Improving case fatality rate of adult tetanus in urban Nigeria: focus on better facilities of care.

Tetanus is a life threatening preventable infection with a high mortality. Our aim was to determine the current case fatality rate at our centre in a retrospective case review of patients aged > 10 years who had been hospitalized with tetanus between August 2006 and July 2011. We show the intrahospital case fatality rate. Data are based on 176 cases for which we had sufficient information. There was a preponderance of males (3.09:1); 167 (95%) had generalized tetanus and nine (5%) had localized tetanus. The overall case fatality rate was 56.2% and was higher in males (64.4%) than females (27.9%; P = 0.0001). In a multivariate analysis, older age (P = 0.000), male gender (P = 0.005) and a longer duration of admission (P = 0.004) were significant determinants of outcome. The case fatality rate of tetanus has declined at our centre from 70% between January 2004 and March 2006 to 56.2% currently. Improved facilities are required in order to significantly reduce adverse outcome from tetanus.