Pathogenesis and Management of Tetanus

Abstract

Tetanus is an infectious disease affecting the central nervous system caused by Clostridium tetani. The bacteria is an anaerobic Gram- positive bacilli that forms spores, which germinate in anaerobic condition to produce an exotoxin known as Tetanospasmin, and this is the whole mark of the pathogenesis of this disease. Tetanus remains a great public health problem in developing countries such as Nigeria. It affects all age group and both males and females. In Nigeria, the death rate differs from the range of 38% to 60%, depending on the infrastructural facilities and personnel at the reporting centre. The disease is not very common in developed nations. Mortality rate of 20-60% was reported in Africa. Four clinical types of tetanus were recognized such as generalized, cephalic, localized and neonatal type. Diagnosis is mainly clinical. The management of tetanus include Neutralization of unbound toxins, eliminating the source of the toxin and prevention of its further production, Control of spasm as well as general measures to support the life of the affected patient. It is a fatal disease with poor prognosis especially the cephalic type in adults, and neonatal tetanus. The objective of this work is to present a reviewed update on pathogenesis and management of tetanus. Additionally, to evaluate the contribution of tetanus towards the increased morbidity and mortality in Nigeria.