[Tetanus following intramuscular injection in Dakar: epidemiological, clinical and prognostic features].

INTRODUCTION

tetanus stills a major public health problem in developing countries despite the availability of an efficient and accessible vaccine. The aim of this study was to evaluate the epidemiological and clinical pattern and the prognosis of intramuscular injection.

PATIENTS AND METHODS

This is a retrospective study from the medical charts of 4 6 patients admitted for tetanus following intramuscular injection in the infectious diseases clinic ward of Fann hospital of Fann, in Dakar, between January 1999 and December 2002.

RESULTS

The prevalence was 10% with a mean of 11.5 cases per year. The mean age was 34.5 years. The substance injected was known in 33 cases. Quinine injection was responsible in 32 cases. The period of onset was shorter than 48 hours in 39 cases (84.8%). The lethality rate was high (60.8%). The prognosis factors were the mean delay before h ospitalisation lower than 3 days (p = 0.03) and a scoring stage more than 4 (P = 0.01).

CONCLUSION

Tetanus following intramuscular injection is usually caused by quinine injection. The effective prevention relies on the training of health care workers and the strict application of the Guidelines of the National Program against Malaria.