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Case-fatality of adult tetanus at Jimma University Teaching Hospital, Southwest Ethiopia.

BACKGROUND
Tetanus remains a major health problem in Ethiopia like in most other developing countries.


OBJECTIVES
To assess the clinical presentation, complications and outcome of tetanus patients.


METHODS
In this retrospective study, patients (age > 13 years) who were admitted to Jimma University Teaching Hospital from 1996 to 2009 were included.


RESULTS
Data from 171 patients were analyzed (129 males, 42 females, mean age 33 years). The mean hospital stay for patients discharged cured and deceased was 21.5 ± 12 and 6.5 ± 6.7 days, respectively. None of our patients was immunized for tetanus. Tracheostomy and mechanical ventilation (MV) was done in 10.5% and 11 %, respectively. The case-fatality was 38%. The mean annual admission and case-fatality increased over the study period from 9 to 20.5 and from 21 % to 51%, respectively. Establishment of intensive care unit (ICU) did not improve mortality due to infrequent tracheostomy and MV.


CONCLUSIONS
The case-fatality was high like in most other studies and the majority of patients died in the first few days indicating that adequate respiratory support was not given. Establishment of ICU did not improve mortality. Tetanus can be prevented by vaccination and if it occurs it needs well equipped ICU.