Title : In-hospital clinical outcomes of adult tetanus patients admitted at a tertiary government hospital
Abstract:
Introduction: Tetanus is an acute disease caused by a powerful neurotoxin produced by the bacterium Clostridium tetani manifested by skeletal muscle spasm and autonomic nervous system disturbance. It is and is completely preventable by vaccination. In 2017, that the Philippine government had declared Neonatal and Maternal Tetanus to be eradicated. However, despite the efforts of the government to completely eradicate Tetanus through its Expanded Program on Immunization since 1976, tetanus still ranks as the 47th cause of mortality in 2021. Published local and/or regional epidemiologic studies about tetanus are rare. In Region 8 (Eastern Visayas), data about tetanus has not been well established thus the conduct of this study.
Methods: Utilized a retrospective, cross sectional study that included all Tetanus patients admitted at Eastern Visayas Medical Center (EVMC) from January 1, 2017 to December 31, 2021. All data collected analyzed descriptively and inferentially using Chi-square test.
Results: About 97 patients were included in the study. Majority were 40-59 years old (46%), males (92.8%), and majority came from Leyte (57.7%). Most common focus of infection was punctured wound (63.9%), most common site of infected were found in the feet (68.8%). Most common period of onset 72-96 hours (37%) and most common presenting sign and symptom was trismus (77.3). Majority of patients required mechanical ventilation (84.5%) majority of the patients were discharge alive (70.1%). This study concluded that there is no significant association between socio-demographic profile (sex, age and occupation) to the discharge disposition of patients. Likewise, there is no significant association between socio-demographic profile (sex, age and occupation) to the need for mechanical ventilation of patients with tetanus. There is significant association between incubation period and severity to the need for mechanical ventilation of patients with tetanus at EVMC. However, there is no significant association between focus and site of infection, period of onset and presence of signs and symptoms to the need for mechanical ventilation of patients with tetanus at EVMC.
Conclusion: Tetanus remains; however, a vaccine-preventable disease and improved preventative strategies should continue to be central to reducing morbidity and mortality from this disease.
