Current Prognostic Factors of Tetanus in Abidjan: 2005-2014

Authors : Aristophane Koffi TANON, Adama DOUMBİA, Patrick Ahuatchi COFFİE

Pages : 125-131

Doi:10.5799/jmid.367529

View : 9 | Download : 4

Publication Date : 2017-09-15

Article Type : Research Paper

Abstract :Objective: To describe the epidemiological, clinical and prognosis aspects of tetanus in patients hospitalized at the Infectious and Tropical Diseases Unit of Treichville Teaching Hospital. Methods: A retrospective study of the medical records of all patients hospitalized between 2005 and 2014. The “Dakar prognosis score” was established on the basis of six parameters: incubation period, duration of invasion, site of entry, presence of paroxysms, body temperature and pulse rate. A logistic regression model was used to identify the factors associated with death. Results: Overall, 455 cases of tetanus were included, with a predominance of males insert ignore into journalissuearticles values(86%);. Most patients lived in Abidjan insert ignore into journalissuearticles values(77%);. A very high proportion of cases were generalized tetanus insert ignore into journalissuearticles values(96%);, and 137 patients insert ignore into journalissuearticles values(30%); died. The factors associated with death were age >60 years insert ignore into journalissuearticles values(aOR 2.76; 95% CI 1.07 to 9.91);, being a labourer insert ignore into journalissuearticles values(aOR 2.83 95% CI 1.07-9.39);, a severe Dakar prognostic score insert ignore into journalissuearticles values(aOR 5.76; 95% CI 2.26-14.72);, no intrathecal serotherapy insert ignore into journalissuearticles values(aOR = 15.6; 95% CI 5.40- 44.84);, no penicillin-therapy insert ignore into journalissuearticles values(aOR 2.33; 95% CI 1.11-4.87); and the presence of complications insert ignore into journalissuearticles values(aOR 8.53, 95% CI 4.83-15.09);. Conclusion: This study identifies a number of factors for a poor prognosis among patients with tetanus admitted to our hospital, indicating that measures to reduce morbidity and mortality due to tetanus should be strengthened and prevention improved in resource limited settings. The prognostic parameters in “the Dakar score” should therefore be adapted to the current epidemiological and clinical contexts in Côte d’Ivoire. 
Keywords : Prognosis factors, tetanus Côte dIvoire, West Africa