Prognosis factors for neonatal tetanus in Dakar

Objective - The purposes of the study was to determine the epidemiological, clinical and prognosis aspects of neonatal tetanus in Dakar and to give recommendations for its eradication. Patients and methods - This retrospective study concerned newborns hospitalized in the Department of Infectious Diseases, for neonatal tetanus, from January 1994 to December 2000, at the Farm hospital in Dakar. We recorded data concerning newborns (age, sex, injection of anti-tetanus serum, type of feeding, period between first sign and hospitalization, birth weight, tetanus gravity, evolution) and data concerning mothers (notion of tetanus vaccination, place of delivery). Results - We recorded 273 cases of neonatal tetanus. The average number was 39 cases per year. The median age was 7 days. The main factors of prognosis were: age under or equal to seven days, no vaccination in mothers, delivery outside of healthcare institutions, birth weight under 2500g, stage III tetanus or score superior to 4, and presence of complications. The main recommendations to eradicate neonatal tetanus are to promote prenatal consultations, tetanus vaccination during pregnancy, and delivery in healthcare institutions. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.