Intrathecal anti-tetanus human immunoglobulin in the treatment of neonatal tetanus.

Abstract

OBJECTIVE: To determine the outcome of tetanus in neonates treated with intrathecal tetanus immunoglobulin in terms of mortality and hospital stay. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Paediatric Unit I, Bahawal Victoria Hospital, Bahawalpur, from April 2004 to December 2007. METHODOLOGY: Seventy neonates with diagnosis of neonatal tetanus were included in the study. The neonates with fits due to causes other than tetanus were excluded. Thirty five patients received intrathecal immunoglobulin in addition to standard treatment (group A) while, the other 35 patients received only standard treatment (group B). The mortality and duration of hospital stay in 2 groups were recorded. RESULTS: In group A, mean duration of hospital stay was 10 days while, in group B it was 13 days (p < 0.001). One patient from group A and 8 patients from group B expired (p = 0.026). The occurrence of refractory fits, repeated apnoeic episodes and high grade fever did not show any statistically significant difference in the 2 groups. CONCLUSION: Intrathecal anti-tetanus immunoglobulin in addition to the standard improved the outcome of neonatal tetanus in terms of mortality and hospital stay.