Safety of Equine Tetanus Antitoxin for Prophylactic use In Ethiopia: A Retrospective Multicenter Study
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Date
2021-04-08
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Addis Ababa University
Abstract
Tetanus remains an important public health problem in many parts of the world. It is indicated to cause an estimated 56,000 deaths annually worldwide. Among global tetanus deaths, 44% occur in sub-Saharan Africa, and the highest proportion of these occurs in East Africa. In 2017 WHO reported 20 cases of tetanus in Ethiopia. Although tetanus antitoxin (TAT, equine origin) has been replaced by human tetanus immunoglobulin (TIG), it is still in use in developing countries due to the high costs and limited access to TIG. Adverse reactions of TAT have not been studied in Ethiopians. Thus, conducting a Retrospective safety study on TAT in Ethiopia is important to promote public health and support improvement of the product by providing scientific evidence from the local context.
Objective: To evaluate the safety of equine tetanus antitoxin when administered to adults under conditions of routine post-exposure prophylactic use in Ethiopia.
Methods: A retrospective multicenter study was conducted in Addis Ababa covering three referral teaching public hospitals, (Tikur Anbessa Specialized Teaching Hospital and Zewditu Memorial Teaching Hospital and) and eight public health centers of with high client load for TAT. Charts of patients (n=1213) treated with equine anti toxin for prophylactic use for their wounds from January 2015 to December 2019, older than 18 years of age were reviewed.
Results: We included 1213 medical record forms in the final analysis (994 males and 264 females) and the mean age was 29.33 years (SD = 11.41 years). Only 0.98%(12/264) of the females had history of TT vaccination. Among all the charts reviewed head trauma, trauma at workplace and open wound were most frequently seen and only one patient experienced adverse event following immunization.
Conclusion and Recommendation: Even though there were major limitation on the data retrieved, on its clarity and completeness, findings from this retrospective study suggests that use of TAT is safe compared to number of injections and the overall disease reported in the country from January 2015 to December 2019. Large study with wider geographical converge will have significance in testing the validity of the current findings.