1921
Volume 96, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

In Vietnam, there are no accurate data on tetanus incidence to allow assessment of disease burden or vaccination program efficacy. We analyzed age structure of 786 tetanus cases admitted to a tertiary referral center in Vietnam for three separate years during an 18-year period to examine the impact of tetanus prevention programs, namely the Expanded Program on Immunization (EPI) and the Maternal and Neonatal Tetanus (MNT) initiative. Most cases were born before the initiation of EPI. Median age increased from 33 (interquartile range: 20–52) in 1994, to 46 (32–63) in 2012 ( < 0.001). Birth-year distribution was unchanged, indicating the same birth cohorts presented with tetanus in 1994, 2003, and 2012. Enzyme-linked immunosorbent assay measurements in 90 men and 90 women covered by MNT but not EPI showed 73.3% (95% confidence interval [CI]: 62.9–82.1%) of women had anti-tetanus antibody compared with 24.4% (95% CI: 15.9–34.7%) of men, indicating continued tetanus vulnerability in older men in Vietnam.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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2017-01-11
2017-11-22
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References

  1. Khan R, Vandelaer J, Yakubu A, Raza AA, Zulu F, , 2015. Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all. Int J Womens Health 7: 171180.
  2. Expanded Program on Immunizations, 2009. National EPI Review Report Vietnam. Available at: http://www.unicef.org/vietnam/EPI_NATIONAL_Review_Report_Vietnam_2009_Final.pdf. Accessed November 1, 2016.
  3. Borrow R, Balmer P, Roper M, , 2006. The Immunological Basis for Immunization Series. Module 3: Tetanus Update 2006. Geneva, Switzerland: Department of Immunization, Vaccines and Biologicals, World Health Organization.
  4. Aboud S, Matre R, Lyamuya EF, Kristoffersen EK, , 2000. Levels and avidity of antibodies to tetanus toxoid in children aged 1–15 years in Dar es Salaam and Bagamoyo, Tanzania. Ann Trop Paediatr 20: 313322.[Crossref]
  5. UNFPA, UNICEF, WHO, 2000. Maternal and Neonatal Tetanus Elimination by 2005. Available at: http://www.unicef.org/health/files/MNTE_strategy_paper.pdf. Accessed November 1, 2016.
  6. Stanfield J, Galazka A, , 1984. Neonatal tetanus in the world today. Bull World Health Organ 62: 647669.
  7. Lam PK, Trieu HT, Lubis IND, Loan HTT, Tran TD, Wills B, Parry CM, Day NPJ, Qui PT, Yen LM, Thwaites CL, , 2014. Prognosis of neonatal tetanus in the modern management era: an observational study in 107 Vietnamese infants. Int J Infect Dis 33C: 711.
  8. Trieu HT, Lubis IN, Qui PT, Yen LM, Wills B, Thwaites CL, Sabanathan S, , 2015. Neonatal tetanus in Vietnam: comprehensive intensive care support improves mortality rates. J Pediatric Infect Dis Soc 5: 227230.[Crossref]
  9. WHO. Progress Towards Global MNT Elimination. Available at: http://www.who.int/immunization_monitoring/diseases/MNTE_initiative/en/index4.html. Accessed June 1, 2016.
  10. Jit M, Huyen DTT, Friberg I, Hoang VM, Kiet PHT, Walker N, Van Cuong N, Duong TN, Toda K, Hutubessy R, Fox K, , 2015. Thirty years of vaccination in Vietnam: impact and cost-effectiveness of the national expanded programme on immunization. Vaccine 33: A233A239.[Crossref]
  11. Thwaites CL, Yen LM, Nga NTN, Parry J, Binh NT, Loan HT, Thuy TT, Bethell D, Parry CM, White NJ, Day NP, Farrar JJ, , 2004. Impact of improved vaccination programme and intensive care facilities on incidence and outcome of tetanus in southern Vietnam, 1993–2002. Trans R Soc Trop Med Hyg 98: 671677.[Crossref]
  12. Boni MF, Chau NNV, Dong N, Todd S, Nhat NTD, De Bruin E, Van Beek J, Hien NT, Simmons CP, Farrar J, Koopmans M, , 2013. Population-level antibody estimates to novel influenza A/H7N9. J Infect Dis 208: 554558.[Crossref]
  13. World Health Organization (WHO). WHO-UNICEF Estimates of DTP3 Coverage. Available at: http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragedtp3.html. Accessed June 1, 2016.
  14. Ibinda F, Bauni E, Kariuki SM, Fegan G, Lewa J, Mwikamba M, Boga M, Odhiambo R, Mwagandi K, Seale AC, Berkley JA, Dorfman JR, Newton CR, , 2015. Incidence and risk factors for neonatal tetanus in admissions to Kilifi County Hospital, Kenya. Plos One 10: e0122606.[Crossref]
  15. Thwaites CL, Loan HT, , 2015. Eradication of tetanus. Br Med Bull 116: 6977.
  16. WHO, 2013. World Health Statistics. Available at: http://www.who.int/gho/publications/world_health_statistics/2013/en/. Accessed November 1, 2016.
  17. Vandelaer J, Partridge J, Suvedi BK, , 2009. Process of neonatal tetanus elimination in Nepal. J Public Health (Oxf) 31: 561565.[Crossref]
  18. Thwaites CL, Beeching NJ, Newton CR, , 2014. Maternal and neonatal tetanus. Lancet 385: 362370.[Crossref]
  19. General Statistics Office Vietnam, 2016. 02. Population and Employment. Available at: https://www.gso.gov.vn/default_en.aspx?tabid=774. Accessed June 1, 2016.
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  • Received : 13 Jun 2016
  • Accepted : 09 Sep 2016

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