Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia; National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia.
Commun Dis Intell (2018). 2023 Oct 19;47. doi: 10.33321/cdi.2023.47.61.
Background We examined trends in tetanus notification, hospitalisation and death data from 2003-2019 to assess the impact of adult tetanus booster recommendations in Australia. Methods Tetanus notifications and deaths from the National Notifiable Diseases Surveillance System; hospitalisations from the Australian Institute of Health and Welfare National Hospital Morbidity Database; and deaths from the Australian Coordinating Registry were analysed by age group, sex, Aboriginal and Torres Strait Islander status and state/territory. Annual rates were calculated using Australian Bureau of Statistics mid-year estimated resident populations from 2003-2019 as denominators. To assess the impact of a recommended booster dose of reduced antigen content diphtheria-tetanus-acellular pertussis (dTpa) vaccine for adults aged ≥ 65 years, notification, hospitalisation and death rates of tetanus per 100,000 population were compared pre (2003-2012) and post (2013-2019) the recommendation's introduction. Results There were 63 notifications of tetanus from 2003-2019 with an average annual incidence rate of 0.02/100,000. Similar to previous studies, the burden of tetanus in the Australian population continues to disproportionately affect the elderly, with those aged ≥ 65 years encompassing 63% (40/63) of notifications and 100% (11/11) of the deaths observed in this timeframe. Following the introduction of a recommendation for those aged ≥ 65 years to receive a dTpa booster, average annual notification and hospitalisation rates in those aged ≥ 65 years were significantly lower (notifications: 0.11/100,000 in 2003-2012 and 0.05/100,000 in 2013-2019, p = 0.01; hospitalisations: 0.24/100,000 in 2003-2012 and 0.10/100,000 in 2013-2019, p = 0.01]). The average annual death rate was similar in the two periods (0.002/100,000), although based on small numbers. Conclusions The findings of this analysis suggest a positive impact from the 2013 recommendation. However, the burden is still disproportionately higher in those aged ≥ 65 years and strategies to improve vaccination coverage in older Australians are recommended.
我们检查了 2003-2019 年破伤风报告、住院和死亡数据的趋势，以评估澳大利亚成人破伤风加强针推荐的影响。
通过年龄组、性别、原住民和托雷斯海峡岛民身份以及州/领地，对国家传染病监测系统的破伤风报告和死亡、澳大利亚卫生和福利研究所国家医院发病率数据库的住院情况、澳大利亚协调登记处的死亡情况进行分析。2003-2019 年，使用澳大利亚统计局年中估计的常住人口作为分母，计算每年的发病率。为了评估推荐给 65 岁及以上成年人接种抗原含量降低的白喉-破伤风-无细胞百日咳（dTpa）疫苗加强针的影响，我们比较了推荐意见出台前后（2003-2012 年和 2013-2019 年）破伤风每 10 万人中的报告、住院和死亡人数。
2003-2019 年共有 63 例破伤风报告，年平均发病率为 0.02/10 万。与以往研究相似，澳大利亚人口中破伤风的负担继续不成比例地影响老年人，63%（40/63）的报告和该时间段内观察到的 100%（11/11）死亡发生在 65 岁及以上人群中。在建议 65 岁及以上人群接种 dTpa 加强针后，65 岁及以上人群的年平均报告和住院率显著降低（报告：2003-2012 年为 0.11/10 万，2013-2019 年为 0.05/10 万，p=0.01；住院：2003-2012 年为 0.24/10 万，2013-2019 年为 0.10/10 万，p=0.01）。两个时期的年平均死亡率相似（0.002/10 万），但基于小样本。
本分析结果表明，2013 年的建议产生了积极影响。然而，65 岁及以上人群的负担仍然不成比例地更高，建议采取措施提高澳大利亚老年人的疫苗接种率。
