Duggal Mubeen Nazar, Bari Attia, Zeeshan Fatima, Jabeen Uzma
The Children's Hospital and Institute of Child Health, Lahore - Pakistan.
J Pak Med Assoc. 2019 Feb;69(2):174-177.
To determine the frequency of risk factors, vaccination status and outcome of tetanus in children beyond neonatal age at a tertiary care centre.
The prospective observational study was conducted at The Children's Hospital, Lahore, Pakistan, from January 2012 to December 2014, and comprised children aged between 1 month and 15 years of either gender admitted with diagnosis of tetanus. Variables recorded included age, gender, vaccination status in terms of number of diphtheria, tetanus and pertussis vaccine doses received per routine infant immunisation and booster doses of tetanus toxoid, risk factors as trauma, ear discharge, ear prick and duration of hospitalisation and outcome. Data was analysed using SPSS 16.
Of the 74 patients, there were 47(63.5%) males and 27(36.5%) females. Overall, the mean age was 6.56+3.15 years 50(67%) were unvaccinated, none (0%) had received booster dose and posttrauma immune prophylaxis. Besides, trauma was the most common risk factor in 33(44.6%) cases followed by ear discharge 15 (20.3%) and ear/nose prick 2(2.7%), while the risk factor was unknown in 24(32.4%) cases. Mean duration of hospitalisation was 14.35±11.65. Mortality rate 16(21.6%) was significantly associated with shorter duration of stay (p<0.001). Mortality was high among unvaccinated children compared to vaccinated children (p=0.01).
Vaccination coverage was found to be inadequate and post-trauma immune prophylaxis had been ignored..
确定某三级医疗中心非新生儿期儿童破伤风的危险因素频率、疫苗接种状况及预后。
2012年1月至2014年12月在巴基斯坦拉合尔儿童医院进行了一项前瞻性观察研究，纳入诊断为破伤风的1个月至15岁的儿童，无论性别。记录的变量包括年龄、性别、按照每次常规婴儿免疫接种所接受的白喉、破伤风和百日咳疫苗剂量以及破伤风类毒素加强剂量计算的疫苗接种状况、创伤、耳部流脓、耳部穿刺等危险因素、住院时间及预后。使用SPSS 16进行数据分析。
74例患者中，男性47例（63.5%），女性27例（36.5%）。总体而言，平均年龄为6.56±3.15岁，50例（67%）未接种疫苗，无人（0%）接受加强剂量及创伤后免疫预防。此外，创伤是33例（44.6%）最常见的危险因素，其次是耳部流脓15例（20.3%）和耳部/鼻部穿刺2例（2.7%），24例（32.4%）病例的危险因素不明。平均住院时间为14.35±11.65天。死亡率16例（21.6%）与住院时间较短显著相关（p<0.001）。未接种疫苗儿童的死亡率高于接种疫苗儿童（p=0.01）。
发现疫苗接种覆盖率不足，创伤后免疫预防被忽视。
