Razzaghi Reza, Khalifesoltani Ahmad, Heravi Mansooreh Momen, Akbari Hosein
Department of Infectious Disease, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Acta Med Iran. 2011;49(6):379-82.
Tetanus can be only prevented by vaccination because immunity against this disease is rarely acquired, even by natural infections. To maintain long-term protective immunity against tetanus, booster immunization is essential for adolescents and adults. Most hospitalized cases and virtually all deaths occur in people over 60 years of age. The purpose of this study was to investigate the degree of protective tetanus immunity among 50 years of age and older people in Kashan city, Iran. This cross-sectional study carried out on 180 randomly individuals aged 50 years or older who were visiting a central laboratory for health examinations in 2008. Participants' serum levels of tetanus antitoxin were measured by enzyme linked immunosorbent assay. 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. Overall, 180 persons were included. Of these, 72 (40%) had never received a toxoid booster, while 47 (26.1%) had received a booster at least once. Among all participants, 30 (16.7%) had protective tetanus antitoxin levels (≥ 0.11 IU/mL), and 34 (18.9%) had protective antitoxin levels without the need of an immediate booster ≥0.51 IU/mL. Among 86 participants aged >60 years, 6 (7%) had protective antitoxin levels ≥0.1-1 IU/mL, and 5(5.8%) had protective antitoxin levels ≥1 IU/mL. Male gender and prior receipt of toxoid booster(s) were associated with protective tetanus immunity. Tetanus antitoxin levels declined with age. It appears that most 50 years of age and older adults do not have protective levels of tetanus antitoxin because of inadequate vaccination coverage. There is a need to improve the immunity levels of this age group. It is recommended to vaccinate elderly people against tetanus.
破伤风只能通过接种疫苗来预防，因为即使是自然感染，也很少能获得针对这种疾病的免疫力。为维持对破伤风的长期保护性免疫，加强免疫对青少年和成年人至关重要。大多数住院病例以及几乎所有死亡病例都发生在60岁以上的人群中。本研究的目的是调查伊朗卡尚市50岁及以上人群中破伤风保护性免疫的程度。这项横断面研究于2008年对180名年龄在50岁及以上、前往中央实验室进行健康检查的随机个体进行。通过酶联免疫吸附测定法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。描述了不同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。总体而言，共纳入180人。其中，72人（40%）从未接受过类毒素加强免疫，而47人（26.1%）至少接受过一次加强免疫。在所有参与者中，30人（16.7%）的破伤风抗毒素水平具有保护性（≥0.11 IU/mL），34人（18.9%）的抗毒素水平具有保护性且无需立即加强免疫（≥0.51 IU/mL）。在86名年龄>60岁的参与者中，6人（�%）的抗毒素水平具有保护性（≥0.1 - 1 IU/mL），5人（5.8%）的抗毒素水平具有保护性（≥1 IU/mL）。男性性别和既往接受类毒素加强免疫与破伤风保护性免疫相关。破伤风抗毒素水平随年龄下降。由于疫苗接种覆盖率不足，大多数50岁及以上的成年人似乎没有破伤风抗毒素的保护水平。有必要提高该年龄组的免疫水平。建议对老年人进行破伤风疫苗接种。
