating disease. Vaccination status is not satisfactory and along with trauma, ear discharge and ear or nose prick are identifiable risk factors. To combat these issues large scale vaccination and booster doses remains promising option.

doi: https://doi.org/10.12669/pjms.35.5.656

How to cite this:
Sultana N, Bari A, Faizan M, Sarwar M. Prognostic factors and outcome of Post-Neonatal Tetanus in an intensive care unit of a Tertiary Care Hospital. Pak J Med Sci. 2019;35(5):1233-1237. doi: https://doi.org/10.12669/pjms.35.5.656

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2019-08-21
Section
Original Articles