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.
Highlights
Tetanus is a potentially severe disease, with high lethality
Brazil is still responsible for the major tetanus’s cases in the American continent, even though, in the period between 2001 and 2011, the country had a reduction of 44 per cent in number of cases of the disease, meaning that in 2001 Brazil registered a total of 578 cases/year and in 2011 were registered 327 cases/year
This study describes incidence and lethality of tetanus’s cases in Pernambuco between 2007 and 2015 and identify associated with death
Summary
Tetanus is a potentially severe disease, with high lethality. The analysis done in 178 countries about tetanus’s incidence related the occurrence of 9.836 cases of the disease, being the highest incidence on the African continent (4.607 cases/year) and the lower on Europe (181 cases/year). Brazil is still responsible for the major tetanus’s cases in the American continent, even though, in the period between 2001 and 2011, the country had a reduction of 44 per cent in number of cases of the disease, meaning that in 2001 Brazil registered a total of 578 cases/year and in 2011 were registered 327 cases/year. The highest proportion of cases in the country, approximately a third, occurs in the Northeast region. 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
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