[Morbidity and mortality of tetanus in the infectious and tropical diseases department in Abidjan 1985 - 1998].

UNLABELLED: In spite of the increase of the antitetanus immunization coverage, tetanus is still one of the main causes of morbidity and mortality in Côte d'Ivoire hospitals.

OBJECTIVE: The purpose of this study was to analyse the epidemiological, clinical and prognosis aspects of tetanus in the department of infectious diseases in Abidjan.

METHODS: A retrospective analysis was carried out from patients files admitted for tetanus in this department from 1985 to 1998. Tetanus diagnosis was based on clinical arguments.

RESULTS: Within a period of fourteen years, 1870 cases of tetanus representing 3% of hospitalised cases were admitted in the infectious diseases department. For 1387 patients answering to the inclusion criteria of the study the ratio MIF was 2.5. The median age was 28 years old (1-85 years). The entrance doors were dominated by cuts (49.3%) and intramuscular injections of drugs (18.7%). Despite the complete vaccination, 7 patients have presented tetanus (0.5%). About 17% have presented progressive complications especially cardio-respiratory complications (41.5%). The total lethality was 31.9% and the after- effects rate 2.3%. The factors of poor prognosis were the age > 60 years old, IM injections, generalised aspect, group III of severity and presence of complications.

CONCLUSION: Tetanus frequency certainly drops in infectious and tropical diseases department, but the lethality remains high therefore a reinforcement of the vaccination efforts and a management of patients are recommended.