Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam
Abstract Background Neonatal tetanus continues to occur in many resource-limited settings but there are few data regarding long-term neurological outcome from the disease, especially in settings with critical care facilities. Methods We assessed long-term outcome following neonatal tetanus in infant...
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doaj-f3e2bb2a69c549768fbf0d6ef19067bd2020-11-25T03:44:35ZengBMCBMC Infectious Diseases1471-23342017-09-011711710.1186/s12879-017-2748-3Long-term outcome in survivors of neonatal tetanus following specialist intensive care in VietnamHuynh T. Trieu0Nguyen Thi Kim Anh1Huynh Ngoc Thien Vuong2T. T. M. Dao3Nguyen Thi Xuan Hoa4Vo Ngoc Cat Tuong5Pham Tam Dinh6Bridget Wills7Phan Tu Qui8Le Van Tan9Lam Minh Yen10Saraswathy Sabanathan11Catherine Louise Thwaites12Hospital for Tropical DiseasesOxford University Clinical Research UnitHospital for Tropical DiseasesOxford University Clinical Research UnitOxford University Clinical Research UnitOxford University Clinical Research UnitOxford University Clinical Research UnitOxford University Clinical Research UnitHospital for Tropical DiseasesOxford University Clinical Research UnitOxford University Clinical Research UnitOxford University Clinical Research UnitOxford University Clinical Research UnitAbstract Background Neonatal tetanus continues to occur in many resource-limited settings but there are few data regarding long-term neurological outcome from the disease, especially in settings with critical care facilities. Methods We assessed long-term outcome following neonatal tetanus in infants treated in a pediatric intensive care unit in southern Vietnam. Neurological and neurodevelopmental testing was performed in 17 survivors of neonatal tetanus and 18 control children from the same communities using tools previously validated in Vietnamese children. Results The median age of children assessed was 36 months. Eight neonatal tetanus survivors and 9 community control cases aged < 42 months were tested using the Bayley III Scales of Infant and Toddler Development (Bayley III-VN) and 8 neonatal tetanus survivors and 9 community controls aged ≥42 months were tested using the Movement Assessment Battery for Children. No significant reductions in growth indices or neurodevelopmental scores were shown in survivors of neonatal tetanus compared to controls although there was a trend towards lower scores in neonatal tetanus survivors. Neurological examination was normal in all children except for two neonatal tetanus survivors with perceptive deafness and one child with mild gross motor abnormality. Neonatal tetanus survivors who had expienced severe disease (Ablett grade ≥ 3) had lower total Bayley III-VN scores than those with mild disease (15 (IQR 14–18) vs 24 (IQR 19–27), p = 0.05) with a significantly lower cognitive domain score (3 (IQR 2–6) severe disease vs 7 (IQR 7–8) mild disease, p = 0.02). Conclusions Neonatal tetanus is associated with long-term sequelae in those with severe disease. In view of these findings, prevention of neonatal tetanus should remain a priority.http://link.springer.com/article/10.1186/s12879-017-2748-3Neonatal tetanusDevelopmentOutcome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Huynh T. Trieu Nguyen Thi Kim Anh Huynh Ngoc Thien Vuong T. T. M. Dao Nguyen Thi Xuan Hoa Vo Ngoc Cat Tuong Pham Tam Dinh Bridget Wills Phan Tu Qui Le Van Tan Lam Minh Yen Saraswathy Sabanathan Catherine Louise Thwaites |
spellingShingle |
Huynh T. Trieu Nguyen Thi Kim Anh Huynh Ngoc Thien Vuong T. T. M. Dao Nguyen Thi Xuan Hoa Vo Ngoc Cat Tuong Pham Tam Dinh Bridget Wills Phan Tu Qui Le Van Tan Lam Minh Yen Saraswathy Sabanathan Catherine Louise Thwaites Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam BMC Infectious Diseases Neonatal tetanus Development Outcome |
author_facet |
Huynh T. Trieu Nguyen Thi Kim Anh Huynh Ngoc Thien Vuong T. T. M. Dao Nguyen Thi Xuan Hoa Vo Ngoc Cat Tuong Pham Tam Dinh Bridget Wills Phan Tu Qui Le Van Tan Lam Minh Yen Saraswathy Sabanathan Catherine Louise Thwaites |
author_sort |
Huynh T. Trieu |
title |
Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam |
title_short |
Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam |
title_full |
Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam |
title_fullStr |
Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam |
title_full_unstemmed |
Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam |
title_sort |
long-term outcome in survivors of neonatal tetanus following specialist intensive care in vietnam |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2017-09-01 |
description |
Abstract Background Neonatal tetanus continues to occur in many resource-limited settings but there are few data regarding long-term neurological outcome from the disease, especially in settings with critical care facilities. Methods We assessed long-term outcome following neonatal tetanus in infants treated in a pediatric intensive care unit in southern Vietnam. Neurological and neurodevelopmental testing was performed in 17 survivors of neonatal tetanus and 18 control children from the same communities using tools previously validated in Vietnamese children. Results The median age of children assessed was 36 months. Eight neonatal tetanus survivors and 9 community control cases aged < 42 months were tested using the Bayley III Scales of Infant and Toddler Development (Bayley III-VN) and 8 neonatal tetanus survivors and 9 community controls aged ≥42 months were tested using the Movement Assessment Battery for Children. No significant reductions in growth indices or neurodevelopmental scores were shown in survivors of neonatal tetanus compared to controls although there was a trend towards lower scores in neonatal tetanus survivors. Neurological examination was normal in all children except for two neonatal tetanus survivors with perceptive deafness and one child with mild gross motor abnormality. Neonatal tetanus survivors who had expienced severe disease (Ablett grade ≥ 3) had lower total Bayley III-VN scores than those with mild disease (15 (IQR 14–18) vs 24 (IQR 19–27), p = 0.05) with a significantly lower cognitive domain score (3 (IQR 2–6) severe disease vs 7 (IQR 7–8) mild disease, p = 0.02). Conclusions Neonatal tetanus is associated with long-term sequelae in those with severe disease. In view of these findings, prevention of neonatal tetanus should remain a priority. |
topic |
Neonatal tetanus Development Outcome |
url |
http://link.springer.com/article/10.1186/s12879-017-2748-3 |
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