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10.2471/BLT.16.185546

http://scihub22266oqcxt.onion/10.2471/BLT.16.185546
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C5677607!5677607!29147059
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suck abstract from ncbi


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pmid29147059      Bull+World+Health+Organ 2017 ; 95 (11): 779-83
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  • Tetanus in adult males, Bugando Medical Centre, United Republic of Tanzania #MMPMID29147059
  • Aziz R; Peck RN; Kalluvya S; Kenemo B; Chandika A; Downs JA
  • Bull World Health Organ 2017[Nov]; 95 (11): 779-83 PMID29147059show ga
  • Problem: In the United Republic of Tanzania, the incidence of non-neonatal circumcision-related tetanus is probably underreported. Approach: We analysed charts and extracted information on outcome and wound location for non-neonatal cases of tetanus admitted to the intensive care unit of Bugando Medical Centre between 2001 and 2016. Local setting: Bugando Medical Centre, which is one of four teaching referral hospitals in the United Republic of Tanzania, has a 13-bed intensive care unit that manages all admitted patients with tetanus. Within the United Republic of Tanzania, formal programmes of tetanus immunization are targeted at infants or women. Relevant changes: From our inpatient logs, we identified six patients with non-neonatal tetanus among male patients with a recent history of circumcision. Only one of these patients had been circumcised within a subnational programme of voluntary medical male circumcision. The other five had been circumcised outside of the programme ? e.g. at small rural dispensaries or by a traditional provider with no formal medical training. The six patients were aged 11?55 years and five (83%) of them died in hospital ? all of overwhelming sepsis. Lessons learnt: Within the Tanzanian programme of voluntary medical male circumcision, education on wound hygiene probably helps to reduce the incidence of non-neonatal circumcision-related tetanus. The corresponding incidence among the boys and men who are circumcised beyond this subnational programme is probably higher. The training of all circumcision providers in wound care and a vaccination programme to ensure that male Tanzanians receive tetanus immunization post-infancy are recommended.
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