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Title: Prognosis of neonatal tetanus in the modern management era: An observational study in 107 Vietnamese infants
Authors: Phung Khanh Lam
Huynh T. Trieu
Inke Nadia D. Lubis
Huynh T. Loan
Tran Thi Diem Thuy
Bridget Wills
Christopher M. Parry
Nicholas P.J. Day
Phan T. Qui
Lam Minh Yen
C. Louise Thwaites
Nuffield Department of Clinical Medicine
Universitas Sumatera Utara
Liverpool School of Tropical Medicine
Mahidol University
Keywords: Medicine
Issue Date: 1-Apr-2015
Citation: International Journal of Infectious Diseases. Vol.33, (2015), e7-e11
Abstract: © 2014 The Authors. 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.
ISSN: 18783511
Appears in Collections:Scopus 2011-2015

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