Damasco P V, Pimenta F P, Filardy A A, Brito S M, Andrade A F B, Lopes G S, Hirata R, Mattos-Guaraldi A L
Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Vila Isabel, RJ, Brasil.
Epidemiol Infect. 2005 Oct;133(5):911-4. doi: 10.1017/S0950268805003997.
The lack of information on the immunity of adults in Brazil against diphtheria prompted us to analyse sera from 234 blood donors aged 18-61 years (30.3% females and 69.7% males). IgG diphtheria antitoxin levels determined by means of an ELISA, validated by toxin neutralization test in Vero cells, showed that 30.7% (95% CI 25.0-37.1) of the population was fully protected (>or=1 IU/ml). The highest percentage of subjects fully protected was in the 31-40 years age group. Most of the subjects with uncertain or no protection (<1 IU/ml) were found in the 18-30 years age group (43.8%, OR 2.18, P=0.01). Antitoxin levels were not influenced by the increase in age. Males were more protected than females (80.5%, OR 0.44, P=0.01). The prevalence of 30% of individuals fully protected against diphtheria in blood donors in Rio de Janeiro supports the fact that immunity to diphtheria among healthy Brazilian adults is inadequate. To avoid diphtheria epidemics in the future the immunity among adults should be raised in the coming years.
巴西缺乏关于成人对白喉免疫力的信息，这促使我们分析了234名年龄在18至61岁之间的献血者的血清（女性占30.3%，男性占69.7%）。通过酶联免疫吸附测定法（ELISA）测定的IgG白喉抗毒素水平，经Vero细胞毒素中和试验验证，结果显示30.7%（95%置信区间25.0 - 37.1）的人群得到了充分保护（≥1 IU/ml）。充分受保护的受试者比例最高的是31至40岁年龄组。大多数保护不确定或无保护（<1 IU/ml）的受试者出现在18至30岁年龄组（43.8%，比值比2.18，P = 0.01）。抗毒素水平不受年龄增长的影响。男性比女性受保护程度更高（80.5%，比值比0.44，P = 0.01）。里约热内卢献血者中30%的个体对白喉有充分保护，这一流行率表明巴西健康成年人对白喉的免疫力不足这一事实。为避免未来白喉流行，未来几年应提高成年人的免疫力。
