Resumo

Tetanus is an infectious preventable disease that still occurs in large numbers in Brazil and has high mortality rates. The goal of this study is to analyze the epidemiological data of tetanus in Brazil from 2008 to 2011, in order to increase awareness of tetanus cases still occurring after almost ten years of the neonatal eradication programs. Epidemiological data on morbidity and mortality of accidental and neonatal tetanus were collected from the System of Information of Notifiable Diseases available on line on the System of Information of Notifiable Diseases SINAN (Sistema de Informação de Agravos de Notificação). There were 1299 cases of accidental tetanus cases with 419 (32%) deaths. Men aged 20 to 59 years were most affected. Northeast region had the majority cases of accidental 486 (37.4%) with 29.8% death rate. For neonatal tetanus North and Northeast region had 87% of the total cases with a lethality of 56.5%. In 65.2% of the neonatal cases the mothers of the children affected had no more than five years of education or no school education at all. Tetanus has been notifiable in Brazil since 1982. A program for eradication of neonatal cases started 1992 and since then cases have been drastically reduced. Greater incidence of accidental tetanus, men aged 20 to 59, is compatible to previous data in Brazil. Men were five times more affected than women, what is in accordance to other studies. Explanation to this fact is related to two main aspects: one is that men are more exposed due to their professions. Many tetanus cases occur in those working with soil such as agricultures, gardeners and bricklayers. The other aspect is that prevention in adults depends on revaccination every ten years; this is not a well known fact for the lay population. Better socioeconomic conditions are directly related to more frequently access to health services and awareness of the need for vaccination, so the low education is one of the socioeconomic factors that influence the prevention of tetanus. The incidence of tetanus is related to a number of factors such as: non-continued and, therefore inadequate vaccination, exposure to the risk of factors, and especially the lack of knowledge about the disease. Our data show a difference in Brazil regions where Northeast has a higher concentration of accidental tetanus as well as death and is also an under privileged region. South and Southeast are more developed regions in this case the high numbers of accidental tetanus can be explained by the fact that their main economic activity is agricultural. Our main conclusion is the need for special public health prevention program for accidental tetanus. Adult male population should be a special target. The program should make available information on different forms of contamination. Individuals should be instructed to seek help in the case of injuries to receive adequate prophylaxis.