TETANUS;

Still cannot be prevented, a three year retrospective study in DHQ hospital, Faisalabad

Abstract

Background: Tetanus still remains a major public health problem in Pakistan like in most other developing countries, with a
high morbidity and mortality. Objectives: To study the demographic profile the clinical profile, the outcome of the tetanus patients and
effectiveness of tetanus immunization coverage in district Faisalabad. Design: Retrospective record based study. Place and Duration:
Surgical unit-5 DHQ Hospital, Faisalabad from January 2010 to December 2012. Subjects and Methods: All data of 198 patients of
tetanus of any age and sex, diagnosed clinically was collected, compiled and analyzed from the Medical Records Department of the
Hospital. Results: Out of 198 patients of tetanus,138(69.7%) were males and 60(30.3%) were females. Their ages ranged from 1 to 85
years with a mean and a standard deviation respectively of 29.36 and 17.48 years.162 (81.8%) were from rural and36(18.2%) were from
urban areas. 47(23.7%) patients were having prior immunization and151(76.3%) were not immunized. The most common presenting
symptoms were trismus (47.5%), body stiffness(24.2%),fits(19.2%) and respiratory distress(9.1%). 23(11.6%) patients were having
mild disease,71(35.9%) patients were having moderate disease,71(35.9%) patients were having severe disease and 33(16.7%) were
having very severe disease. Overall mortality rate was 41.4%. Respiratory failure was the most common cause of death and there was
statistically significant association between mortality and increasing grades of disease. Conclusions: By making expanded programme
of immunization(EPI) more effective and removing flaws from out-dated vaccination through incomplete vaccination. By improving
awareness in public and complete vaccination through EPI program, we can reduce the incidence of tetanus.