Mbaye K Diallo, Lakhe N A, Sylla K, Diallo V M P Cissé, Massaly A, Ka D, Fall N M, Déguénonvo L Fortes, Ndour C T, Soumaré M, Seydi M
Clinique des maladies infectieuses, CHNU de Fann, BP 5035 Dakar, Sénégal.
Laboratoire de parasitologie-mycologie, faculté de médecine, université Cheikh-Anta-Diop de Dakar, Sénégal.
Bull Soc Pathol Exot. 2018;111(5):275-277. doi: 10.3166/bspe-2019-0051.
This retrospective, descriptive study carried out in the Infectious Diseases Department of CHNU, Fann from 1 January 2012 to 3st December 2016 aimed to describe the epidemiological aspects and the course of post-circumcision tetanus and to formulate public health recommendations. During our study period, 16 cases of post-circumcision tetanus were collected out of a total of 452 patients with tetanus, equivalent to a rate of 3.5%. The median age was 8 years (3-40). None of the patients had a vaccination card. In 63% of cases, circumcision was performed at home, by a practitioner whose qualification was not documented in 63% of cases. All signs of tetanus were found with trismus (100%), dysphagia (63%) and paroxysms (88%). These were mostly Mollaret stage II forms in 14 cases, and grade 3 Dakar score in 7 cases. The median duration of hospitalization was 10 days [6-15]. Mechanical or infectious complications were noted in two cases, with a lethality rate of 13%. Post-circumcision tetanus is a reality in Senegal. Good community awareness, continuous training of staff and implementation of vaccination catch-up strategies for children of circumcised age should eradicate this form of tetanus.
