Determination of diphtheria risk indicators based on the study of antidiphtheria immunity in the population of Dnipropetrovsk region
Keywords:population immunity, diphtheria, vaccination, antibodies
Background. Vaccination is the most effective part of primary prevention. Serological monitoring of infectious diseases covered by national immunization programs is very important as it provides up-to-date information on the burden of the infection and the immunological status of the population. The study was aimed to present an analysis of epidemiological monitoring of the protection against diphtheria of the population, to show the generalized epidemiological situation regarding diphtheria, and to determine the risk of diphtheria among the population of Dnipropetrovsk region. Materials and methods. Epidemiological analysis of diphtheria immunity (2017–2019) was performed based on the results of enzyme-linked immunosorbent assay of IgG antibodies levels against diphtheria toxin in 271 residents of Dnipropetrovsk region. Results. Analysis of the results revealed that only 30.6 % (n = 83) of the population have levels of antitoxic antibodies of 1.0 IU/ml or more, which provides sufficient protection against diphtheria in the next 5–7 years of life. At that time, the majority of the population (69.4 %) needs immediate one-time booster vaccination (n = 134; 49.5 %) or immediate basic vaccination (n = 54; 19.9 %) due to low levels of antitoxic diphtheria antibodies. In the age group 8–15 years, 65.9 % (n = 62) of patients require immediate basic or booster vaccination, which indicates that children of this age do not have basic immunological protection due to violations of the vaccination schedule or its absence. In the group aged 27 years and older, 79.1 % (n = 72) of the subjects do not have protective levels of anti-diphtheria antibodies, which indicates a lack of actual protection against diphtheria. Conclusions. The results indicate insufficient protection of the population against diphtheria. In this regard, the development of strategic measures for mass immunoprophylaxis of diphtheria both in children and adults is relevant. The country should conduct regular epidemiological monitoring, which would study the population’s immunity against diphtheria and other controlled infections, and draw up a long-term strategic and tactical plan to address shortcomings in the work of mass immunoprophylaxis of the population.
Global Health Risks: mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization (WHO), 2009. 62 p. https://apps.who.int/iris/handle/10665/44203
Ревенко Г.О., Будаєва І.В., Маврутенков В.В. Серологічний моніторинг популяційного антитоксичного протидифтерійного імунітету в мешканців Дніпропетровської області. Клінічна та профілактична медицина. 2019. 4(9–10). 128-133. https://doi.org/10.31612/2616-4868.4(10).2019.07
Kutty J.M., RajanBabu B., Thiruvoth S. Immune status against diphtheria in healthy adults. J. Family Med. Prim. Care. 2019. 8(10). 3253-3257. doi: 10.4103/jfmpc.jfmpc_589_19.
Weinberger B. Vaccination of Adults and the Older Population against Tetanus, Diphtheria, Pertussis, and Tick-Borne Encephalitis: The Importance of Booster Vaccinations throughout Life. Interdiscip. Top. Gerontol. Geriatr. 2020. 43. 146-157. doi: 10.1159/000504489.
Frasca D. Senescent B cells in aging and age-related diseases: their role in the regulation of antibody responses. Exp. Gerontol. 2018. 107. 55-58. doi: 10.1016/j.exger.2017.07.002.
Grasse M., Meryk A., Schirmer M., Grubeck-Loebenstein B., Weinberger B. Booster vaccination against tetanus and diphtheria: insufficient protection against diphtheria in young and elderly adults. Immun. Ageing. 2016. 13(1). 26. doi: 10.1186/s12979-016-0081-0.
Revenko H.О., Мavrutenkov V.V., Chykarenko Z.О. Clinical and laboratory predictors of antitoxic immunity against diphtheria and tetanus in adults with HIV infection. Medicni perspektivi. 2020. 25(3). 117-124. https://doi.org/10.26641/2307-0404.2020.3.214846
Hammarlund E., Thomas A., Poore E.A., Amanna I.A., Rynko A.E., Mori M., Chen Z., Slifka M.K. Durability of Vaccine-Induced Immunity Against Tetanus and Diphtheria Toxins: A Cross-sectional Analysis. Clin. Infect. Dis. 2016. 62(9). 1111-1118. doi: 10.1093/cid/ciw066.
Liang J.L., Tiwari T., Moro P., Messonnier N.E., Reingold A., Sawyer M., Clark T.A. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm. Rep. 2018. 67(2). 1-44. doi: 10.15585/mmwr.rr6702a1.
Swart E.M., van Gageldonk P.G.M., de Melker H.E., van der Klis F.R., Berbers G.A.M., Mollema L. Long-term protection against diphtheria in the Netherlands after 50 years of vaccination: results from a seroepidemiological study. PLoS One. 2016. 11(2). e0148605. doi: 10.1371/journal.pone.0148605.
Yao N., Zeng Q., Wang Q. Seroepidemiology of diphtheria and pertussis in Chongqing, China: serology-based evidence of Bordetella pertussis infection. Public Health. 2018. 156. 60-66. doi: 10.1016/j.puhe.2017.12.00.
Маврутенков В.В., Ревенко Г.О. Вакцинопрофілактика: досягнення, проблеми і перспективи розвитку. Медичні перспективи. 2016. 21(3). 56-61. DOI: 10.26641/2307-0404.2016.3.82025.
Public Health Center of the Ministry of Health of Ukraine [Internet]. Available online: https://phc.org.ua/kontrol-zakhvoryuvan/inshi-infekciyni-zakhvoryuvannya/monitoring-i-ocinka/infekciyna-zakhvoryuvanist-naselennya-ukraini
Bonanni P., Bonaccorsi G., Lorini C., Santomauro F., Tiscione E., Boccalini S., Bechini A. Focusing on the implementation of 21st century vaccines for adults. Vaccine. 2018. 36(36). 5358-5365. doi: 10.1016/j.vaccine.2017.07.100.
Gower C.M., Scobie A., Fry N.K., Litt D.J., Cameron J.C., Chand M.A., Brown C.S., Collins S., White J.M., Ramsay M.E., Amirthalingam G. The changing epidemiology of diphtheria in the United Kingdom, 2009 to 2017. Eurosurveillance. 25(11). 1900462. doi: 10.2807/1560-7917.ES.2020.25.11.1900462.
Berbers G., van Gageldonk P., van de Kassteele J., Wiedermann U., Desombere I., Dalby T., Toubiana J., Tsiodras S., Ferencz I.P., Mullan K., Griskevicius A., Kolupajeva T., Vestrheim D.F., Palminha P., Popovici O., Wehlin L., Kastrin T., Maďarová L., Campbell H., Ködmön C., Bacci S., Barkoff A.M., He Q. Circulation of pertussis and poor protictio against diphtheria among middle-aged adults in 18 European countries. 2021. 12. 2871. doi: 10.21203/rs.3.rs-35858/v1.
Jablonka A., Behrens G.M., Stange M., Dopfer C., Grote U., Hansen G., Schmidt R.E., Happle C. Tetanus and diphtheria immunity in refugees in Europe in 2015. Infection. 2017. 45(2). 157-164. doi: 10.1007/s15010-016-0934-7.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.