Mubeen Nazar Duggal, Attia Bari, Fatima Zeeshan, Uzma Jabeen.
Frequency of risk factors, vaccination status and outcome of tetanus in children at the Children's Hospital Lahore.
J Pak Med Assoc Jan ;69(2):174-7.

Objective: To determine the frequency of risk factors, vaccination status and outcome of tetanus in children beyond neonatal age at a tertiary care centre. Methods: The prospective observational study was conducted at The Children's Hospital, Lahore, Pakistan, from January 2012 to December 2014, and comprised children aged between 1 month and 15 years of either gender admitted with diagnosis of tetanus. Variables recorded included age, gender, vaccination status in terms of number of diphtheria, tetanus and pertussis vaccine doses received per routine infant immunisation and booster doses of tetanus toxoid, risk factors as trauma, ear discharge, ear prick and duration of hospitalisation and outcome. Data was analysed using SPSS 16. Results: Of the 74 patients, there were 47(63.5%) males and 27(36.5%) females. Overall, the mean age was 6.56+3.15 years 50(67%) were unvaccinated, none (0%) had received booster dose and posttrauma immune prophylaxis. Besides, trauma was the most common risk factor in 33(44.6%) cases followed by ear discharge 15 (20.3%) and ear/nose prick 2(2.7%), while the risk factor was unknown in 24(32.4%) cases. Mean duration of hospitalisation was 14.35±11.65. Mortality rate 16(21.6%) was significantly associated with shorter duration of stay (p<0.001). Mortality was high among unvaccinated children compared to vaccinated children (p=0.01). Conclusion: Vaccination coverage was found to be inadequate and post-trauma immune prophylaxis had been ignored.

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