Assessment of Incidence and Mortality of Tetanus at Sir Ronald Ross Institute of Tropical andCommunicable Diseases (Govt. Fever Hospital), Hyderabad – Five Year Study

Back ground:Tetanus is a neurological disorder characterised by increased muscle tone, spasms and autonomic instability with high a mortality .Though it is easily preventable with highly effective vaccine, tetanus is still a major health problem in India and other developing countries and is associated with high morbidity and mortality. Aims: The aim of our study is to assessthe epidemiological and clinical profile of tetanus and outcome of the patients in relation to the clinical grading of the patients. Materials and Methods:A total of 157Tetanus patients who were admitted in SRRITCD,Hyderabad in a period of 5 years from January 2010 to December 2014 were taken as study group. For all patients epidemiological features and mortality were assessed. Results:In this study, males (56.69%) were commonly effected than females( 43.31%). Only 21.66% of the patients had primary childhood immunization. None of the patients received tetanus immunoglobulins. 74.25% had a reasonably identifiable acute injury prior to the onset of tetanus and commonly involved the lower limbs(79%). All patients had generalized tetanus with 40.76% mortality. Patients with incubation period of less than7 days showed 58.06% mortality, patients with grade IIIwere with 85.24% mortality whereas grade IV patients showed 100% mortality. Theseverity of the disease was found to be significantly associated with higher mortality. Conclusions: Tetanus, a vaccine preventable disease still remains as difficult disease with high morbidity and mortality. The incidencecan be reduced by implementing the preventive measures like strengthening of primary immunisation programme , implementation of effective immunisation program for adults, educating the people about booster doses of tetanus vaccine for every 5 years to maintain protective level of tetanus antibodies and proper wound care .