A case study of pediatric tetanus in Rural Zambia
AbstractBackground: Health care professionals from industrialized nations often travel to work in developing countries
as volunteers during natural disasters, as part of short-term medical missions, or to work as members of armed
forces and non-governmental organizations. When providing direct patient care, these clinicians are more likely
to encounter vaccine-preventable diseases that they may rarely observe in a developed country. In addition,
many children who do not have adequate vaccine coverage enter developed nations through international
adoption processes or as political refugees. Additionally, despite much debunking of immunization myths, there
is a sizable community of parents who choose to withhold immunizations from their children because of fear of
unproven side effects.
Methods and Results: This case study highlights a case of a globally-common, vaccine-preventable disease
(tetanus), which rarely occurs in developed nations but is more common in Africa and Asia. Diagnosis and
management of a 7-year old boy is presented with differential diagnoses and adaptation of optimal disease
management within the context of an undeveloped nation. All cases of tetanus are diagnosed clinically, with
laboratory testing used to rule out other causes of neurological impairment. The management of acute tetanus
infection includes vaccination, antibiotics, immunoglobulin or antitoxin, and nutritional support. Even with
optimal treatment, tetanus infection has a high fatality rate and requires prompt recognition for best possible
Conclusion: Educating caregivers about the importance and safety of immunizations and maintaining the
appropriate vaccination schedule is vital to control these preventable diseases.
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