Journal des maladies infectieuses et de la médecine préventive
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Tetanus in Women of Childbearing Age at Brazzaville University Hospital: Prevalence and Associated Factors

Ossibi Ibara BR, Adoua DT, Ekat M, Ekouya BG, Ellenga MFB, Amona M, Angonga PE, Bitséné MG, Poutoukoue S, Itoua C

Objective: To determine the prevalence of tetanus in women of childbearing age and to find out associated factors.

Patients and Methods: Prospective study for descriptive and analytical purposes of tetanus cases in women of reproductive age registered in the Infectious Diseases Department at the Brazzaville University Hospital between January 1st, 2018 and July 31st, 2019.

Results: Fifty-one cases of patients were collected (4.02% of admissions) with mean age 24.22 ± 10.38 (15-49 years), female students (n=31, 60.78%), single (n=43, 84.3%), low socio-economic status (n=33, 65.35%) and immunodepressed with HIV type 1 (n=10, 19.60%), (n=43, 84.31%). Patients lived in city (n=43, 84.31%). Immunization status was doubtful and absent respectively in 20 cases (39.21%). Patients had an average delay of 94.56 ± 45.38 hours (48-336) for trismus (n=41, 80.4%), other contractures (n=8, 15.7%), and paroxysms (2, 3.9%). Tetanus was generalized at admission (n=49, 96.1%), without complication (n=46, 90.2%). The entryway was integumentary (n=35, 68.6%), intramuscular (n=10, 19.6). The antitetanus serum was administered to all patients (100%) but suboccipital serum in only three patients (5.9%). In thirty patients (58.8%), the trimming of the entryway has not been realized. The Dakar score was ranked 3 in 25 patients (49.0%) and the mean duration of hospitalization was 10.55 ± 6.22 days (range 1-30). The evolution was favorable for thirty four patients (66.7%). The IM (p=0.000) and integumentary (p=0.003) and the Dakar 3 (p=0.000) gateways had a connection to the occurrence of death.

Conclusion: The situation of tetanus in women of childbearing age is worrying at the University Hospital of Brazzaville with a high prevalence despite the existence of a vaccine. It is therefore important to prevent this disease by systematizing tetanus vaccination within this target population group.