联邦教学医院冈贝儿童破伤风的流行病学趋势和病死率：20 年回顾。

EPIDEMIOLOGIC TREND AND CASE FATALITY OF CHILDHOOD TETANUS IN FEDERAL TEACHING HOSPITAL GOMBE; A 20YEARS REVIEW.

机构信息

Department of Paediatrics, Federal Teaching Hospital, Gombe.

出版信息

West Afr J Med. 2023 Nov 10;40(11 Suppl 1):S9.

Abstract

INTRODUCTION

Tetanus is a vaccine-preventable disease, it remains a significant cause of morbidity and mortality in both neonatal and post-neonatal periods, especially in developing countries with limited health facilities and inadequate vaccination. The overall case fatality rate (CFR) is 13.2% globally, highest in the neonatal period and in sub-Saharan Africa. CFR is 64%, 47%, and 43% in Nigeria, Uganda, and Tanzania respectively.

OBJECTIVES

To determine the Case Fatality Rate of Childhood tetanus in FTHG from 2000-2019.

METHODOLOGY

All cases and deaths from tetanus amongst children aged 0-18 years in paediatric medical ward of FTHG over the last two decades diagnosed clinically and classified using ICD-10 were analysed.

RESULTS

95 cases of tetanus out of 26,716 total admissions constituting 0.004%. There were 49 tetanus deaths out of 3956 total childhood deaths (0.012%) over the study period. Males constituted 66% (63/95). 30% (28/95) were aged 0-28 days; 23.1% (22/95) were adolescents. Fulani and Hausa constituted 37% (34/95) and 31% (29/95) respectively. Admission was highest in the dry season 52% (50/95 %). The overall tetanus CFR was 51.6%; 78% of deaths were in males (38/49), 30% in neonates, and 23% in adolescents. CFR was highest during the dry season (67.3%). Hausa and Fulani had CFR of 51% and 40% respectively. P-value <0.05 The CFR was 88% between 2000-2004, 72% from 2005-2009, 71% between 2010-2014 and 33% from 2015-2019.

CONCLUSION

Tetanus CFR is still high among neonates and adolescents. Maternal tetanus vaccine and booster doses in children need strengthening.

摘要

简介

破伤风是一种可通过疫苗预防的疾病，在新生儿和新生儿后期仍然是发病率和死亡率的重要原因，尤其是在卫生设施有限和疫苗接种不足的发展中国家。全球总体病死率（CFR）为 13.2%，新生儿期和撒哈拉以南非洲地区最高。在尼日利亚、乌干达和坦桑尼亚，CFR 分别为 64%、47%和 43%。

目的

确定 FTHG 2000-2019 年儿童破伤风的病死率。

方法

对过去 20 年来在 FTHG 儿科病房临床诊断并使用 ICD-10 分类的 0-18 岁儿童破伤风病例和死亡病例进行分析。

结果

26716 例总住院人数中，有 95 例破伤风病例，占 0.004%。在研究期间，3956 例儿童死亡中，有 49 例（0.012%）为破伤风死亡。男性占 66%（63/95）。30%（28/95）的患者年龄在 0-28 天；23.1%（22/95）为青少年。富拉尼族和豪萨族分别占 37%（34/95）和 31%（29/95）。住院人数在旱季最高，占 52%（50/95）。总的破伤风 CFR 为 51.6%；78%的死亡病例为男性（38/49），30%为新生儿，23%为青少年。旱季的 CFR 最高（67.3%）。富拉尼族和豪萨族的 CFR 分别为 51%和 40%。P 值<0.05 CFR 在 2000-2004 年为 88%，2005-2009 年为 72%，2010-2014 年为 71%，2015-2019 年为 33%。