Traoré A M, Coulibaly I, Dabo G, Cissé H, Diallo K, Soukho-Kaya A, Diango M D, Cissé T, Dembélé M, Traoré H A, Pichard E, Minta D K
Faculté de médecine et d'odonto-stomatologie, 333 Bamako, Mali, Service des maladies infectieuses, CHU du Point G, 333 Bamako, Mali.
Service des maladies infectieuses, CHU du Point G, 333 Bamako, Mali.
Med Sante Trop. 2017 Jun 1;27(2):176-181. doi: 10.1684/mst.2017.0667.
The aim of this study was to describe the epidemiological, clinical, and prognostic aspects of tetanus associated with road accidents and to make recommendations. This observational study collected retrospective clinical data over a 9-year period about adults admitted for trismus and/or generalized or localized paroxysm after a road accident. The study included 25 patients, accounting for 22.12 % of all tetanus cases. Men were massively overrepresented (sex-ratio M/F: 24/1). The median age was 34 ± 8 years. In all, vaccination status was unknown for 4 patients and known to be negative for 21. Immunoprophylaxis was nonexistent in all cases. The generalized clinical form was dominant (96 %). Severity reached level III for 12 % of patients. The points of entry included open leg fractures (4 cases), head wounds (2), mucocutaneous wounds (14), and muscle contusions (5). The mean time to referral for tetanus was 8 ± 7 days, and the median hospital stay 9.08 ± 11 days. Patients were mostly residents of urban (56 %) and suburban areas (28 %) [P = 0.04]. Two cases were complicated by severe malaria. The mortality rate was 60 %, and 52 % of the deaths occurred within the first 72 hours after hospitalization. It is essential to promote serum therapy and tetanus immunization for patients after road accidents. Increasing the awareness of traditional healers of these treatments deserves consideration.
