Sako F B, Sylla A O, Diallo M O S, Touré A, Traoré F A, Tounkara T M, Chamkoue B Woachie, Barry M, Cissé M
Université Gamal Abdel Nasser de Conakry, Guinée, Service des maladies infectieuses et tropicales de l'hôpital national Donka, Conakry, Guinée.
Université Gamal Abdel Nasser de Conakry, Guinée, Institut national de santé publique, Conakry, Guinée.
Med Sante Trop. 2019 Aug 1;29(3):333-336. doi: 10.1684/mst.2019.0924.
In developing countries, tetanus remains a public health problem because of its frequency, severity, and still high mortality. The objective of this study was to describe the epidemiological profile of patients hospitalized for tetanus and to identify the factors associated with dying from it. This retrospective, descriptive, and analytical study reviewed hospital records of all patients, of all ages and genders who were treated for tetanus in our department over a 5-year period. Among 3549 patients during the study period, 75 had tetanus (2.11%), and 71 of them were included in our study. The median age of patients was 35 years (range: 11-70 years) with a male prevalence of 80%. The most frequently affected socio-professional categories were students (21.1%), farmers (18.3%), workers (15.5%), and shopkeepers and tradespeople (15.5%). The main entry points were post-traumatic (40.9%), cutaneous (33.8%), and post-surgical (16.90%). Paroxysm (95.8%), trismus (93.0%), generalized contracture (67.6%), and dysphagia (46.5%) were the most frequent signs. Among these cases, 40.9% were severe (40.85%), 49.3% moderate (49.30%), and 9.6% benign. We recorded 34 deaths (48%). Factors associated with death were age> 60 years (P = 0.01), fever (P = 0.01), hypertension (P = 0.02), and HIV infection (P = 0.01). Tetanus remains a frequent disease with high lethality. Death is associated with specific factors that should be taken into account in the criteria for assessing its prognosis.
在发展中国家，破伤风因其发病频率、严重程度以及居高不下的死亡率，仍然是一个公共卫生问题。本研究的目的是描述破伤风住院患者的流行病学特征，并确定与之相关的死亡因素。这项回顾性、描述性和分析性研究，对我们科室在5年期间治疗的所有年龄和性别的破伤风患者的医院记录进行了审查。在研究期间的3549例患者中，75例患有破伤风（2.11%），其中71例纳入我们的研究。患者的中位年龄为35岁（范围：11 - 70岁），男性患病率为80%。受影响最频繁的社会职业类别是学生（21.1%）、农民（18.3%）、工人（15.5%）以及店主和商人（15.5%）。主要的感染途径为创伤后（40.9%）、皮肤（33.8%）和术后（16.90%）。痉挛（95.8%）、牙关紧闭（93.0%）、全身挛缩（67.6%）和吞咽困难（46.5%）是最常见的症状。在这些病例中，40.9%为重度（40.85%），49.3%为中度（49.30%），9.6%为轻度。我们记录到34例死亡（48%）。与死亡相关的因素为年龄>60岁（P = 0.01）、发热（P = 0.01）、高血压（P = 0.02）和HIV感染（P = 0.01）。破伤风仍然是一种常见且致死率高的疾病。死亡与特定因素相关，在评估其预后的标准中应予以考虑。
