台湾地区破伤风抗毒素水平随年龄的下降情况。

Decline of tetanus antitoxin level with age in taiwan.

作者信息

Wu Chi-Jung, Ko Huei-Chen, Lee Hsin-Chun, Tsai Wei-Chuan, Li Min-Gi, Pao Yu-Zhen, Lee Nan-Yao, Chang Chia-Ming, Shih Hsin-I, Ko Wen-Chien

机构信息

Graduate Institute of Clinical Medicine, National Cheng Kung University, Medical College, and Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.

出版信息

J Formos Med Assoc. 2009 May;108(5):395-401. doi: 10.1016/S0929-6646(09)60083-8.

DOI:10.1016/S0929-6646(09)60083-8

PMID:19443293

Abstract

BACKGROUND/PURPOSE: Tetanus is caused by Clostridium tetani, and is a vaccine-preventable infectious disease. The purpose of this study was to investigate the degree of protective tetanus immunity among adolescents and adults in Taiwan, which may provide valuable information for recommendations for tetanus vaccination strategy.

METHODS

Individuals aged 16 years or older who were visiting a local hospital for health examinations were invited to participate in the study. Participants' serum levels of tetanus antitoxin were measured. A standard questionnaire was used to collect demographic data and information about risk factors. The prevalence of protective tetanus immunity in various age groups was described and sociodemographic factors that potentially influenced the degree of tetanus immunity were analyzed.

RESULTS

Overall, 326 persons were included. Of these, 217 (67%) had never received a toxoid booster, while 109 (33%) had received a booster at least once. Among all participants, 95% had protective tetanus antitoxin levels (> or = 0.11 IU/mL), and 60% had protective antitoxin levels without the need of an immediate booster, i.e. > or = 0.51 IU/mL. Among 70 participants aged > 60 years, 89% had protective antitoxin levels > or = 0.11 IU/mL, and 31% had protective antitoxin levels > or = 0.51 IU/mL. Tetanus antitoxin levels declined with age. Male gender, birth after 1955, and prior receipt of toxoid booster(s) were independently associated with protective tetanus immunity (> or = 0.51 IU/mL) by multivariate analysis. Compared with those without tetanus toxoid boosters, individuals with a prior booster had higher antitoxin levels. The percentage of people with protective immunity declined if the interval between the last toxoid booster increased.

CONCLUSION

Waning immunity to tetanus was observed after primary tetanus vaccination or toxoid booster. The public health policy that one dose of toxoid booster after primary vaccination should be emphasized for continuing protection against tetanus.

摘要

背景/目的：破伤风由破伤风梭菌引起，是一种可通过疫苗预防的传染病。本研究的目的是调查台湾青少年和成年人中破伤风保护性免疫的程度，这可为破伤风疫苗接种策略的建议提供有价值的信息。

方法

邀请16岁及以上到当地医院进行健康检查的个体参与研究。测量参与者血清中的破伤风抗毒素水平。使用标准问卷收集人口统计学数据和有关危险因素的信息。描述了各年龄组中破伤风保护性免疫的患病率，并分析了可能影响破伤风免疫程度的社会人口学因素。

结果

总共纳入326人。其中，217人（67%）从未接受过类毒素加强免疫，而109人（33%）至少接受过一次加强免疫。在所有参与者中，95%的人破伤风抗毒素水平具有保护性（≥0.11 IU/mL），60%的人抗毒素水平具有保护性且无需立即加强免疫，即≥0.51 IU/mL。在70名年龄大于60岁的参与者中，89%的人抗毒素水平≥0.11 IU/mL具有保护性，31%的人抗毒素水平≥0.51 IU/mL具有保护性。破伤风抗毒素水平随年龄下降。多因素分析显示，男性、1955年后出生以及既往接受过类毒素加强免疫与破伤风保护性免疫（≥0.51 IU/mL）独立相关。与未接受破伤风类毒素加强免疫的人相比，既往接受过加强免疫的个体抗毒素水平更高。如果最后一次类毒素加强免疫的间隔时间增加，具有保护性免疫的人群比例会下降。