Post-Neonatal tetanus from broomstick injuries: a word of caution for caregivers

Abstract

Tetanus is a vaccine-preventable disease that is acquired through exposure to the spores of the bacterium Clostridium tetani which are ubiquitous in the soil. Post-neonatal tetanus is an increasing problem in developing countries, including Nigeria. This is mainly as a result of inadequate immunization coverage, unsustainable immunization programmes, and non-administration of booster doses of tetanus toxoid at appropriate periods to eligible children. The spores of the bacterium can get into the body through broken skin, commonly through injuries from contaminated objects. There have also been reports of broomstick injury as the portal of entry. Indeed, it has been reported to be the commonest portal of entry in a center in Nigeria. This is important because flogging (of children) with brooms is common in parts of Nigeria, despite it being forbidden in several cultures in the country. Two cases of post-neonatal tetanus arising from broomstick injuries in Uyo, Nigeria, are herein reported, to illustrate the inherent dangers and implications of broomstick injuries in children. It is hoped that advocacy campaigns will be conducted at different public health fora to raise awareness of the general population concerning post-neonatal tetanus from broomstick injuries. Furthermore, there is urgent need to institutionalize the administration of booster doses of tetanus toxoid at primary and secondary school entry.

Tetanus in School Age Children Seen at the University of Port Harcourt Teaching Hospital: A Need for Booster Doses of Tetanus Vaccine

“…Lack of immunisation with primary and booster doses of TT or incomplete immunisation have been identified as major risk factors for the persistence of post neonatal tetanus in Nigeria [5,15,26,27,28]. In this study, as much as 79.2% of the children were either not immunised or were incompletely immunised with TT containing vaccines in infancy, which is consistent with the reports from other studies in Nigeria [8,14,15].…”

Post Neonatal Tetanus as Seen in Rivers State University Teaching Hospital, Nigeria: Prevalence, Clinical Profile and Outcome

“…In earlier studies conducted in Port Harcourt, [8,30] broomstick injury was however the commonest portal of entry. This portal of entry for PNT was also documented by Komomo et al [31] and Ijiezie et al [36] in Calabar and Uyo respectively. The study at Uyo, reported that this injury is obtained when caregivers flog their children with the broom, mostly when upset with them.…”

“…The study at Uyo, reported that this injury is obtained when caregivers flog their children with the broom, mostly when upset with them. [36] It is however interesting to note that broomstick injury as a portal of entry was only documented in studies carried out in the south-south geopolitical region of Nigeria and not in other parts of the country [26][27][28][29][30] or in other countries. [33,35] One can only ponder at this stage if this behaviour of using broom to flog children is peculiar to this geopolitical zone of the country or if it was erroneously omitted in studies from other parts of Nigeria.…”