Focus Report Tetanus in The ASEAN

Tetanus is an acute infectious disease caused by Clostridium tetani spores, which are ubiquitously present in environmental reservoirs such as soil, ash, faecal matter, and contaminated surfaces, including rusted instruments (WHO, 2024a). The disease is acquired predominantly through wound contamination, and person-toperson transmission does not occur. Despite the availability of tetanus-toxoidcontaining vaccines (TTCV), natural infection with Clostridium tetani does not confer protective immunity. Therefore, immunization remain necessary to prevent infections for all susceptible populations. Neonatal and maternal tetanus remain the primary contributors to global morbidity and mortality, particularly in regions with insufficient immunization coverage and unhygienic birth practices. In neonates, exposure to contaminated instruments or materials used during cord care represents a critical risk factor, whereas inadequate booster coverage in adolescents and adults predisposes males undergoing circumcision to infection.