Pre-post effects of a tetanus care protocol implementation in a sub-Saharan African intensive care unit.
Riaz AzizSoledad ColombeGibonce MwakisambweSolomon NdeziJim ToddSamuel KalluvyaHalinder S MangatReed MaglebyArndt KoeblerBernard KenemoRobert N PeckJennifer A DownsPublished in: PLoS neglected tropical diseases (2018)
The overall mortality in patients suffering non-neonatal tetanus is high (>40%). Institution of a standardized tetanus management protocol, in accordance with WHO recommendations, decreased immediate mortality related to primary causes of death after tetanus. However, this was offset by an increase in death due to later ICU complications such as sepsis. Our results illustrate the complexity in achieving mortality reduction even in illnesses thought to require few critical care interventions. Improving basic ICU care and strengthening vaccination programs to prevent tetanus altogether are essential components of efforts to decrease the mortality caused by this lethal, neglected disease.
Keyphrases
- intensive care unit
- cardiovascular events
- healthcare
- risk factors
- quality improvement
- palliative care
- randomized controlled trial
- end stage renal disease
- newly diagnosed
- ejection fraction
- physical activity
- primary care
- coronary artery disease
- type diabetes
- cardiovascular disease
- prognostic factors
- peritoneal dialysis
- affordable care act
- clinical practice
- health insurance
- acute respiratory distress syndrome