Pathogenesis and Management of Tetanus

Authors

  • Abdullahi Samaila Department of Pharmacology, Faculty of Medicine, Umaru Musa Yar’adua University, Katsina, Nigeria.
  • Bashir Abdulkadir Department of Microbiology, Umaru Musa Yar’adua University, Katsina, Nigeria.
  • Kamaladdeen Kabir Department of Microbiology, Umaru Musa Yar’adua University, Katsina, Nigeria.
  • Sani Aliyu Department of Microbiology, Umaru Musa Yar’adua University, Katsina, Nigeria.
  • Zubairu Umar Department of Microbiology, Umaru Musa Yar’adua University, Katsina, Nigeria.

DOI:

https://doi.org/10.47430/ujmr.1831.003

Keywords:

tetanus, tetanospasmin, spasm, immunization, trismus

Abstract

Tetanus is an infectious disease affecting the central nervous system caused by Clostridium tetani. The bacteria is an anaerobic Gram- positive bacilli that forms spores, which germinate in anaerobic condition to produce an exotoxin known as Tetanospasmin, and this is the whole mark of the pathogenesis of this disease. Tetanus remains a great public health problem in developing countries such as Nigeria. It affects all age group and both males and females. In Nigeria, the death rate differs from the range of 38% to 60%, depending on the infrastructural facilities and personnel at the reporting centre. The disease is not very common in developed nations. Mortality rate of 20-60% was reported in Africa. Four clinical types of tetanus were recognized such as generalized, cephalic, localized and neonatal type. Diagnosis is mainly clinical. The management of tetanus include Neutralization of unbound toxins, eliminating the source of the toxin and prevention of its further production, Control of spasm as well as general measures to support the life of the affected patient. It is a fatal disease with poor prognosis especially the cephalic type in adults, and neonatal tetanus. The objective of this work is to present a reviewed update on pathogenesis and management of tetanus. Additionally, to evaluate the contribution of tetanus towards the increased morbidity and mortality in Nigeria. 

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References

Ahmadsyah, I., & Salim, A. (1985). Treatment of tetanus: an open study to compare the efficacy of procaine penicillin and metronidazole. Br Med J (Clin Res Ed), 291(6496), 648-650.

https://doi.org/10.1136/bmj.291.6496.648

Aliyu, A. A., Abdulkadir, I., Amadu, L., & Dahiru, T. (2017). A 14-year review of neonatal tetanus at Ahmadu Bello University Teaching Hospital, Zaria, Northwest Nigeria. Journal of Public Health and Epidemiology, 9(5), 99-105.

https://doi.org/10.5897/JPHE2016.0882

Anwer, J., Babar, M. I., Yar, H. M., Mahmood, Z., & Niazi, K. (2015). Audit of childhood tetanus patients admitted in tertiary care hospital.

Apte, N. M., & Karnad, D. R. (1995). The spatula test: A simple bedside test to diagnose tetanus. The American journal of tropical medicine and hygiene, 53(4), 386-387.

https://doi.org/10.4269/ajtmh.1995.53.386

Babatunde, O. A., Adebara, V. O., Atoyebi, O. A., & Oluwagbemi, O. A. (2014). Neonatal tetanus in Federal Medical Center, Ido-Ekiti South West Nigeria in a five-year retrospective study. Greener J Med Sci, 4(2), 42-47.

https://doi.org/10.15580/GJMS.2014.2.062014273

Badoe, E. A., Archampong, E. Q., & da Rocha Afodu, J. T. (2000). Principles and practice of surgery. 3rd ed.

Bhargavan, P. V., & Ravi, K. (2016). A Case of Local Tetanus. BMH Medical Journal- ISSN 2348-392X, 3(4), 107-109.

Bleck, T.P., (1995). Clostridium tetani. In: Mandell GL, Bennett JE, Dolin R, eds. Bennett's Principles and Practice of Infectious Diseases. Philadelphia, Pa: Churchill Livingstone; 2373-8.

Bunch, T. J., Thalji, M. K., Pellikka, P. A., & Aksamit, T. R. (2002). Respiratory failure in tetanus: case report and review of a 25-year experience. Chest, 122(4), 1488-1492.

https://doi.org/10.1378/chest.122.4.1488

Chukwubike, O. A., & Asekomeh, E. G. (2009). A 10-year review of outcome of management of tetanus in adults at a Nigerian tertiary hospital. Annals of African medicine, 8(3).

Cohen, J. E., Wang, R., Shen, R. F., Wu, W. W.,& Keller, J. E. (2017). Comparative pathogenomics of Clostridium tetani. PloS one, 12(8), e0182909.

https://doi.org/10.1371/journal.pone.0182909

Federal Ministry of Health Nigeria, (2008). Standard Treatment Guidelines.

