Analysis of 92 hospitalized cases of non-neonatal tetanus in Guizhou Province, China.

BACKGROUND

Tetanus has a high mortality rate and remains a major public health threat in low- and middle-income countries. Although neonatal tetanus has been eliminated in China, the burden of non-neonatal tetanus is still heavy. This study analyzed the case characteristics, outcomes, and hospitalization expenses of non-neonatal tetanus inpatients in Guizhou Province, China, and provided a basis for reducing the disease burden.

METHODS

One tertiary medical institution was randomly selected from each of the nine cities (states) in the province, and the data of non-neonatal tetanus hospitalized cases from 2021 to 2025 were collected. Descriptive epidemiological methods, the simple seasonal index method, and multiple linear regression were used in the analysis.

RESULTS

A total of 92 cases were included. Males accounted for 65.22% (60/92); farmers accounted for 86.96% (80/92); the median age was 60 (55-69) years; the incubation period ranged from 1 to 27 days; and cases peaked in summer. 95.65% (88/92) were not vaccinated with tetanus toxoid-containing vaccine (TTCV), and only 21.74% (20/92) received standardized treatment within 24 h after injury. The case fatality rate was 15.22% (14/92). None of the non-survivors were inoculated with TTCV, no standardized treatment was performed within 24 h after injury, the severity was severe or above, and the family members gave up treatment on their own. The median hospitalization cost was 55,724 yuan (equivalent to 8,359 US Dollars); the highest was 239,365 yuan (equivalent to 35,905 US Dollars); and the number of hospitalization days was the main influencing factor (t = 5.751, p < 0.001).

CONCLUSION

Non-neonatal tetanus in Guizhou Province was mainly in middle-aged and older male farmers, with a high incidence in summer, and most of them were not vaccinated with TTCV. The non-survivors were not vaccinated with TTCV and did not receive standard treatment within 24 h after injury. The disease had a high case fatality rate and was a serious economic burden. It is recommended to strengthen TTCV vaccination and standardized post-exposure disposal in high-risk groups, enhance medical financial support to prevent abandonment of treatment for economic reasons, and ensure that patients receive timely and comprehensive clinical care.