Author(s): Dao S, Oumar AA, Maiga I, Diarra M, Bougoudogo F
Objective: The aims of this study were to describe the therapeutic itinerary, the epidemiological and clinical features and outcome of tetanus in children and adult in Dakar. Patients and Methods: A prospective study was conducted from January to July 2009, enrolling systematically all patients aged of 1 year or more, that have been hospitalized for tetanus in the Infectious Diseases Clinic of the National University Hospital of Fann. Results: 67 cases (50 males, 17 females) of tetanus were enrolled representing 11.8% of total admission in the ward. The mean age of the patients was 27.8 ± 22.1 years. Most of the patients (89.6%) had at least visited one medical center before their admission. Fifteen patients (22.4%) went to at least two different health centers prior to their admission. The diagnosis of tetanus was unknown in 30% of cases after the first visit, in 33.3% of cases after the second visit and also 33.3% of cases after the third visit. In one patient the diagnosis of tetanus was made only after visiting the fifth health care center. Only seven patients (10.4%) have directly been admitted in Fann teaching hospital. The average delay from the beginning of the disease to admission in the infectious disease clinic was 3.8 ± 3.1 days. The case fatality rate was 26.9%. The existence of more than one previous visit in a health care center was significantly associated with increased of complications (p=0,001) and death (p=10-7). Conclusion: The awareness and the continuous training of health care workers can contribute to reduce significantly the mortality rate of tetanus.