Indian experience of tetanus - A study from south India

"Abstract: Introduction: Tetanus is an old world disease where 2 centuries ago people had realized the link between wound leading to muscle spasm and fatality, Even today there are many cases of fatalities of tetanus being reported from different parts of the country even after viability of a tetanus toxoid and Immunoglobulin injections. This one of very few recent studies done in India on tetanus, as there is very little data available on tetanus so we are trying to share our experience on tetanus, so it will help the physicians to get a better understanding. Materials and Methods: This retrospective study has done collecting the patients' detail from 2017- 2019, detailed case sheet review was done and the patients' clinical presentation and the prognosis were noted in predesigned format. Inclusion criteria – all diagnosed cases of tetanus, exclusion criteria – patient already received treatment from the local hospital. The patient details were kept confidential during all times. Results: The total of 58 cases – 35 males and 23 females, The average duration of hospital stay was 15 days. The most common occupation were farmers (barefoot workers). The site of injury was the foot in 65% cases followed by injuries to the fingers or the hand in 30% and 5% cases due to injury while tooth picking with a pin, splinter removal using pins. Clinical symptoms – trismus “lockjaw” (41), difficulty in walking (2), limb pain/stiffness (17), back muscle pain/stiffness (12), dysphagia (7), 72% autonomic dysfunction. Opisthotonus position and risus sardonicus developed after 7-8 days of infection. 20% of cases were vaccinated still developed diseases. 18% mortality was noted most cases were unvaccinated cases. Conclusion: Tetanus is preventable diseases if TT vaccination and IMMUNOGLOBIN are administered on time. In all primary health care levels, the cold chain should be maintained for vaccines. The patients should be made sensitized about the consequence of the disease process. Keywords: tetanus, bacterial infection"