A 10 year retrospective evaluation of cases of post neonatal tetanus seen in a paediatric unit of a university teaching hospital in south western Nigeria (1985 to 1994).

A review of 56 children with post neonatal tetanus admitted over a 10 year period (January 1985 t December 1994) was undertaken at the Wesley Guild Hospital, IIesa, South Western Nigeria. The male: female ratio was 1.8:1. About 64.3 pc of the cases were above six years of age (mean 7.6 years). Wounds on the lower limb were identified as portal of entry in 39.2 pc of cases and discharging Otitis media in 21.4 pc. Otitis media was the usual portal of entry among the pre-school children (six years) in 55 pc of the cases. The patients were managed with antibiotics, alternating does of diazepam, phenobarbitone and chlorpremazine and nasogastric tube feeding. It was noticed (in 1992) that the patients showed varying degrees of talkativeness and disinhibition during therapy, which tended to subside one to two weeks after discontinuation of chlorpremazine and phenobarbitone. One case had a relapse which occurred one week after complete cessation of the initial symptoms which had taken four weeks to nurse. Resolution of symptoms followed the removal of a foreign body from the left foot on the 58th day of admission. Mortality was recorded in 39.3 pc of cases. Only 12.5 pc of the survivors completed the scheduled immunization doses after discharge.