Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam
Autor: | Phan Tu Qui, Huynh Trung Trieu, Vo Ngoc Cat Tuong, Huynh Ngoc Thien Vuong, T. T. M. Dao, Lam Minh Yen, Le Van Tan, Saraswathy Sabanathan, Pham Tam Dinh, Bridget Wills, Nguyen Thi Kim Anh, Catherine Louise Thwaites, Nguyen Thi Xuan Hoa |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
Pediatrics medicine.medical_specialty Developmental Disabilities 030231 tropical medicine Gross motor skill Neurological examination Development lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Intensive care Intensive Care Units Neonatal medicine Humans lcsh:RC109-216 030212 general & internal medicine Survivors Toddler Child Outcome Pediatric intensive care unit Tetanus medicine.diagnostic_test business.industry Case-control study medicine.disease Neonatal tetanus Infectious Diseases Vietnam Case-Control Studies Child Preschool Female business Research Article Follow-Up Studies |
Zdroj: | BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-7 (2017) BMC Infectious Diseases |
ISSN: | 1471-2334 |
Popis: | Background: Neonatal tetanus continues to occur in many resource-limited settings but there are few data regarding long-term neurological outcome from the disease, especially in settings with critical care facilities. Methods: We assessed long-term outcome following neonatal tetanus in infants treated in a pediatric intensive care unit in southern Vietnam. Neurological and neurodevelopmental testing was performed in 17 survivors of neonatal tetanus and 18 control children from the same communities using tools previously validated in Vietnamese children. Results: The median age of children assessed was 36 months. Eight neonatal tetanus survivors and 9 community control cases aged < 42 months were tested using the Bayley III Scales of Infant and Toddler Development (Bayley III-VN) and 8 neonatal tetanus survivors and 9 community controls aged ≥42 months were tested using the Movement Assessment Battery for Children. No significant reductions in growth indices or neurodevelopmental scores were shown in survivors of neonatal tetanus compared to controls although there was a trend towards lower scores in neonatal tetanus survivors. Neurological examination was normal in all children except for two neonatal tetanus survivors with perceptive deafness and one child with mild gross motor abnormality. Neonatal tetanus survivors who had expienced severe disease (Ablett grade ≥ 3) had lower total Bayley III-VN scores than those with mild disease (15 (IQR 14–18) vs 24 (IQR 19–27), p = 0.05) with a significantly lower cognitive domain score (3 (IQR 2–6) severe disease vs 7 (IQR 7–8) mild disease, p = 0.02). Conclusions: Neonatal tetanus is associated with long-term sequelae in those with severe disease. In view of these findings, prevention of neonatal tetanus should remain a priority. |
Databáze: | OpenAIRE |
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