Abstract
Tetanus remains a vaccine-preventable but potentially fatal disease, with control relying on vaccination coverage, maternal/neonatal protection, adult boosters, wound prophylaxis, and clinical management. This study characterized the global research landscape, thematic evolution, and emerging frontiers of tetanus literature from 2005 to 2025. English-language articles and reviews were retrieved from the Web of Science Core Collection (WoSCC) and Scopus, with the final search conducted on May 12, 2026. Records were merged, deduplicated, and manually screened. Bibliometrix, VOSviewer, CiteSpace, and Scimago Graphica were used for descriptive analyses and visualization of collaboration, keyword co-occurrence, co-citation, and burst patterns. Citation-trend and reference co-citation analyses were restricted to WoSCC records. A manually verified clinical-treatment subset underwent supplementary keyword analysis. Of 28,912 retrieved records, 8307 publications met the inclusion criteria, comprising 7689 articles and 618 reviews. Annual publication output remained relatively stable, with a modest increase after 2010. The United States contributed the most publications (2578; 31.03%), followed by the United Kingdom, India, Germany, and China. The Centers for Disease Control and Prevention was the most productive institution, and Vaccine was the leading journal (643 publications). Three broad thematic domains emerged: toxin biology and immune mechanisms, vaccines and immunization strategies, and public health implementation and population protection. Recent keyword bursts highlighted vaccination coverage, pregnancy, women, vaccine hesitancy, and public health, while mechanistic and immunological research remained active. The clinical-treatment subset included 675 publications and emphasized intensive care, antitoxin and immunoglobulin therapy, autonomic dysfunction, and mortality. Recent tetanus research fronts increasingly emphasize immunization delivery and population protection, alongside continuing mechanistic research. Clinical management constitutes a distinct but less prominent subdomain. These findings provide a publication-level overview to inform future evidence synthesis and research planning but should be interpreted alongside clinical, epidemiological, and surveillance evidence.