Use of the tetanus quick stick (TQS) test in the emergency services

Martín-Casquero, Tamara; Ruescas-Escolano, Esther; Tuells, José

doi:10.1016/j.medcle.2019.06.016

Cited by 3 publications

(7 citation statements)

References 15 publications

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“…In addition to vaccination strategies, it is essential to pay attention not only to the risk of tetanus in acute injuries but also to how protocols are formulated for managing chronic injuries that are common in the elderly people 17 . a rapid test to assess serological status in individuals with suspected lesions, to avoid unnecessary expenses with prophylaxis, since less than 50% of patients remember about their vaccination 25 . However, it is necessary to assess the cost-benefit in Brazil.…”

Section: Discussionmentioning

confidence: 99%

Temporal trends in tetanus incidence and lethality in Brazil: analysis of the national database from 2009 to 2018

Carvalho

Marques

Rodrigues

2021

Rev. Assoc. Med. Bras.

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OBJECTIVE: This study aimed to analyze the epidemiological and hospital characteristics of cases and deaths due to accidental tetanus in Brazil. METHODS:A time-series study with secondary data extracted from the Department of Informatics of the Brazilian Unified Health System.The time series were evaluated by linear regression parameters, considering a significance level of 1%.RESULTS: A total of 2,772 cases were reported between 2009-2018. Predominant cases were men and aged between 40-59 years old, with incomplete 1st-4th grade. The lethality rate was found to be predominant in women, whites, illiterates, and those who aged above 80 years. The overall lethality was 32.5%. The incidence rate reduced from 1.6 in 2009 to 0.95 per million inhabitants in 2018, but lethality increased from 30.77-40.70%. The highest rate of incidence and lethality occurred in the elderly people and in the northern region. CONCLUSION:The high cost and lethality of tetanus configure it as a public health problem. The demonstration of the epidemiology of patients who most evolve to death can help to contribute to a reduction in lethality, which shows an increase in the analysis period.Finally, special attention should be given to the elderly people and those living in the northern region.

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Section: Discussionmentioning

confidence: 99%

Temporal trends in tetanus incidence and lethality in Brazil: analysis of the national database from 2009 to 2018

Carvalho

Marques

Rodrigues

2021

Rev. Assoc. Med. Bras.

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“…Complementary tests tend to be conducted to reject other types of neurological and/or otorhinolaryngology pathologies that are part of the differential diagnosis. Given that a diagnostic test for tetanus does not exist, the availability of a fast bedside test (Tetanus Quick Stick, Nephrotek Laboratory, Rungis, France) to clarify the state of immunization of the patient could be of great help [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Survivor: A Clinical Case of Tetanus in a Non-Immunized, Parenteral Drug User, Former Female Convict with HIV and HCV

Vicente-Alcalde¹,

Martín-Casquero

Ruescas-Escolano

et al. 2020

Vaccines

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Tetanus is a serious and potentially fatal systemic disease, caused by the bacterium Clostridium tetani. It is estimated that 1 million cases occur worldwide annually. Immunization programs have drastically decreased tetanus in developed countries, and the sporadic cases have been linked to injecting drug users (IDUs), immunosuppressed individuals, or those older than 65 without complete vaccination. Regrettably, it is still endemic in under-developed countries. In Spain, an average of 10 cases are notified each year, especially affecting those older than 65. The present article describes a case of a 48-year-old Spanish woman, an ex-convict and IDU with infection antecedents of Human Immunodeficiency Virus (HIV) and Hepatitis C (HCV), who was admitted to the Emergency Department of a University Hospital with cervical rigidity and trismus. In a few hours, a neurological and respiratory deterioration was observed, resulting in admittance to the intensive care unit under the suspicion of a generalized tetanus infection. The treatment included hemodynamic support and respiratory therapy, antibiotics, muscle relaxants, sedatives, and tetanus immunoglobulin. Her stay in the ICU lasted 47 days. The clinical suspicion, the antecedents of risk, and the verification of the vaccination records should provide early guidance for diagnostics and the establishment of a treatment in these cases.

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“…Measuring antibody concentrations using ELISA (cut‐off antibody concentrations for protection: 0.1–0.2 IU/mL) 1 or rapid immunoassay [using the Tetanus Quick Stick (TQS); Nephrotek Laboratory, Rungis, France] may be useful in emergency departments. 31 , 32 Tetanus in the presence of protective concentrations of antibody is rare, and therefore a diagnosis of tetanus should be considered unlikely in individuals with serum antibody titers of more than 0.1 IU/mL, as tested by ELISA. 1 However, conventional tetanus antibody assays by ELISA are laboratory based and challenging to implement in clinical settings, such as the emergency room.…”

Section: Reviewmentioning

confidence: 99%

“…Thus, the usefulness of the rapid immune assay in clinical settings, such as the emergency room, has been recommended. 31 , 32 …”

Section: Reviewmentioning

confidence: 99%

“…Thus, the usefulness of the rapid immune assay in clinical settings, such as the emergency room, has been recommended. 31,32 The Ablett classification system score (Table 2) is the most widely used system for defining tetanus severity. 33 The Ablett classification has been used in intensive care units (ICUs) outside the United States to identify the severity of tetanus and prevent airway and respiratory complications, which are the most common causes of death.…”

Section: Diagnosismentioning

confidence: 99%

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The threat of a new tetanus outbreak due to urban flooding disaster requires vigilance: a narrative review

Yamaguchi

Kinoshita

2023

Acute Medicine & Surgery

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Vaccines for tetanus prevention have rapidly progressed, and the number of outbreaks, especially the incidence of tetanus in developed countries, has decreased dramatically. However, the mortality rate associated with severe tetanus remains high. Tetanus eradication is difficult owing to the widespread presence of the spores of tetanus bacteria in the environment, but tetanus can be prevented by acquired immunity from vaccines. Older people, intravenous drug users, and migrants are at a high risk of tetanus in developed countries owing to the lack of booster vaccination programs. Natural disasters, especially floods, often cause an increase in the prevalence of tetanus because of the associated injuries. Precautions should be taken to combat the threat of a new tetanus outbreak due to floods in urban areas owing to global warming. In particular, Japan is facing a high risk of urban flooding‐induced tetanus, despite its status as a developed country. This review aims to highlight the data on the epidemiology, causes, treatment, and prevention of tetanus and problems associated with tetanus countermeasures during future floods.

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Use of the tetanus quick stick (TQS) test in the emergency services

Cited by 3 publications

References 15 publications

Temporal trends in tetanus incidence and lethality in Brazil: analysis of the national database from 2009 to 2018

Temporal trends in tetanus incidence and lethality in Brazil: analysis of the national database from 2009 to 2018

The Survivor: A Clinical Case of Tetanus in a Non-Immunized, Parenteral Drug User, Former Female Convict with HIV and HCV

The threat of a new tetanus outbreak due to urban flooding disaster requires vigilance: a narrative review

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