TITLE:
Epidemiological Profile of Clostridium tetani Portals of Entry in Tetanus Patients at the Point-G University Hospital Center, Bamako, Mali
AUTHORS:
Abdoulaye Mamadou Traoré, Ibrahim Dollo, Hamsatou Cissé, Djenebou Traoré, Djibril Sy, Kadidia Sanguisso, Kaly Keita, Lassine Diallo, Mamadou Salia Diarra, Ousmane Sylla, Tidiani Cissé, Douro dit Seydou Ouologuem, Brahima Ba, Mamadou Cissoko, Assetou Kaya, Daouda Kassoum Minta
KEYWORDS:
Tetanus, Portal of Entry, Pelvic and Thoracic Limbs, Serotherapy, Vaccination, Bamako
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.15 No.4,
November
6,
2025
ABSTRACT: Introduction: Tetanus remains a serious medical emergency and a major public health problem in developing countries. The presence of portal of entry (POE) remains an essential condition for the bacterium (Clostridium tetani) to enter the body. Objective: To determine the frequency and main tetatogenic profiles of bacterial POE and describe their topography. Patients and Method: We conducted a descriptive and analytical cross-sectional study with retrospective data collection at Point-G University Hospital over a period of 22 years. Our study population consisted of tetanus patients whose bacterial POEs were found upon admission. The variables analyzed were collected from complete and analyzable hospital records. The distribution of quantitative variables was described by the mean, standard deviation and extreme values. The expected significance threshold was set at p Results: We recorded 258 tetanus patients, representing 5% of hospitalizations. The POE was found in 217 cases (84.10%) with a sex ratio (M/F) of 9.85 and an average age of 35.94 ± 15.58 years. Unskilled laborers (32.7%), farmers (25.8%), pupils/students (10.1%), traders (11.1%) and housewives (5.1%) were the predominant occupations, with no statistically significant difference in cases where POEs were not found (p = 0.63). The most common POEs were skin and mucosal injuries (65.4%), open fractures (10.6%), skin lesions (7.8%) and deep wounds (7.4%). The most significant anatomical sites were the pelvic limbs (62.2%), thoracic limbs (26.3%), head (5.5%) and uterus (2%). Generalized forms appeared to be more common in anatomical sites located on the pelvic and thoracic limbs, with no statistical difference as regards the origin of the clinical form (p = 0.45). The overall mortality rate was 42.2%. Specifically, 41.5% of deaths were observed in patients with bacterial portal of entry found (BPOEF) versus POEs not found (46.3%) with p = 0.77. Conclusion: Tetanus continues to be a reality despite the availability of effective prevention methods. The implementation of good practices in primary care for bacterial portals of entry would be a significant contribution to tetanus elimination strategies.