Hodes R M, Teferedegne B
Addis Ababa University, Ethopia.
East Afr Med J. 1990 Dec;67(12):887-93.
Fifty five cases of tetanus in patients over age 11 years from 6 Addis Ababa hospitals over several years are analyzed. No patient had been immunized. Mean age was 30, male:female 39:16, 34 patients were admitted from April through August (P less than .05). Most common causes of wounds were metal objects, thorns, and nails. There was no history of trauma in 8 patients. Mean incubation period was 11.9 days (range 1-90 days), mean invasion period was 38 hours (range less than 1 day-9 days). All cases were generalized tetanus, clinically diagnosed. Laboratory data was not helpful in management. Patients were treated with tetanus antitoxin, antibiotics, and sedatives. 15 patients (27%) died, there was no correlation between treatment and outcome. Deaths correlated with short incubation and invasion periods, and presence of abdominal rigidity, tachycardia, sweating, and fluctuating blood pressure. Only 3 patients received tetanus toxoid prior to discharge. Comparison is made with African and western studies. Tetanus remains a significant problem in Ethiopia, and vaccination is highly recommended.
对来自亚的斯亚贝巴6家医院数年间11岁以上的55例破伤风患者进行了分析。所有患者均未接种过疫苗。平均年龄为30岁，男女比例为39:16，34例患者于4月至8月入院（P<0.05）。伤口最常见的原因是金属物品、荆棘和钉子。8例患者无外伤史。平均潜伏期为11.9天（范围1 - 90天），平均侵入期为38小时（范围少于1天至9天）。所有病例均为临床诊断的全身性破伤风。实验室数据对治疗并无帮助。患者接受了破伤风抗毒素、抗生素和镇静剂治疗。15例患者（27%）死亡，治疗与预后之间无相关性。死亡与潜伏期和侵入期短以及出现腹部强直、心动过速、出汗和血压波动有关。只有3例患者在出院前接种了破伤风类毒素。并与非洲和西方的研究进行了比较。破伤风在埃塞俄比亚仍然是一个严重问题，强烈建议进行疫苗接种。
