Outcome of Neonatal Tetanus in Hospitalized Patients

Abstract

Objective: To determine the outcome of neonatal tetanus in hospitalized patients.

Study Design: A hospital based cross sectional study.

Place and Duration of Study: This study was conducted in Children Hospital Quetta from April 2011 to
March 2012.

Materials and Methods: A hospital based cross sectional study was conducted to determine the outcome of neonatal tetanus. 60 full term neonates from 0 to 28 days of age were included in the study after fulfilling the criteria of tetanus. Diagnosis was established exclusively on clinical grounds.

Results: Mean age of presentation was 7.5 days, male female ratio was 3:1. Most common presentation was generalized seizure in 51. 5 % cases, 30.1 % presented with lock jaw, 15.1% presented with opisthotonos and only 03. 3% presented with poor sucking. 92 % mothers were illiterate, 85% belong to the low socio economic status, 78% were from rural area, 75% delivered at home, immune status was low in 70% mothers, cord was cut by non sterilized equipments in 65%, cord was tied with unclean thread in 60%, unhygienic material was applied to the cord in 54%, and 25% developed tetanus after circumcision done by non sterilized instruments at home. 25 out of 60 neonates died and the overall mortality rate was 40.1% out of 60 cases, 24 were put on ventilator and 9 of them (37.5%) died, while out of 36 unventilated cases 16 (44.4%) died.

Conclusion:  The findings of the study demonstrate that the high mortality rate of neonatal tetanus is due to lack of knowledge of risk factors. Lack of maternal education, low immune status of mothers against tetanus along with unsafe and unhygienic delivery practices are major risk factors responsible for the development of neonatal tetanus.