When Oliver Bukirwa’s son, Umar Muwonge, innocently stepped on a rusted nail, little did they anticipate that it would lead to a life-threatening illness—tetanus. Living in Zana, Wakiso District, the family’s ordeal began in October 2021 when Muwonge, seemingly recovering from the injury, started experiencing excruciating pain, breathing difficulties, and a serious fever. The situation rapidly escalated, necessitating admission to TMR International Hospital in Naalya.
Tetanus, a vaccine-preventable infectious bacterial disease, is characterized by painful uncontrollable muscle contractions, with potential fatal consequences, especially if left untreated. The Bukirwa family’s journey through Muwonge’s treatment involved emotional and financial stress, resulting in property loss and a fundraising drive to settle a substantial medical bill exceeding Shs200 million.
Uganda grapples with an annual average of 4,000 tetanus cases, according to the Ministry of Health, with a recent research report highlighting 17,903 cases reported between 2012 and 2016. The disease remains a significant cause of death, with a death rate ranging from 11 to 49 percent among infected individuals.
The research emphasizes the need for a reevaluation of vaccination strategies, urging the government to refocus and scale up tetanus toxoid (TT) vaccination for both adult males and females. While maternal and neonatal tetanus elimination was validated in 2011, Uganda continues to report one of the highest rates of non-neonatal tetanus globally.
Dr. Robert Mugagga, an obstetrician and gynecologist, advocates for pregnant mothers to receive tetanus shots during each pregnancy, emphasizing the necessity of revisiting vaccination schedules. Dr. Hellen Aanyu, the head of the pediatrics department at Mulago National Referral Hospital, adds that even children vaccinated as infants require boosters every 10 years to maintain immunity.
The financial toll of tetanus treatment is highlighted by cases like Victoria Nabiteeko, who paid at least Shs165 million for her son’s treatment. The lack of awareness and delayed diagnosis were additional challenges faced by families, as demonstrated by the loss of two children to tetanus at Kibuli Hospital due to stepping on broken glass.
Health officials, recognizing the severity of tetanus, are planning to extend immunization efforts to include adult males and females. Dr. Michael Baganizi from the Uganda National Expanded Programme on Immunisation emphasizes the difficulty of handling tetanus cases in hospitals and the need for preventive measures. Dr. Allan Muruta, the commissioner for epidemics at the Ministry of Health, underscores the importance of booster doses and addressing hygiene practices contributing to the contraction of the tetanus bacteria.
As Uganda confronts the challenges posed by tetanus, the imperative is clear—enhanced awareness, timely vaccinations, and preventive measures are crucial in mitigating the impact of this potentially fatal disease.
