Complications infectieuses au cours du Tétanos au service des Maladies Infectieuses et Tropicales à Abidjan, Côte d’Ivoire

Abstract

Objective. Describe the infectious complications during tetanus and to identify the factors associated with their occurrence as well as with mortality. Design:  We conducted a retrospective study including patients hospitalized for tetanus at the contagious and tropical diseases department in Abidjan from 2015 to 2020. The diagnosis of tetanus was confirmed based on the presence of clinical signs. Infectious complications were evaluated based on a range of clinical and biological arguments. Multivariate logistic regression to assess potential risk factors for tetanus complications and mortality. Results: We included 191 cases of tetanus.  The median age was 25 years old.  The portals of entry were found in 83.2%. They concerned the skin in almost all cases (91.2%). 83 patients presented at least one infectious complication (43.5%). Infectious complications were cutaneous superinfection (83%), urinary tract infections (11%) and pulmonary superinfection (6%). In multivariate analyses, the age group 15-60 years (p<0.001), the presence of comorbidities (p<0.01), and Dakar score ≥ 2 (p<0.001) were factors associated with the occurrence of infectious complications. Mortality was 30.4%. The factors associated with death were incubation < 7 days (p=0.003), presence of q SOFA ≥ 2 (p=0.005), time to treatment (p= >0.01) and presence sepsis (p= 0.01). Conclusion: High rates of infectious complications and mortality in patients admitted to hospital for the management of tetanus. Early diagnosis of infections will significantly reduce morbidity and mortality related to infectious complications of tetanus.