A case study of pediatric tetanus in Rural Zambia

  • Michelle LaTanya Drew Texas Woman's University
  • Sukhpreet Kaur Texas Woman's University
  • Peggy Mancuso Texas Woman's University
Keywords: pediatric, case study, tetanus, vaccine-preventable, metronidazole


Background: 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.

Author Biographies

Michelle LaTanya Drew, Texas Woman's University
I am a Nurse Midwife and Family Nurse Practitioner and a student on the Doctorate pf Nursing Practice Program at Texas Woman's University in Dallas Texas, USA
Sukhpreet Kaur, Texas Woman's University

MS Nursing Student at Texas Woman's Univerisity

Dallas, Texas

Peggy Mancuso, Texas Woman's University
Professor, Coodinator pf the Doctoract of Nursing Practice Program, Texas Woman's University


Afshar, M., Raju, M., Ansell, D., & Bleck, T. (2011). Narrative review: Tetanus-a health threat after natural disasters in developing countries. Annals of Internal Medicine, 154(5), 329-335.

Bleck T.P., & Brauner J.S. (2004). Tetanus. In: Scheld W.M., Whitley R.J., Durack D.T. (Eds.) Infections of the central nervous system (3rd ed., pp. 629-623). Philadelphia, PA: Lippincott-Raven Publishers.

Campbell, J. I., Yen, L. T. M., Loan, H. T., Diep, T. S., Nga, T. T. T., Van Minh Hoang, N., Son,L. T., et al. (2009). Microbiologic characterization and antimicrobial susceptibility of Clostridium tetani isolated from wounds of patients with clinically diagnosed tetanus. American Journal of Tropical Medicine and Hygiene, 80(5), 827-831.

CDC (2006). Facts about Strychnine. Retrieved from


CDC (2011). Tetanus Surveillance- United States, 2001-

Morbidity and Mortality Weekly Report, 60(12) 365-

Retrieved from



Grunau, B. and Olson, J. (2010). An interesting case of

pediatric tetanus. Canadian Journal of Emergency

Medicine;12(1), 69-72.

Howard, C., & John, C. (2011). International adoption. In:

CDC Health Information for International Travel, The

Yellow Book, 2012. Oxford New York: Oxford University

Press. Retrieved 09/25/11 from



Thwaites, C.L., and Yen, L (2008). Tetanus. In: Mason’s

Tropical Diseases (21st ed., pp 1113-19). Philadelphia: W.B.

Saunders, Elsevier Limited.

Thwaites, C. L., Yen, L. M., Glover, C., Tuan, P. Q., Nga, N.

T. N., Parry, J., Loan, H. T., Bethell, D., Day, N. P. J., White,

N. J., Soni, N., & Farrar, J. J. (2006), Predicting the clinical

outcome of tetanus: the tetanus severity score. Tropical

Medicine & International Health, 11: 279–287. doi:


World Health Organization. (n.d.). Immunization

surveillance and monitoring. Retrieved from


World Health Organization. (2006). Tetanus vaccine: WHO

position paper. World Epidemiological Record. 81, 197–

How to Cite
Drew, M. L., Kaur, S., & Mancuso, P. (2012). A case study of pediatric tetanus in Rural Zambia. International Journal of Nursing, 1(1), 15-20. Retrieved from https://www.ijnonline.com/index.php/ijn/article/view/17
Community Health Nursing