Clinical study of Pediatric Tetanus A hospital based study

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Clinical study of Pediatric Tetanus A
hospital based study

• Dr. Sanjeev Chetry
• Dr. Kamal Lochan Bora
• Prof. D.K. Patgiri

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Introduction

• Areteus inhuman calamity, and unseemly sight, a
  spectacle painful event to be hold, not to be
  recognised by dearest friends.
• Occurs sporadically.
• Not a notifiable disease.
• Not an uncommon condition in this part
• No comprehensive data available

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Materials and methods

• All cases in age group of 0 12yrs with features
  suggestive of tetanus.
• Period April 2002 to August 2005
• Grading done as per Modified Patel and Joag
  criteria.
• Medical and Surgical management.

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Age wise distribution of cases
Age Number of cases Percentage ()
0 1 month 10 20.8
1month - lt2yrs 3 6.3
2yrs - lt6yrs 14 27.1
6 12yrs 21 45.8
Total 48 100
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Age and sex wise distribution of the cases
33.4
18.8
Percentage of cases
12.5
8.3
12.4
8.3
4.2
2.1
Age --
6
12.5
39.6
47.9
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SHOWING POSSIBLE MODE OF ENTRY
Neonatal Tetanus
Post Neonatal Tetanus
Practices No. of cases
Application of goats excreta 4
Use of bamboo knife to cut Umbilical cord 2
Application of ash mustard oil 4
Total 10
Etiology No. of cases
Definite h/o injury 21
H/o chronic ear discharge 14
unknown 3
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Age and mode of infection in Post Neonatal
Tetanus
No. of cases -
Age -
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Clinical features in Post Neonatal Tetanus
Clinical features Number of cases Percentage
Trismus 38 100
Stiffness and rigidity 34 89.5
Intermittent spasm 26 55.3
Difficulty in swallowing 15 39.5
Fever 14 36.4
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Incidence of Tetanus according to grade (as per
Modified Patel Joag criteria)
10.5
21.1
68.4
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Showing incubation period
Days No. of cases Percentage
0 7 18 37.5
8 14 8 16.7
15 21 0 0
gt 22 5 10.4
Not known 17 36.4
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Showing Immunisation status
Neonatal Tetanus 10 Immunisation status of mother Immunisation status of mother Immunisation status of mother
Neonatal Tetanus 10 Unimmunised Immunised Partially immunised
Neonatal Tetanus 10 7 1 2
Post Neonatal Tetanus 38 Unimmunised child Immunisation not completed Unknown
Post Neonatal Tetanus 38 30 5 3
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Neonatal Tetanus
Showing Mortality
Post neonatal Tetanus
20
34.5
65.5
80
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Key message

• No change in occurence of cases.
• Its only the tip of an iceberg.
• Otogenic tetanus is most common below 6yrs while
  post traumatic tetanus is common above 6yrs.
• Check for tetanus immunisation in all cases with
  Otitis Media.
• Awareness about birth and cord care practices.
• Awareness about immunisation and its practical
  implementation in tea garden of upper Assam is
  the need of hour to reduce the incidence of cases.

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THANK YOU