Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Case Report Volume 6 Issue 1

Tetanus: The First Child Case Report from Hevi Pediatric Teaching Hospital at Kurdistan Region - Iraq

Federica Buzzi1, Nizar Bakir Yahya2, Khalaf Hussein Gargary3*, Adel Hevan Al-Atroushy4 and Maiandi Stefano5

11RN, Head of Pediatric and Neonatal Intensive Care Clinical Training, E.U. Project MADAD, Italian Association for Solidarity among Peoples, Duhok, KR, Iraq and Nurse, Hematology and Bone Marrow Transplantation Unit and Pediatric Immunohematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
2Assisntant Professor, Hevi Paediatric Teaching Hospital Duhok, KR, Iraq
3Professor, College of Medicine, University of Duhok, KR, Iraq
4Pediatrician FIBMS, Pediatric Intensive Care Unit, Hevi Pediatric Teaching Hospital Duhok, KR, Iraq
5MsN, Professional Development and Research, Directorate of Health Professions, ASST of Lodi, Italy

*Corresponding Author: Khalaf Hussein Gargary, Professor, College of Medicine, University of Duhok, KR, Iraq.

Received: October 08, 2021; Published: December 13, 2021


Background: Tetanus is a vaccine-preventable disease caused by a robust neurotoxin produced by the spore-forming bacterium Clostridium tetani. However, numerous cases continue to be reported in internationally published literature indicating that tetanus continues to be a substantial problem despite the existence of vaccines.

In this case report, we describe the first case of tetanus at the Hevi Paediatric Teaching Hospital in Duhok, Iraq.

Case Presentation: Our patient was a 13-year-old boy admitted to the emergency room for widespread spasms and difficulty swallowing and urinating. The patient was admitted to the paediatric intensive care unit for suspicion of tetanus. The WHO international guidelines for the treatment and care of tetanus were adopted. After 17 days of hospitalization, the patient was discharged without neurological sequelae. Treatment for tetanus patients is long, complex, and multidisciplinary.

Conclusions: It is crucial to raise the awareness of tetanus and to vaccinate even the most vulnerable populations owing to the high costs of care and poor prognosis of patients with tetanus. In low- to middle-income countries such as Iraq, tetanus can impact overall healthcare management due to the complexity of patient care and high healthcare costs.

Keywords: Tetanus; WHO Guideline; Vaccine; Iraq; Kurdistan


  1. Rhinesmith E and Fu L. “Tetanus Disease, Treatment, Management”. Pediatric Review8 (2018): 430-432.
  2. Woldeamanuel YW. “Tetanus in Ethiopia: unveiling the blight of an entirely vaccine-preventable disease”. Current Neurology and Neuroscience Reports 6 (2012): 655-665.
  3. Aggarwal M., et al. “Tetanus in pediatric patients--predictors affecting mortality and role of immunoglobulin”. Indian Pediatrics12 (2011): 987-988.
  4. Ibinda F., et al. “Incidence and risk factors for neonatal tetanus in admissions to Kilifi County Hospital, Kenya”. PLoS One4 (2015): e0122606.
  5. Lafta R and Hussain A. “Trend of vaccine preventable diseases in Iraq in time of conflict”. Pan African Medical Journal 31 (2018): 130.
  6. Scobie HM., et al. “Tetanus Immunity Gaps in Children 5-14 Years and Men ≥ 15 Years of Age Revealed by Integrated Disease Serosurveillance in Kenya, Tanzania, and Mozambique”. American Society of Tropical Medicine and Hygiene 2 (2017): 415-420.
  7. Thwaites CL., et al. “Maternal and neonatal tetanus”. Lancet (London, England)9965 (2015): 362-370.
  8. Yen LM and Thwaites CL. “Tetanus”. Lancet (London, England)10181 (2019): 1657-1668.
  9. Oyedeji OA., et al. “Trends in neonatal and post-neonatal tetanus admissions at a Nigerian teaching hospital”. Journal of Infection in Developing Countries 2012;6 (12): 847-853.
  10. Ergonul O., et al. “An unexpected tetanus case”. Lancet Infectious Disease6 (2016): 746-752.
  11. Rodrigo C., et al. “Pharmacological management of tetanus: an evidence-based review”. Critical Care2 (2014): 217.
  12. Kyu HH., et al. “Mortality from tetanus between 1990 and 2015: findings from the global burden of disease study 2015”. BMC Public Health 1 (2017): 179.
  13. Tetanus vaccines: WHO position paper – February 2017”. Releve Epidemiologique 6 (2017): 53-76.
  14. Animasahun BA., et al. “Profile and outcome of patients with post-neonatal tetanus in a tertiary centre in south west Nigeria: any remarkable reduction in the scourge?” Pan African Medical Journal 21 (2015): 254.
  15. Liu L., et al. “Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals”. Lancet (London, England)10063 (2016): 3027-3035.
  16. Narang M., et al. “Epidemiological trends of tetanus from East Delhi, India: a hospital-based study”. Journal of Infection and Public Health 2 (2014): 121-124.
  17. Şık G., et al. “Intrathecal baclofen use in the management of tetanus related spasm: A case report”. Turkish Journal of Pediatrics1 (2019): 126-129.


Citation: Federica Buzzi., et al. “Tetanus: The First Child Case Report from Hevi Pediatric Teaching Hospital at Kurdistan Region - Iraq”.Acta Scientific Medical Sciences 6.1 (2022): 122-125.


Copyright: © 2022 Federica Buzzi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US