Résumé
Objectives. - This Study had for aim to describe and compare the epidemiological, clinical and outcome features of tetanus in neonates (NT) and women of child bearing age (WCBAT) in Dakar.
Patients andinethod. - This retrospective study was made on NT (3 to 28 days of age) and WCBAT (15 to 49 years of age) patient files, admitted in the Farm University Hospital Infectious Diseases Clinic from 2000 to 2007.
Results. - One hundred and thirty-eight WCBAT (11.9%) and 103 NT (8.9%), for a total of 1156 cases of tetanus were admitted. A decrease of the annual rate of these populations was noted over this 8 year period.
The majority (59.4%) of WCBAT was between 15 and 25 years of age and the mean age of NT was 9.3 days. Most of the patients in both groups came from suburban areas (78%). The tetanus immunization status was not updated for 92% of WCBAT. The most frequent portals of entry were cutaneous wounds for WCBAT (77.4%) and umbilical stumps for NT (85.4%). On admission, 64% of NT presented with severe tetanus (stage III on the Mollaret scale) compared to 11.6% for WCBAT. The death rate was significantly higher in NT (48.5%) than in WCBAT (26.8%); p = 0.0005.
Conclusion. - To eliminate neonatal tetanus, the prognosis of which is worse in Dakar, an intensification of the large vaccination program is needed with supplementary vaccination campaigns including women of child bearing age in areas of risk. (C) 2008 Elsevier Masson SAS. Tous droits reserves.