Tetanus
Chris Carter in Critical Care Nursing in Resource Limited Environments, 2019
Effective immunisation programmes in HIC have eradicated the disease, whereas in low-income settings tetanus remains a significant cause of mortality aimed to eradicate maternal and neonatal tetanus by 2015 and, apart from 18 countries, this has been achieved. The spore-forming bacillus is found in the bowels of herbivorous animals and distributed in soil. Examples of tetanus prone wounds include those contaminated with manure, soil or rusty metal, via an umbilical cord cut with a non-sterile instrument, burns, frostbite, puncture wounds and high-velocity missile injuries. In cases of severe tetanus, critical care admission is appropriate; however, mortality rates can be high. F. Ajose and O. Odusanya reported mortality of 70% from generalised tetanus in one hospital in Nigeria. M. M. Muteya et al. reported tetanus accounted for 2.5% of all admissions and had a mortality of 52.4% within the tetanus cohort in critical care admissions in the Democratic Republic of Congo.
Specific Infections in Children
Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar in Handbook of Refugee Health, 2021
Children in refugee settings are especially vulnerable to infection through a combination of disrupted immunisation programmes, poor water and sanitation and lowered immunity through malnutrition. Those on the move or living in a country where the immunisation programme is not accessible to refugees are at risk of being unvaccinated or incompletely vaccinated. The section discusses some specific vaccine-preventable diseases and other infectious diseases, such as tetanus, pertussis, measles, diphtheria, polio, dengue, typhoid, malaria, tuberculosis and human immunodeficiency virus. Many vaccine-preventable diseases are notifiable, and cases must be reported to public health bodies for monitoring and surveillance purposes, for example, measles and polio. Local guidance should be consulted for drug choices and doses, as well as reporting mechanisms.
Bites, stings and allergic reactions
Ffion Davies, Colin E. Bruce, Kate Taylor-Robinson in Emergency Care of Minor Trauma in Children, 2017
Bites from various animals are quite common in children. Regardless of the source of the bite, for the most part the general principles of wound management apply, including checking the child's tetanus vaccination status. Bites are usually heavily contaminated with bacteria, and the wound edges are often irregular or crushed. The human mouth carries large numbers of aerobic and anaerobic bacteria, which means that bites have a high risk of infection. For management, prophylactic antibiotics are required to cover both aerobic and anaerobic bacteria, for example coamoxyclavulanic acid. The other bites include dog bites, cat bites, snake bites, insect bites and so on. Insect bites may occur without a clear history. Symptoms within the first 48 hours are caused by a localised allergic response causing itching, erythema and swelling. Bee and wasp stings usually present as localised pain and swelling. Stings from jellyfish in the waters around the UK lead to local irritation only.
Tetanus: a patient in a primary healthcare setting
Published in Southern African Journal of Infectious Diseases, 2015
Indiran Govender, Christopher Clark
Tetanus is a disease caused by a Clostridium tetani infection, a complication of wounds. We present a case in which a patient presented with seizures and was incorrectly assessed to have epilepsy. Permission to publish this report was obtained from the patient. The clinical diagnosis was tetanus. A review of the literature is provided. Due to the fatality of this disease, primary care health professionals need to have a high index of suspicion of it as the consequences could be fatal if missed.
Perioperative care of a child with tetanus
Published in Southern African Journal of Anaesthesia and Analgesia, 2011
B Schloss, G Cambier, JD Tobias
Tetanus is caused by tetanospasmin, a toxin that is produced by the anaerobic bacterium, Clostridium tetani. Despite widespread vaccination, which limits its incidence in many parts of the world, tetanus may still occur owing to lack of immunisation related to religious tenets, cultural beliefs or inaccessibility to medical care. Of major concern during the perioperative care of such patients is control of the muscle spasms and the propensity for autonomic dysfunction, resulting in blood pressure instability. Ongoing muscle spasms may impair upper airway control or respiratory muscle function, thereby resulting in respiratory failure. Autonomic dysfunction may result in profound hypertension followed by hypotension, bradycardia and asystole. The pathophysiology of tetanus, its clinical manifestations, and current treatment options are discussed. The preoperative implications of tetanus and the care of these patients are reviewed.
Effect of cash incentives on tetanus toxoid vaccination among rural Nigerian women: a randomized controlled trial
Published in Human Vaccines & Immunotherapeutics, 2020
Tetanus toxoid vaccination is freely available for most women in developing countries, yet maternal and neonatal tetanus are still prevalent in 13 countries, 9 of which are in sub-Saharan Africa. We evaluated whether providing cash incentives increases the uptake of tetanus toxoid vaccination among women of childbearing age in rural northern Nigeria. We randomized amounts of cash incentives to women in three groups: 5 Nigerian naira (C5), 300 naira (C300), and 800 naira (C800) (150 naira = 1 U.S. dollar). Overall, of 2,482 women from 80 villages, 1,803 (72.6%) women successfully received the vaccination (419 of 765 [54.8%] women in C5, 643 of 850 [75.7%] women in C300, and 741 of 867 [85.5%] women in C800). Women in C300 and C800 were significantly more likely to receive the vaccine than women in C5. We further found that transportation costs are one of the significant barriers that prevent women from receiving vaccination at clinics, and that cash incentives compensate for transportation costs unless such costs are large.
Related Knowledge Centers
- Clostridium
- Clostridium Tetani
- Infectious Disease
- Tetanus Toxin
- Skeletal Muscle
- Clostridium Infections
- Clostridioides