Document Detail


Adult tetanus in Accra, why the high mortality? An audit of clinical management of tetanus.
MedLine Citation:
PMID:  16092319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tetanus is a life threatening infection relatively uncommon in the developed countries but occurs frequently in developing countries with case fatality rates of 40-60 %. Recent review of adult tetanus at the Korle-bu Teaching Hospital showed a high case fatality of 50%. In order to determine the factors underlying this high case fatality we conducted a retrospective clinical audit of the clinical management of adult tetanus admitted in 1994 to 2001 to the Korle-bu Teaching Hospital. METHODS: Data extracted from the admission and discharge books of the Fevers' Unit of Korle-bu Teaching Hospital, Accra and patient case notes were examined and analysed. RESULTS: Case fatality rate (CFR) varied from 25 % in 1999 to 72.7% in 2001. There was no gender difference in the case fatality. There was no significant difference in the mean age of those who died and those who survived, however, the CFR rose with age. The presence of neck and a dirty wound were associated with increased CFR. The CFR correlated with the severity of tetanus and increased when an expected treatment action, wound debridement, administration of antibiotics and/or immunoglobulin, was not performed. The administration of anti-tetanus toxin was associated with an increased CFR. CONCLUSION: The high case fatality rate in Accra was due to inappropriate management with most of the patients not treated with immunoglobulin and antibiotics and had inadequate wound care.
Authors:
I F A Hesse; A Mensah; D K Asante; M Lartey; A Neequaye
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  West African journal of medicine     Volume:  24     ISSN:  0189-160X     ISO Abbreviation:  West Afr J Med     Publication Date:    2005 Apr-Jun
Date Detail:
Created Date:  2005-08-11     Completed Date:  2005-10-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301891     Medline TA:  West Afr J Med     Country:  Nigeria    
Other Details:
Languages:  eng     Pagination:  157-61     Citation Subset:  IM    
Affiliation:
Department of Medicine and Therapeutics, University of Ghana Medical School College of Health Sciences, Accra. ahesse@ug.edu.gh
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Debridement
Drug Utilization Review
Female
Ghana / epidemiology
Hospital Mortality*
Hospitals, Teaching / standards*
Humans
Male
Medical Audit*
Middle Aged
Patient Care Management / standards
Retrospective Studies
Tetanus / diagnosis,  mortality*,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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