Geographical distribution of tetanus in the world, 1951-60. A review of the problem.

The introduction of tetanus toxoid about three decades ago, which was followed in many parts of the world by programmes of immunization of the population, has contributed greatly to the control of tetanus in the developed countries. Nevertheless, during the decade 1951-60, tetanus remained an unsolved problem in many of the developing countries.In the present report, it is shown, on the basis of the available literature and WHO statistics, that tetanus causes more than 50 000 deaths each year all over the world. Indeed, this figure should be regarded as an underestimate, since it only partially reflects the actual situation in the developing countries. The paper draws attention to the geographical distribution of tetanus in the world and indicates that existing "foci" or "zones" of infection may be attributed to environmental conditions as well as to social, economic and cultural factors.