Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam
<p><b>Background:</b> 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.</p> <p><b>Methods:</b> We ass...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
BioMed Central
2017
|
| _version_ | 1826296284687892480 |
|---|---|
| author | Trieu, H Anh, N Vuong, H Dao, T Hoa, N Tuong, V Dinh, P Wills, B Qui, P Van Tan, L Yen, L Sabanathan, S Thwaites, C |
| author_facet | Trieu, H Anh, N Vuong, H Dao, T Hoa, N Tuong, V Dinh, P Wills, B Qui, P Van Tan, L Yen, L Sabanathan, S Thwaites, C |
| author_sort | Trieu, H |
| collection | OXFORD |
| description | <p><b>Background:</b> 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.</p> <p><b>Methods:</b> 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.</p> <p><b>Results:</b> 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), <i>p</i> = 0.05) with a significantly lower cognitive domain score (3 (IQR 2–6) severe disease vs 7 (IQR 7–8) mild disease, <i>p</i> = 0.02).</p> <p><b>Conclusions:</b> 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.</p> |
| first_indexed | 2024-03-07T04:13:58Z |
| format | Journal article |
| id | oxford-uuid:c8c673a7-1a3c-4285-8f20-190e4814d363 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:13:58Z |
| publishDate | 2017 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:c8c673a7-1a3c-4285-8f20-190e4814d3632022-03-27T06:54:34ZLong-term outcome in survivors of neonatal tetanus following specialist intensive care in VietnamJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c8c673a7-1a3c-4285-8f20-190e4814d363EnglishSymplectic Elements at OxfordBioMed Central2017Trieu, HAnh, NVuong, HDao, THoa, NTuong, VDinh, PWills, BQui, PVan Tan, LYen, LSabanathan, SThwaites, C <p><b>Background:</b> 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.</p> <p><b>Methods:</b> 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.</p> <p><b>Results:</b> 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), <i>p</i> = 0.05) with a significantly lower cognitive domain score (3 (IQR 2–6) severe disease vs 7 (IQR 7–8) mild disease, <i>p</i> = 0.02).</p> <p><b>Conclusions:</b> 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.</p> |
| spellingShingle | Trieu, H Anh, N Vuong, H Dao, T Hoa, N Tuong, V Dinh, P Wills, B Qui, P Van Tan, L Yen, L Sabanathan, S Thwaites, C Long-term outcome in survivors of neonatal tetanus following specialist intensive care in Vietnam |
| title | 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_short | 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 |
| work_keys_str_mv | AT trieuh longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT anhn longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT vuongh longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT daot longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT hoan longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT tuongv longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT dinhp longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT willsb longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT quip longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT vantanl longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT yenl longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT sabanathans longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam AT thwaitesc longtermoutcomeinsurvivorsofneonataltetanusfollowingspecialistintensivecareinvietnam |