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| LETTER TO EDITOR |
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| Year : 2017 | Volume
: 6
| Issue : 4 | Page : 105 |
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Tetanus after Trauma: Still Existed Problem in Tropical Country
Viroj Wiwanitkit
Department of Tropical Medicine, Hainan Medical University, Haikou, China
| Date of Web Publication | 20-Feb-2018 |
Correspondence Address:
Prof. Viroj Wiwanitkit
Hainan Medical University, Haikou
China
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/atr.atr_59_17
How to cite this article:
Wiwanitkit V. Tetanus after Trauma: Still Existed Problem in Tropical Country. Arch Trauma Res 2017;6:105 |
Dear Editor,
An important concern on the management of trauma case is the tetanus prevention. In the past, when tetanus toxoid, is not easily available, the rate of posttraumatic tetanus was very high. In tropical countries, the problem of tetanus is still existed. Here, the author discusses and summarizes the problem of tetanus after trauma in the local reports [1],[2] in Thailand, a tropical country in Asia. Based on database review (PubMed, Scopus, and Thai Index Medicus) on case reports of tetanus in Thailand in the past 15 years period (2001–2016), there are at least 132 accumulated cases of posttraumatic tetanus. The male-to-female ratio was 2:1. The mortality rate is 8.02%. In all cases, the patients did not receive the tetanus toxoid.
It is interesting that tetanus still exists in the period after the millennium, the year 2000 in a tropical country where the sanitation and public health system is significantly better at present. The history tracking shows that almost all patients neglected the importance of posttraumatic tetanus vaccination due to the small wound. Nevertheless, there are also some cases of minorities who cannot assess the medical facilities to get vaccinated. The importance to promote the knowledge of wound care and posttraumatic tetanus vaccination to the local people is required. As noted by Pandejpong and Phisalprapa,[3] “vaccination program remains a problem in Thailand especially among older generations and low-socioeconomic groups.” Furthermore, the coverage of service to the minorities who lack opportunities to assess medical facilities is needed.[4]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Sathirapanya P, Sathirapanya C, Limapichat K, Setthawacharawanich S, Phabphal K. Tetanus: A retrospective study of clinical presentations and outcomes in a medical teaching hospital. J Med Assoc Thai 2009;92:315-9.  [ PUBMED] |
| 2. | Kanchanapongkul J. Tetanus in adults: A review of 85 cases at Chon Buri Hospital. J Med Assoc Thai 2001;84:494-9. |
| 3. | Pandejpong D, Phisalprapa P. Awareness of and factors influencing willingness to receive a tetanus-diphtheria toxoid booster vaccine among Thai adults. Southeast Asian J Trop Med Public Health 2013;44:1047-54. |
| 4. | Greenfield LS, Page LC, Kay M, Li-Vollmer M, Breuner CC, Duchin JS, et al. Strategies for increasing adolescent immunizations in diverse ethnic communities. J Adolesc Health 2015;56:S47-53. |
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