Risk factors and preventive role of vaccination in adult tetanus fatality: a systematic review of reported cases (1990-2024) and meta-analysis
International Journal of Infectious Diseases·
- DOI
- 10.1016/j.ijid.2025.107781
- PMID
- 39814168
- PMCID
- —
- OpenAlex
- W4406320394
- Study type
- Systematic review
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings emphasize the importance of maintaining current vaccination schedules to reduce tetanus severity and improve outcomes. The study suggests that prompt diagnosis and timely booster vaccinations are crucial for reducing mortality, particularly since immunity may not entirely prevent infection but does mitigate disease severity.
Structured evidence summary
Research question
The study identifies risk factors associated with fatal outcomes in adult tetanus patients and evaluates whether vaccination status and antibody levels influence disease severity and mortality.
Study design
A systematic review and meta-analysis of 182 tetanus cases reported across 36 countries in publications from 1990 to 2024.
Population and setting
Adult tetanus patients reported in case studies and case series from 36 countries over a 34-year period.
Main findings
Autonomic dysfunction, opisthotonus, shorter incubation periods, diabetes mellitus, cardiovascular diseases, and dermatological conditions were identified as risk factors for fatal outcomes. Some fatalities occurred even when patients had antibody levels above the protective threshold, indicating that serological immunity is not absolute. No deaths were observed among patients who had completed childhood vaccination courses, and those with complete vaccination histories experienced less severe disease.
Public-health relevance
The findings emphasize the importance of maintaining current vaccination schedules to reduce tetanus severity and improve outcomes. The study suggests that prompt diagnosis and timely booster vaccinations are crucial for reducing mortality, particularly since immunity may not entirely prevent infection but does mitigate disease severity.
Important limitations
This summary relies on the supplied single-article abstract and metadata. Full interpretation requires access to the complete published paper, including details on case selection criteria, heterogeneity across the 36 countries, potential publication bias in case reports, and the specific antibody assays and thresholds used.
GIDS interpretation
The article was identified through classifier links to tetanus, diphtheria, diagnostics, and vaccination topics, making it discoverable for literature surveillance related to vaccine-preventable diseases and clinical risk factors. The study provides contextual evidence on tetanus outcomes and vaccination impact but does not report new surveillance data or outbreak signals.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 9 auditable classifier relationships to diseases, places, topics, and study design.