He Li, Liu Cheng, Nie Xianli, He JiangShan, Deng Dachuan, Zhou Wenlai, Zheng Xiangde
Department of Critical Care Medicine, Dazhou Central Hospital, Dazhou, Sichuan, China.
Department of Pediatrics, Dazhou Central Hospital, Dazhou, Sichuan, China.
BMJ Paediatr Open. 2025 May 14;9(1):e003326. doi: 10.1136/bmjpo-2025-003326.
Understanding trends in the incidence and mortality of tetanus in infants and young children is essential to develop prevention and intervention strategies.
Data on tetanus incidence and mortality among children aged under 5 years from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021. Estimated annual percentage changes were calculated to assess the trends in the change of children's tetanus incidence and mortality and the burden of disease. The relationship between disease burden and Sociodemographic Index (SDI) was also analysed.
Globally, the incidence of children's tetanus decreased from 308 931 cases in 1990 to 17 788 cases in 2021. Similarly, tetanus mortality among children has decreased significantly over the past 30 years, from 24.62 per 100 000 to 1.34 per 100 000, with little gender difference observed. The highest rates were seen in the Caribbean, Central Sub-Saharan Africa, Eastern Sub-Saharan Africa, North Africa and the Middle East, South Asia, Southeast Asia and Western Sub-Saharan Africa. The incidence and mortality of tetanus in children are significantly different in areas with different SDI levels. The incidence and mortality in areas with low SDI are higher than those in areas with high SDI.
The incidence and mortality of tetanus in children have decreased to varying degrees worldwide, but they are still high in some regions, especially in countries with low SDI, which highlights the impact of socioeconomic factors on the outcome of the disease. More targeted supportive measures are imperative for mitigating the global burden posed by children's tetanus.
了解婴幼儿破伤风的发病率和死亡率趋势对于制定预防和干预策略至关重要。
从《2021年全球疾病负担研究》中获取1990年至2021年5岁以下儿童破伤风发病率和死亡率的数据。计算年度估计百分比变化，以评估儿童破伤风发病率和死亡率的变化趋势以及疾病负担。还分析了疾病负担与社会人口指数（SDI）之间的关系。
在全球范围内，儿童破伤风发病率从1990年的308931例降至2021年的17788例。同样，在过去30年中，儿童破伤风死亡率显著下降，从每10万人24.62例降至每10万人1.34例，几乎没有观察到性别差异。发病率最高的地区是加勒比地区、撒哈拉以南非洲中部、撒哈拉以南非洲东部、北非和中东、南亚、东南亚以及撒哈拉以南非洲西部。不同SDI水平地区儿童破伤风的发病率和死亡率存在显著差异。SDI低的地区发病率和死亡率高于SDI高的地区。
全球范围内儿童破伤风的发病率和死亡率均有不同程度下降，但在一些地区仍然很高，尤其是在SDI低的国家，这凸显了社会经济因素对疾病结局的影响。必须采取更有针对性的支持措施，以减轻儿童破伤风造成的全球负担。
