Tetanus in Romania-Trends and Challenges

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Tetanus is a severe, vaccine-preventable illness caused by *Clostridium tetani* neurotoxins.
• Environmental spores make eradication impossible, but global vaccination has reduced incidence.
• Romania's tetanus surveillance data from 2010-2023 is analyzed to understand disease trends.

Purpose of the Study:

• To analyze tetanus incidence and fatality trends in Romania between 2010 and 2023.
• To identify demographic groups most affected by tetanus in Romania.
• To inform public health strategies for tetanus prevention and control.

Main Methods:

• Retrospective analysis of national tetanus surveillance data from 2010-2023.
• Calculation of incidence rates, case fatality ratios, and annual percentage changes.
• Statistical analysis using incidence rate ratios (IRR) and p-values.

Main Results:

• 97 tetanus cases reported (0.03/100,000 inhabitants); highest incidence in children (1-14 yrs), males, and rural populations.
• A 7% annual decline in case numbers was observed, but incidence trends were not statistically significant.
• 47 deaths recorded (42% case fatality ratio), showing a significant 9% annual decrease.

Conclusions:

• Despite a slight decrease in case numbers, tetanus remains a concern in Romania due to stable incidence and high case fatality.
• High vaccination coverage in children/adolescents and adult booster doses are essential.
• Improved management of tetanus-prone wounds is critical for reducing disease burden.