Tetanus following Guboow complications of Somali traditional burn therapy: a case report

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BACKGROUND: Tetanus remains a significant public health concern, particularly in regions with low vaccination rates and prevalent traditional healing practices. Guboow, a Somali traditional healing practice involving intentional skin burns using heated objects, poses a high risk of infections, including tetanus, due to nonsterile conditions. This case highlights the complications arising from Guboow and emphasizes the importance of vaccination and culturally sensitive healthcare interventions. CASE PRESENTATION: A 35-year-old Somali male, unvaccinated against tetanus, developed an infection 10 days after undergoing Guboow. The patient presented with respiratory distress, muscle stiffness, and trismus. Clinical examination revealed opisthotonus, burn ulcers, and autonomic instability. Laboratory investigations confirmed hypoxemia and mild hypernatremia. The patient was admitted to the intensive care unit and managed with mechanical ventilation, tetanus immunoglobulin, antibiotics, and wound care. Supportive intensive care unit management, including treatment for muscle spasms and autonomic dysfunction, led to a significant clinical improvement. By day 14 (post intensive care unit), the patient was successfully weaned off the ventilator, transferred to the general ward, and discharged without residual symptoms on day 24 (post intensive care unit). CONCLUSION: This case underscores the dangers of unsafe traditional healing practices and highlights the critical role of vaccination in tetanus prevention. There is an urgent need for culturally tailored public health education and collaboration with traditional healers to reduce the health risks associated with these unsafe practices. Further research is essential to assess the impact of traditional healing methods on infectious disease outcomes.

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