Publication: Prognosis of neonatal tetanus in the modern management era: An observational study in 107 Vietnamese infants
Issued Date
2015-04-01
Resource Type
ISSN
18783511
12019712
12019712
Other identifier(s)
2-s2.0-84921506417
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Infectious Diseases. Vol.33, (2015), e7-e11
Suggested Citation
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 Prognosis of neonatal tetanus in the modern management era: An observational study in 107 Vietnamese infants. International Journal of Infectious Diseases. Vol.33, (2015), e7-e11. doi:10.1016/j.ijid.2014.12.011 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36480
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Title
Prognosis of neonatal tetanus in the modern management era: An observational study in 107 Vietnamese infants
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.