Incidence and Factors Associated with Death for Tetanus in Adults

R. Beltrão, C. Pinho, Evelyn Quirino, Ana Catarina de Melo Araújo, Sara Larissa de Melo Araújo, Aline Beatriz dos Santos Silva, M. B. A. Silva, D. B. Miranda-Filho, M. S. Andrade
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Abstract

Introduction: Tetanus has a worldwide distribution and high lethality. The goal of this study was to characterize the tetanus cases confirmed in Pernambuco and identify factors associated with death in these patients. Methods: Cross-sectional, with internal comparison groups. For data analysis we used the chi-square test and Pearson estimated the odds ratios and their respective confidence intervals at 95%. Multivariate analysis was applied to multiple logistic regression Results: The incidence of tetanus ranged between 0.65 and 2.79 cases per 100,000 inhabitants with higher involvement of adults, male and city population. Only 13.8% had received the vaccine and 23.4% received it as prophylaxis. The average mortality rate was 20.4%. In multivariate analysis, presented neck stiffness as a symptom (p = 0.029), which was associated with increased mortality. Conclusion: There is a need for greater investment in the prevention of the disease, both in immunization coverage and in the application of prophylaxis. Despite the hospitalization guarantee with proper care, there was an increase in tetanus mortality, suggesting that more specific studies should be conducted to investigate what may have influenced this change. Special attention should be offered to cases that presented neck stiffness as a symptom, because these groups have a higher chance of progressing to death.
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成人破伤风的发病率和死亡相关因素
简介:破伤风在世界范围内分布广泛,致死率高。本研究的目的是描述伯南布哥确诊的破伤风病例,并确定与这些患者死亡相关的因素。方法:横断面,采用内对照组。对于数据分析,我们使用卡方检验,Pearson估计比值比及其各自的置信区间为95%。多因素分析应用于多元逻辑回归结果:破伤风的发病率在0.65至2.79例/10万居民之间,成人、男性和城市人口的发病率较高。只有13.8%的人接种了疫苗,23.4%的人作为预防接种。平均死亡率为20.4%。在多变量分析中,以颈部僵硬为症状(p=0.029),这与死亡率增加有关。结论:需要加大对该疾病预防的投资,包括在免疫覆盖率和预防应用方面。尽管有适当护理的住院保障,破伤风死亡率仍有所上升,这表明应该进行更具体的研究来调查可能影响这一变化的因素。应特别注意以颈部僵硬为症状的病例,因为这些群体有更高的死亡几率。
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