Background
Over the past few decades, better immunisation practices
and prophylaxis have reduced the prevalence of
tetanus in developed nations,1,2 although it remains
endemic in many developing countries. As testimony
to this, the World Health Organization received reports
of 10,011 cases of tetanus across the globe in 2012.3
Although tetanus remains endemic in Jamaica,4 the
epidemiologic profile has not been reported. This study
aims to document the epidemiology of tetanus in order
to direct public health efforts to eradicate tetanus in
Jamaica.
Methods
This study was done at the University Hospital in
Kingston – a 500-bed facility that serves as the main
tertiary referral centre for the country.5 Approval from
the institutional review board was secured to allow
access to hospital records for this study.
Admission registers were accessed to identify all
patients with a diagnosis of tetanus between 1
January 1993 and 1 December 2010. We also reviewed
the national surveillance database maintained by the
Ministry of Health in order to identify patients who
may have been treated for tetanus at smaller
institutions without transfer to the national referral
hospital. All hospital records were retrospectively
reviewed and the following data were extracted: patient
demographics, injury details, disease severity, duration
of hospitalisation and mortality. Disease severity was
graded according to the Ablett Classification.1 Patients
with Grades 3 and 4 tetanus were considered to have
severe disease. The data were analysed using SPSS version
12.0.