Evaluation of Tetanus Cases Presenting to the Emergency Department at a Tertiary hospital in Somalia

Şule Yakar; Nasteho Mohamed Sheıkh Omar; Funda İpekten

doi:10.19161/etd.1400851

TR EN

Somali'de Üçüncü Basamak Bir Hastanenin Acil Servisine Başvuran Tetanoz Olgularının Değerlendirilmesi

Öz

Amaç: Tetanoz, Clostridium tetaninin ürettiği toksinlerin neden olduğu kas spazmları ve trismusla karakterize bir enfeksiyondur. Tetanoz aşıyla önlenebilir bir hastalık olmasına rağmen gelişmekte olan ülkelerde ölüm oranlarının yüksek olduğu bir halk sağlığı sorunu olmaya devam etmektedir. Bu çalışma, tetanoz hastalarının klinik profillerini ve sonuçlarını değerlendirmek, hospitalizasyon ünitesini, hastanede kalış süresini ve mortaliteyi etkileyen faktörleri belirlemek amacıyla yapıldı. Gereç ve Yöntem: Bu çalışma; Somali'deki Üçüncü basamak bir acil serviste tetanoz tanısı alan hastalarla yürütülen retrospektif, kesitsel bir çalışmadır. Demografik veriler, semptomlar, laboratuvar bulguları ve uygulanan tedavi yöntemleri ile hospitalizasyon ünitesi (servis/yoğun bakım ünitesi), hastanede kalış süresi ve mortalite ilişkisi analiz edildi. Bulgular: Dört yıllık çalışma süresinde tetanoz tanısı alan 67 hasta çalışmaya dahil edildi. Hastaların ortalama yaşı 12,8±14,89 yıl olup %73,1'i erkekti. En sık görülen semptom jeneralize kas spazmı (%85,7), en sık kullanılan ilaç ise benzodiazepinler (%95,5) idi ve ortalama hastanede kalış süresi 10,73±8,15 gündü. Yoğun bakımda yatan hasta oranı ise %20,9 olarak saptandı. Toplam mortalite oranı ise %19,5 olarak hesaplandı. Opisthotonos, boyun sertliği, risus sardonicus, jeneralize kas spazmı ve dispne varlığı mortalite ile anlamlı korelasyon göstermiştir (p<0.05). Sonuç: Tetanoz Somali'de mortalitesi yüksek, önemli bir halk sağlığı sorunu olmaya devam etmektedir. Acil servise başvuru sırasında geç dönem klinik bulgular olması, hastanın yoğun bakım ünitesine kabulü ve mortalite ile güçlü bir şekilde ilişkilidir.

Anahtar Kelimeler

Evaluation of Tetanus Cases Presenting to the Emergency Department at a Tertiary hospital in Somalia

Abstract

Aim: Tetanus is an infection characterized by muscle spasms and trismus caused by toxins produced by Clostridium tetani. Although tetanus is a vaccine-preventable disease, it continues to be a public health problem in developing countries with high mortality rates. This study was conducted to evaluate the clinical profile and outcome of tetanus patients and determine the factors affecting the hospitalization unit, the length of hospital stay, and mortality. Materials and Methods: This is a retrospective cross-sectional study conducted with patients diagnosed with tetanus in a Tertiary care emergency department (ED) in Somalia. The relationship of demographic data, symptoms, laboratory findings, applied treatment methods with the hospitalization unit (regular inpatient floor/intensive care unit), length of hospital stay, and mortality were analyzed. Results: Sixty-seven patients diagnosed with tetanus during a 4-year study period were included. The mean patient age was 12,8±14,89 years, and 73,1% were males. Generalized muscle spasm (85,7%) was the most common symptom, benzodiazepines (95,5%.) were the most commonly used medications, and the mean length of hospital stay was 10.73±8.15 days. The rate of patients hospitalized in the ICU was 20,9%. The overall mortality rate was calculated as 19,5%. The presence of opisthotonos, neck stiffness, risus sardonicus, generalized muscle spasm, and dyspnea significantly correlated with mortality (p<0.05). Conclusion: Tetanus remains a significant public health problem with high mortality in Somalia. Late-stage clinical findings at ED presentation are strongly associated with admission to the intensive care unit and mortality.

Keywords

References

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Details

Primary Language

English

Subjects

Pediatric Emergency , Pediatric Infectious Diseases , Emergency Medicine , Infectious Diseases , Clinical Microbiology

Journal Section

Research Article

Authors

Şule Yakar ^*
0000-0002-0885-8445
Türkiye

Nasteho Mohamed Sheıkh Omar
0000-0001-7382-3436
Somalia

Funda İpekten
0000-0002-6916-9563
Türkiye

Publication Date

September 9, 2024

Submission Date

December 6, 2023

Acceptance Date

May 24, 2024

Published in Issue

Year 2024 Volume: 63 Number: 3

DOI

https://doi.org/10.19161/etd.1400851

IZ

https://izlik.org/JA62RJ85TH

Cite

RIS / Bibtex

Vancouver

1.Şule Yakar, Nasteho Mohamed Sheıkh Omar, Funda İpekten. Evaluation of Tetanus Cases Presenting to the Emergency Department at a Tertiary hospital in Somalia. EJM. 2024 Sep. 1;63(3):428-34. doi:10.19161/etd.1400851