Review of tetanus admissions to a rural Ugandan hospital

Abstract

Tetanus, which can be eliminated through an effective immunization programme, remains a significant cause of morbidity and mortality in Uganda with a high case fatality rate. This study was carried out in St Francis Hospital Buluba (SFHB) after observing that the hospital was registering an abnormally high number of tetanus patients. Its aim was to retrospectively establish the socio-demographic characteristics of the patients and determine the case-fatality rate among tetanus patients admitted between 2005- 2008. Records of all patients registered and treated for tetanus up to the time of death or discharge on the Medical and Pediatric wards were evaluated. Case notes of 71 patients were retrieved and analyzed for clinical characteristics. During the three-year period under study, 163 patients (0.65% of all admissions) were managed for tetanus. Analysis was done for only 154 (94.5%) patients because records of the others lacked basic data. The majority of the patients (67%) were males and most were young (81% were below 13 years of age). Forty two percent (42%) came from areas outside Mayuge district. The registered case-fatality rate was 47%, with mortality being highest in the extremes of age. This paper recommends scaling up and sustaining immunization service to the whole population. Presentation of an immunization certificate should be made compulsory for all children joining school at all levels. Finally, programmes that help the population to access booster doses later in life should also be implemented.