Shohra Qaderi1, Farah Qaderi2, Farzad Esmaeili Tarki3, Jaffer Shah4, Siamak Afaghi5, Mohmmad Delsoz6, Asghar Shah7. 1. Department of Communicable Disease, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Communicable Disease, Kabul Antani Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan. Electronic address: shohra_qaderi@yahoo.com. 2. Department of Communicable Disease, Emam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: farah.qaderi1@gmail.com. 3. Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: Farzad.esmaeili.t@sbmu.ac.ir. 4. Drexel University College of Medicine, Pennsylvania, USA. Electronic address: jaffer.shah@Drexel.edu. 5. Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: Siamak.Afaghi@sbmu.ac.ir. 6. Department of Communicable Disease, Kabul Antani Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan. Electronic address: Delsoz-mohammad@yahoo.com. 7. Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA. Electronic address: asghar_shah@brown.edu.
Abstract
OBJECTIVES: To describe the clinical features and outcomes of a case series of adult tetanus and illustrate inadequacies in confronting this preventable disease. DESIGN AND METHODS: This study retrospectively evaluated 24 relatively severe, confirmed cases of tetanus, diagnosed between March 2017 and December 2018, in Kabul Antani Hospital, Afghanistan. RESULTS: Regarding the source of the infection: 18 patients (75%) had a history of injuries, 1 had a history of a dog bite and 1 was an intravenous drug user; 4 patients had no external injuries or wounds. Dysphagia was the main clinical manifestation for which patients sought medical treatment (50%). Of the 12 patients who died, 7 presented with confusion and seizure, 1 with acute kidney injury, and 2 with pneumonia. CONCLUSIONS: Mortality due to tetanus is high in Afghanistan (Case Fatality Rate (CFR) 50%)), suggesting an urgent need for vaccination policy and programs, post-exposure protocols, and facilities equipped for the treatment of adult tetanus. The Ministry of Public Health of Afghanistan should seek to improve the accessibility, distribution and recording of tetanus immunization through vaccination.
OBJECTIVES: To describe the clinical features and outcomes of a case series of adult tetanus and illustrate inadequacies in confronting this preventable disease. DESIGN AND METHODS: This study retrospectively evaluated 24 relatively severe, confirmed cases of tetanus, diagnosed between March 2017 and December 2018, in Kabul Antani Hospital, Afghanistan. RESULTS: Regarding the source of the infection: 18 patients (75%) had a history of injuries, 1 had a history of a dog bite and 1 was an intravenous drug user; 4 patients had no external injuries or wounds. Dysphagia was the main clinical manifestation for which patients sought medical treatment (50%). Of the 12 patients who died, 7 presented with confusion and seizure, 1 with acute kidney injury, and 2 with pneumonia. CONCLUSIONS:Mortality due to tetanus is high in Afghanistan (Case Fatality Rate (CFR) 50%)), suggesting an urgent need for vaccination policy and programs, post-exposure protocols, and facilities equipped for the treatment of adult tetanus. The Ministry of Public Health of Afghanistan should seek to improve the accessibility, distribution and recording of tetanus immunization through vaccination.
Authors: Andrew Kazibwe; Noah Emokol Okiror; Felix Bongomin; Amelia Margaret Namiiro; Joseph Baruch Baluku; Robert Kalyesubula; Magid Kagimu; Irene Andia-Biraro Journal: Open Forum Infect Dis Date: 2022-07-25 Impact factor: 4.423