Mortality Rate and Prognostic Factors in Neonatal Tetanus: A 3-Year Analysis of Cases Presented to Turkey-Somalia Mogadishu Training and Research Hospital

Author:

Güdeloğlu Elif12ORCID,Demirel Mustafa Enes32ORCID

Affiliation:

1. Dr. Behçet Uz Pediatric Diseases and Surgery Education and Research Hospital, Izmir, Turkey

2. Turkey-Somalia Mogadishu Training and Research Hospital, Mogadishu, Somalia

3. Department of Emergency, Medical School of Düzce University, Merkez/Düzce, Turkey

Abstract

Abstract Objective The aim of this study was to evaluate mortality rate and prognostic factors in neonatal tetanus cases presented to Turkey-Somalia Mogadishu Training and Research Hospital. Methods A total of 35 neonatal tetanus cases presented to Turkey-Somalia Mogadishu Training and Research Hospital between 2014 and 2017 were included in this prospective observational study. Data on demographic, clinical and maternal obstetric characteristics, and laboratory findings including complete blood count and blood biochemistry were recorded in each patient. Study parameters were evaluated with respect to survivorship status, while multiple logistic regression analysis was performed to determine independent predictors of increased mortality risk. Results Overall, mortality occurred in 22 (62.9%) of 35 neonates diagnosed with neonatal tetanus. Tetanus prophylaxis was absent in the majority of neonates, regardless of survivorship status (100.0% in nonsurvivors vs. 84.6% in survivors, p = 0.131). In nonsurvivor versus survivor groups, significantly higher likelihood of constipation (50.0 vs. 7.7%, p = 0.002), contracture (81.8 vs. 46.2%, p = 0.035), and ventilator support (95.4 vs. 53.8%, p = 0.006) as well as significantly lower hemoglobin (14.45 ± 2.06 vs. 17.15 ± 1.77, p = 0.003) and potassium (3.50 ± 0.86 vs. 4.14 ± 0.93, p = 0.003) levels and neutrophil (3.34 ± 1.75 vs. 4.47 ± 1.08, p = 0.047, white blood cell (WBC) (5.54 ± 2.30 vs. 7.78 ± 1.70, p = 0.003) and platelet (median [min-max] 133.5 [68–332] vs. 196 [123–550], p = 0.006) counts were noted. Presence of contracture (odds ratio [OR]: 14.525, 95% confidence interval [CI]: 1.398–150.870, p = 0.025) and ventilator support (OR: 22.282, 95% CI: 1.269–391.131, p = 0.034) was the independent determinants of increased risk of mortality. Conclusion Our findings emphasize high mortality in neonatal tetanus cases in Somalia along with lack of maternal tetanus prophylaxis in majority of cases. Presence of contractures and ventilator support were significant determinants of poor survival, while factors such as constipation, lower hemoglobin, and potassium levels and lower neutrophil, WBC and platelet counts were also more common among nonsurvivors, albeit not found to be associated with mortality risk in the multivariate analysis.

Publisher

Georg Thieme Verlag KG

Subject

Infectious Diseases,Pediatrics, Perinatology and Child Health

Reference19 articles.

1. Progress towards the global elimination of neonatal tetanus, 1990-1998;World Health Organization;Wkly Epidemiol Rec,1999

2. Child mortality in a collapsing African society;M M Ibrahim;Bull World Health Organ,1996

3. Mortality rates in displaced and resident populations of central Somalia during 1992 famine;P S Moore;Lancet,1993

4. Determinants of noncompletion of the third dose of tetanus toxoid vaccine in pregnant women in Dschang Health District, Cameroon;F Ymele Fouelifack;Adv Prev Med,2020

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3