Seasonal variation in Non Neonatal Tetanus: 7 years Retrospective Record based Study
Abstract
Non-neonatal tetanus (NNT) is a public health problem because of inadequate immunization and awareness in population. But it is not given due weightage so there is scarcity of studies regarding NNT. This present retrospective study was conducted in Isolation ward of SMS Medical Hospital, Jaipur weith the aim to study the seasonal variation of NNT if exist. A record based cross-sectional study of tetanus patients admitted since 1st Jan 2004 to 31st Dec 2010 in isolation ward of SMS Hospital, Jaipur, Rajasthan. Seasonal variation of admitted tetanus patients and its association on outcome of patients was analysed. It was found that post monsoon season has significantly higher number of cases admitted in each year of 7 years of study period so it may be associated with occurrence of tetanus which needs further exploration through studies. Although minimum cases were admitted in winter but CFR of tetanus was observed significantly higher in winter season.
Keywords
Download Options
Introduction
Tetanus described 3000 years ago in ancient Egypt. Inadequate immunization coverage in pregnant women, unclean delivery practice and cord care, and social taboos (application of cow dung or ghee on umbilical stump) are the most important risk factor for neonatal tetanus (NT). In contrast to this, 50% of cases of non neonatal tetanus (Non NT) had an identifiable lower limb injury as a portal of entry and but in 20% cause remain obscured. 1-3 In remaining cases of NNT etiological factor are penetrating injuries of upper limb, head, face, neck and trunk, otorrhoea, abortion, puerperum, vaccination, injection, surgical operation as a cause of tetanus.
As far as the seasonal variation is concern in case of tetanus, there is extreme scarcity of studies conducted in this direction. A handful of articles mentioned about prevalence of tetanus among various season without showing any statistical significance. Most of them observed that it is more prevalent in the hot, dry season while others reported that it is more common in the wet or humid seasons. 4 Convincing the scarcity of available studies concluding regarding association of seasonal variation with tetanus; this study was designed to find out any seasonal variation in tetanus. As if seasonal variation comes out to be a significant epidemiological factor for prevalence of tetanus then it would be definitely helpful in planning future strategy towards elimination of tetanus.
Conclusion
More than Post monsoon season has significantly higher number of cases in each year of 7 years study period so it may be associated with occurrence of tetanus which needs further exploration through studies. As per these observations it can be sought to draw our prevention strategy for tetanus elimination predominantly in post-monsoon season.