[Epidemiology, clinical features and prognosis of juvenile tetanus in Dakar, Senegal].

This study was conducted to determine the prevalence of juvenile tetanus and to describe its epidemiological aspects, clinical features and prognosis. We prospectively recruited tetanus cases among patients in the age group 1-15 years admitted to the Infectious Diseases Clinic in Fann teaching hospital, Dakar, from March to September 2002. Forty cases of juvenile tetanus were recruited, accounting for 5.3% of total patients and 43% of all tetanus cases hospitalized during the study period. Mean age was 8.8 years +/- 4.4 years and sex-ratio M/F was 3. None of the patients was reported to have completed a full course of tetanus toxoid and most of them (77%) had been living in suburbs in Dakar were uneducated (77%) and had parents with no occupation (70%). Portals of entry were: skin injuries (62%), circumcision (20%), ear pearcing (5%) and suppurative otitis (8%). Tetanus became widespread in all cases, most of which having mild grade disease (72%). Pseudomonas aeruginosa bacteremia was diagnosed in the development of two fatal cases of otogenous tetanus. The overall case fatality rate was 8% (three deaths) and no sequelae was observed among those who recovered. The expanded programme on immunization should be reinforced and complemented with booster doses strategy to avoid tetanus whatever the age group.