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Prognosis of neonatal tetanus in the modern management era: an observational study in 107 Vietnamese infants

Lam, Phung Khanh, Trieu, Huynh T, Lubis, Inke Nadia D, Loan, Huynh T, Thuy, Tran Thi Diem, Wills, Bridget, Parry, Christopher, Day, Nicholas P J, Qui, Phan T, Yen, Lam Minh and Thwaites, C Louise (2014) 'Prognosis of neonatal tetanus in the modern management era: an observational study in 107 Vietnamese infants'. International Journal of Infectious Diseases, Vol 33, pp. 7-11.

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Abstract

Objectives:
Most data regarding the prognosis in neonatal tetanus originate from regions where limited resources have historically impeded management. It is not known whether recent improvements in critical care facilities in many low- and middle-income countries have affected indicators of a poor prognosis in neonatal tetanus. We aimed to determine the factors associated with worse outcomes in a Vietnamese hospital with neonatal intensive care facilities.

Methods:
Data were collected from 107 cases of neonatal tetanus. Clinical features on admission were analyzed against mortality and a combined endpoint of ‘death or prolonged hospital stay’.

Results:
Multivariable analysis showed that only younger age (odds ratio (OR) for mortality 0.69, 95% confidence interval (CI) 0.48–0.98) and lower weight (OR for mortality 0.06, 95% CI 0.01–0.54) were significantly associated with both the combined endpoint and death. A shorter period of onset (OR 0.94, 95% CI 0.88–0.99), raised white cell count (OR 1.17, 95% CI 1.02–1.35), and time between first symptom and admission (OR 3.77, 95% CI 1.14–12.51) were also indicators of mortality.

Conclusions:
Risk factors for a poor outcome in neonatal tetanus in a setting with critical care facilities include younger age, lower weight, delay in admission, and leukocytosis.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Infection. Bacterial Infections > Other Bacterial Infections. Zoonotic Bacterial Infections > WC 370 Tetanus. Trismus
WS Pediatrics > By Age Groups > WS 421 Diseases of newborn infants
WY Nursing > WY 157.3 Maternal-child nursing. Neonatal nursing. Perinatal nursing
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/j.ijid.2014.12.011
Depositing User: Jessica Jones
Date Deposited: 19 Jan 2016 16:26
Last Modified: 06 Feb 2018 13:11
URI: http://archive.lstmed.ac.uk/id/eprint/5516

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