Morbidity and mortality of Tetanus Neontorum (T.N)In salahaldeen Governorate

Abstract

The objectives of the present study are, determination of mortality rate of T.N. in our province, reviewing lines of management & determination of poor prognostic signs. The case records of 35 cases of T.N. admitted to Tikrit General Hospital and Infectious Diseases Hospital in Tikrit were analyzed, over the period from 1989 to 1993. The diagnosis of T.N. depended upon WHO criteria. No cerebro-spinal fluid examination was done. Other tests were kept minimum. The author shared in the management of these cases. All babies were home delivered. All mothers were un-vaccinated against tetanus during pregnancy. Age range was 3-15 days on admission and weight range was 2.5-3.75 kilograms. Range of duration of illness before admission was 1-5 days. Thirty five cases of T.N. over 4 years indicate persistence of poor traditions in the conduct of delivery. The following poor prognostic factors were deduced from the study. (1) Late presentation. (2) Early cyanosis. (3) Temperature > 38 C. (4) Repeated convulsions. (5) Persistent lockjaw. (6) Dehydration. (7) Infected umbilicus. (8) Frothy mouth. (9) Low birth weight. (10) Younger age. (11) Prematurity. (12) Male sex. (13) Complications (pneumonia). The author concluded a mortalityrate of 64%, while international figures varied between 80-100%. Considering the effects of Gulf War in 1991, and the economic sanctions imposed on Iraq, 64% represents an acceptable achievement.