Tetanus: Epidemiology And Factors Associated With Death In The Departement Of Tropical And Infectious Diseases Of Donka National Hospital, Guinea

Introduction: In developing countries, tetanus remains a public health problem because of its frequency, severity, and still high mortality. The objective of this study was to describe the epidemiological profile of patients hospitalized for tetanus and to identify the factors associated with dying from it. Material and methods: This retrospective, descriptive, and analytical study reviewed hospital records of all patients, of all ages and genders who were treated for tetanus in our department over a 5-year period. Results: Among 3549 patients during the study period, 75 had tetanus (2.11%), and 71 of them were included in our study. The median age of patients was 35 years (range: 11-70 years) with a male prevalence of 80%. The most frequently affected socio-professional categories were students (21.1%), farmers (18.3%), workers (15.5%), and shopkeepers and tradespeople (15.5%). The main entry points were post-traumatic (40.9%), cutaneous (33.8%), and post-surgical (16.90%). Paroxysm (95.8%), trismus (93.0%), generalized contracture (67.6%), and dysphagia (46.5%) were the most frequent signs. Among these cases, 40.9% were severe (40.85%), 49.3% moderate (49.30%), and 9.6% benign. We recorded 34 deaths (48%). Factors associated with death were age > 60 years (P = 0.01), fever (P = 0.01), hypertension (P = 0.02), and HIV infection (P = 0.01). Conclusion: Tetanus remains a frequent disease with high lethality. Death is associated with specific factors that should be taken into account in the criteria for assessing its prognosis.