Analysis of the case fatality rate of tetanus among adults in a tertiary hospital in Turkey

The aim of this study was to present the epidemiological and clinical characteristics of tetanus as related to case fatality in 43 adult patients hospitalized between 1990 and 2000 in Turkey's largest state tertiary hospital. All patients were > or =15 years of age, with the mean age being 4...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2003-03, Vol.22 (3), p.188-190
Main Authors: ERGONUL, O, ERBAY, A, EREN, S, DOKUZOGUZ, B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Bacterial diseases
Bacterial diseases of the nervous system. Bacterial myositis
Biological and medical sciences
Clostridium tetani - drug effects
Clostridium tetani - isolation & purification
Fatalities
Female
Hospitalization
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Mortality
Protozoa
Rigidity
Severity of Illness Index
Survival Rate
Tetanus - drug therapy
Tetanus - epidemiology
Tetanus - mortality
Turkey - epidemiology
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Summary:The aim of this study was to present the epidemiological and clinical characteristics of tetanus as related to case fatality in 43 adult patients hospitalized between 1990 and 2000 in Turkey's largest state tertiary hospital. All patients were > or =15 years of age, with the mean age being 45 years. Sixty-five percent of the patients were male. Most patients (77%) were from rural Anatolia. The most common clinical manifestations were trismus (100%), abdominal rigidity (93%), dysphagia (81%), and risus sardonicus (72%). The overall case fatality rate was 58%. In a multivariable logistic regression model an incubation period of < or =8 days versus >8 days was a significant predictor of case fatality (odds ratio, 4.8; P=0.044; 95%CI, 1.04-22.26), as was each day of delay between onset of symptoms and admission to the hospital (odds ratio, 7.4; P=0.035; 95%CI, 1.15-48.28). Although the case fatality rate of tetanus in our clinic has declined in the last 5 years, the overall rate was high. This suggests a need for adult vaccination programs and/or a plan to educate the public to recognize symptoms early and then rapidly seek medical care.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-003-0904-8