Tetanus Adverse Event after VMMC for HIV Prevention in a Pre-circumcision Tetanus Immunized Male from Uganda: A Case Report

International Journal of Medical and Pharmaceutical Case Reports

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Title Tetanus Adverse Event after VMMC for HIV Prevention in a Pre-circumcision Tetanus Immunized Male from Uganda: A Case Report
Creator Lugada, E.
Nyanzi, A.
Bwayo, D.
Musinguzi, H.
Akao, J.
Wamundu, C.
Musinguzi, A.
Kikaire, B.
Lawoko, S.
Kak, N.
Almossawi, H.
Rwegyema, T.
Kinuthia, F. K.
Seruwagi, G.
Description Background: Although tetanus is a life-threatening disease, its occurrence is rare in the post-vaccination era, especially in developed countries. The US President’s Emergency Plan for AIDS Relief (PEPFAR) has supported scale up of Voluntary Medical Male Circumcision (VMMC) to reduce female-to-male HIV transmission in countries with a high prevalence of HIV. VMMC is generally safe, with less than 2% of clients experiencing moderate to severe adverse events. However, in most sub-Saharan countries with a high HIV prevalence and low male circumcision coverage, tetanus vaccination coverage among infants, especially male, remains suboptimal. This is a case report of a 45-year-old male who developed tetanus after pre-circumcision tetanus vaccination in a VMMC HIV/AIDS prevention intervention program in Uganda.
The Case: A healthy 45-year-old male presented for voluntary circumcision at field VMMC centre. He received a standard pre-circumcision tetanus immunization and had no incident immediate post-operative. 14 days later he reported at a local health facility with a history of difficulty in swallowing, difficulty in breathing, loss of speech and was ultimately diagnosed with tetanus after 2 days. The patient was immediately admitted in intensive care unit, treated, improved and eventually discharged.
Conclusions: This report highlights the possibility of tetanus vaccine failure and importance of prompt diagnosis and treatment of tetanus. It also highlights the need for institution of aggressive quality improvement and pre-circumcision tetanus vaccination procedures. Post vaccination surveillance for possible vaccine failure is recommended in addition to a review of existing national immunization medical practice and policies.
Publisher SCIENCEDOMAIN international
Date 2021-02-12
Type info:eu-repo/semantics/article
Format application/pdf
Identifier http://journalijmpcr.com/index.php/IJMPCR/article/view/30121
Source International Journal of Medical and Pharmaceutical Case Reports; 2021 - Volume 14 [Issue 1]; 6-10
Language eng
Relation http://journalijmpcr.com/index.php/IJMPCR/article/view/30121/56516
Rights Copyright (c) 2021 Lugada et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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