Tetanus in children in four peripheral public hospitals in Dakar: Epidemiological-Clinical evolving therapeutics and associated factors

Abstract

Introduction: Tetanus is a severe acute poisoning caused by a neurotoxin produced by Clostridium tetani. Its frequency remains high in developing countries' hospitals. The insufficiency of data on juvenile tetanus in Senegal's peripheral zone motivated the realization of this study, which aimed to describe the epidemiological, clinical, therapeutic, evolutionary aspects and associated factors of child tetanus in four peripheral public hospitals. Methods: Multicenter, retrospective, descriptive and analytical study carried out in the four peripheral public hospitals in Senegal from the files of patients [0-15 years old] hospitalized for tetanus from 2014 to 2019. The diagnosis of tetanus is purely clinical. The data were used using an Excel spreadsheet. Results: A total of 37 patients were collected for a general hospital, such as 0.31% for all hospitalized children. The majority of patients (51%) were from rural areas. The patients' mean age was 88 months ± 37 [15 months and 15 years], and the sex ratio was 2.3. Nineteen (19) patients or 51% received an anti-tetanus vaccination against 15 patients or 41% who did not receive an anti-tetanus vaccine. The integumentary gateway was the most common (46%). Severe tetanus, classified as stage III of Mollaret, represented 24% of cases. Almost all of the patients had presented with a generalized form (89%). Nearly 65% of patients showed metabolic and nutritional complications. The case fatality rate was 5%, with factors associated with the occurrence of death, the severity of the symptoms, and the occurrence of complications. Conclusion: Juvenile tetanus remains a public health problem in Senegal's peripheral zone due to its high prevalence, its severity, and the occurrence of multiple complications.