Le tétanos à Hô-Chi-Minh-Ville, Vietnam : épidémiologie, clinique et pronostic, à propos de 389 cas à l’Hôpital des maladies tropicales

Autor: V T An, M Strobel, L M Yen, P M Khue, N D Phong
Rok vydání: 2015
Předmět:
Zdroj: Bulletin de la Société de pathologie exotique. 108:342-348
ISSN: 1961-9049
0037-9085
DOI: 10.1007/s13149-015-0450-5
Popis: The objective of this study is to describe the different aspects of tetanus during the past recent years in southern Vietnam: epidemiology, clinical picture, management, and death risk factors. It is a retrospective study concerning 389 cases admitted in 2007 and 2008 at the reference Hospital for Tropical Diseases in Ho Chi Minh City. 93% of all cases were generalized tetanus, and 50% were severe cases. A majority of patients were adult males (medium age 43, M/ F sex-ratio 2.9). Half of them underwent tracheotomy and 39% assisted ventilation. Case fatality rate was 6.4%, the lowest reported rate worldwide in the last ten years. Fatalities resulted mainly from neuro-vegetative disorders, essentially cardiogenic shock (28% of all deaths) [OR = 16.95; p 12.000/mm(3) [OR = 2.32; p < 0.020] were significantly associated with fatal outcome, contrarily to incubation and extension phase durations, or delayed serum administration. Systematic extension of vaccination to all adult males, and improved access to post exposure sero-immunization at all levels of health centres throughout the country may further reduce tetanus burden in Vietnam.
Databáze: OpenAIRE