Factors influencing mortality in adult patients with tetanus hospitalized in the ward of Infectious and Tropical Diseases of Point-G Teaching Hospital of Bamako in Mali

Abstract

Introduction: Tetanus remains a public health problem in developing countries
The purpose of this survey was to study the clinical manifestations. The evolution of tetanus and to determine factors related to death in adults patients hospitalized in the ward of Infectious and Tropical Diseases of Point-G Teaching Hospital.
Patients and Methods: We conducted a retrospective and prospective study of descriptive and analytical type on inpatients. Records of all cases of tetanus aged 15 years and over hospitalized in the Department of Infectious Diseases at Point G University Hospital were included. The diagnosis of tetanus was clinically based and data were computed with SPSS software. Frequency outcome were compared for age, gender, job, ethnicity. Prognosis was evaluated according to Dakar scoring. Chi square test was used for the comparison of qualitative variables, p threshold was set at 0.05.
Results: Thirty-five cases of tetanus were collected out of nine hundred and seventy-two hospitalizations, a prevalence of 3.6%. All our patients were men and none had a correct vaccination. The majority of lesions, 31.7%, were due to a public road accident (PRA). The most exposed occupation was farmers with 37.1% and the age group 35-44 was the most represented with 40%. The co-morbidities were malaria, hypertension and diabetes with 50%, 80% and 100%, respectively. During the hospitalization, there were 13 complications with 61.5% deaths. The tetanus lethality rate was 25.7%.
Conclusion: In this study we noted the presence of comorbidity and potential complications increase the lethality of tetanus. Improvement of technical skills, in order to prevent, to diagnose and to manage quickly and correctly complications and comorbidities would have a positive impact on the prognosis of patients suffering of tetanus.