Abstract
Background: Tetanus is a disease of worldwide distribution and rare in countries with developed immunization programs. Argentina incorporates 19 mandatory and free vaccines, strengthening vaccination in adults. Objective: describe the epidemiological profile of the cases of tetanus assisted during the study period Methods & Materials: A descriptive, retrospective and observational study. We analyzed the medical history of patients with a diagnosis of tetanus since 1999 till 2017 admitted in referral center in Buenos Aires City. Demographic data was considered. Tetanus was classified as: acute, subacute and peracute. It was categorized by type of wound. Type I: injuries and traumatisms. Type II: surgical, injectable intramuscular and odontological. Type III: bites and Type IV: infected people without means of entry of the disease. Previous vaccination history was recorded. The average number of days of stay and the lethality rate for the period were calculated. Results: 77 patients were diagnosed with tetanus. During a first period 1999-2003, the average was 10 patients per year, in the second period (until 2009) it went down until no cases were registered and finally a third period 2009-2017 where an annual increase was observed 6 cases in the last years. The median age 65, ranged from 13-85 years with a masculinity ratio of 1.33. 80.52% resided in Buenos Aires Province, 11.69% in Buenos Aires City and 7.79% in other areas. 95% had no history of vaccination in the last 15 years. The means of entry were: Type I: injuries (n = 46) and traumatisms (n = 19). Type II: surgical wounds (n = 4) and intramuscular injectable (n = 4). Type III: animal bites (n = 4). They presented acute clinical form of the disease in 72 cases, 4 subacute and 1 peracute. The average of stay at the hospital was 49 days. The case-fatality rate was 28.57% Conclusion: The patients analyzed were older adults without antecedents of vaccination in the last years and antecedent of Tipo I wound. Tetanus vaccination should be a priority in the primary care of the community and not only in the pediatric population
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