Review Tetanus in Burirum Hospital Jan. 2000-Apr. 2005
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Abstract
Background: Tetanus should be a rare disease in Thailand and in Burirum provinces, which were successful immunization programs and had modern medical knowledge. But why we still found tetanus cases occasionally all year.
Objective: To study the cause, incidence, clinical manifestation, laboratory investigation, treatment, result and clinical course of tetanus patients
Research design: This research is retrospective descriptive study.
Subjects: Inpatients were diagnosed tetanus in Burirum Hospital during 1st Jan 2000.-31st Apr 2005.
Methods: By descriptive statistic methods, (mean, median, average and percent)
Result: Incidence of tetanus in Burirum Hospital was 32 cases. The highest incidence of reported tetanus were among persons aged 60-80 years-old Thai farmers. Diagnosis was from history and clinical presentation. Common form of tetanus was generalized tetanus. Most patients who sustained acute injury did not seek medical care for their wounds or did not receive the prophylaxis tetanus toxoid or antitoxin for tetanus. Onset of clinical after wound injury was among 10 days. Average days of admission was 31 days. Average cost of treatment was 101,015 bahts per case. Treatment in most patients were admitted in ICU 87.57%, early tracheostomy 84.37%, intermittent intravenous diazepam (100%), Oral diazepam 93.75%, tetanus antitoxin received 93.75% (average dose was 40,133 units/ case), tetanus toxoid booster were received 59.37% after admission. All cases received antibiotic for prophylaxis infection. Wound debridement was done in 72.73% of wound cases. Mortality rate was 15.625% from major complication.
Conclusion: Tetanus is worldwide distribution, most disease occurs in elderly. Tetanus occurs in several clinical forms, including generalized, neonatal, cephalic and localized disease. In Burirum Hospital tetanus is a disease affecting the elderly Thai farmers, who are likely to be exposed to wound injury without first aid care and booster dose of vaccination. Although tetanus is entirely preventable by immunization. Therefore, improved education in general population, physicians and recheck up variable of vaccine should be done in Burirum province.
Key word: Tetanus
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References
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