Fortes Déguénonvo, L., Leye, M. M. M., Dia, N. M., Ndiaye, R., & Lakhe, N. A. (2015). Complication of Tetanus: Report of 402 Cases at the Fann University Hospital Center of Dakar in Senegal. J Trop Dis, 4(182), 2.

Hassel, B. (2013). Tetanus: pathophysiology, treatment, and the possibility of using botulinum toxin against tetanus- induced rigidity and spasms. Toxins, 5(1), 73-83.

https://doi.org/10.3390/toxins5010073

Hinfey, P. B., (2017). Background, Aetiology and Pathophysiology of Tetanus.availabe@emedicine.medscape.com

Hunt, D.M. (2015). Parasitology. In: Microbiology and Immunology On-line. Available@ http://www.microbiologybook.org

Kunisawa, T. (2015). Evolutionary relationships of completely sequenced Clostridia species and close relatives. International journal of systematic and evolutionary microbiology, 65(11), 4276-4283.

https://doi.org/10.1099/ijsem.0.000638

Lin, T. S., Chen, L. K., Lin, T. Y., Wen, S. H., Chen, M. C., & Jan, R. H. (2011). Autonomic dysfunction because of Masuyer, G., Conrad, J., & Stenmark, P. (2017).

The structure of the tetanus toxin reveals pH-mediated domain dynamics. EMBO reports, 18(8), 1306-1317.

Longmore, M., Wilkinson, I., Baldwin, A., & Wallin, E. (2014). Oxford handbook of clinical medicine. Oxford University Press.

https://doi.org/10.1093/med/9780199609628.001.0001

Nass, S. S., Danawi, H., Cain, L., & Sharma, M. (2017). Predictors of Neonatal Tetanus Mortality in Katsina State, Northwestern Nigeria. Health Services Research and Managerial Epidemiology, 4, 2333392817723970.

https://doi.org/10.1177/2333392817729585

https://doi.org/10.1177/2333392817723970

Nicholas, A. B., Nicki, R. C., Brian, R., & John,A. A. H. (2006). Davidson's Principles and Practice of Medicine. Churchill Livingstone Elsevier, 1241.

Ogunrin, O. A. (2009). Tetanus-a review of current concepts in management. Benin Journal of Postgraduate Medicine, 11(1).

https://doi.org/10.4314/bjpm.v11i1.48828

Papadakis, M.A., and Mc Phee, SJ, (2016). Current Medical Diagnosis and Treatment. 56th ed. Lange Current Series: 9780071845090.

Petitjeans, F., Turc, J., Coulet, O., Puidupin, M., Eve, O., & Benois, A. (2009). The severe tetanus in an unvaccinated child. Pediatrics & Neonatology, 52(3), 169-171.

https://doi.org/10.1258/td.2008.080236

use of boluses of propofol for the management of severe tetanus in a child. Tropical doctor, 39(1), 52-53.

https://doi.org/10.1258/td.2008.080236

Prevots DR., (1999). Neonatal tetanus. MMWR Morb Mortal Wkly Rep, 48 Suppl: 176-7.

Sanford J.P., (1995). Tetanus--forgotten but not gone. N Engl J Med. 332(12), 812-3. Thwaites CL, Beeching NJ & Newton CR., (2015). Maternal and neonatal tetanus.

https://doi.org/10.1056/NEJM199503233321209

Lancet journal, 385(9965), 362-70.Thwaites CL, Farrar JJ (2003). Preventing tetanus. Br. Med J. 326(7381):117-118.

https://doi.org/10.1136/bmj.326.7381.117

Levinson, W. E. (2016). Review of medical microbiology and immunology, 12th ed. McGraw Hill Professional.

World Health Organization (WHO) (2006). Tetanus vaccination weekly. Epidemiol. Rec. 81(20), 198-208.

World Health Organization, (2010). Current recommendations for treatment of tetanus during humanitarian emergencies.

Yeh, F. L., Dong, M., Yao, J., Tepp, W. H., Lin, G., Johnson, E. A., & Chapman, E. R. (2010). SV2 mediates entry of tetanus neurotoxin into central neurons. PLoS pathogens, 6(11), e1001207.

https://doi.org/10.1371/journal.ppat.1001207

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Published

30-06-2018

How to Cite

Abdullahi Samaila, Bashir Abdulkadir, Kamaladdeen Kabir, Sani Aliyu, & Zubairu Umar. (2018). Pathogenesis and Management of Tetanus. UMYU Journal of Microbiology Research (UJMR), 3(1), 16–23. https://doi.org/10.47430/ujmr.1831.003

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