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. 2017 Jan 11;96(1):93-96.
doi: 10.4269/ajtmh.16-0470. Epub 2016 Nov 7.

Tetanus in Southern Vietnam: Current Situation

Duong Bich Thuy  1   2   3 , James I Campbell  1   2 , Tran Tan Thanh  2 , Cao Thu Thuy  2 , Huynh Thi Loan  3 , Nguyen Van Hao  3 , Yen Lam Minh  2 , Le Van Tan  1   2 , Maciej F Boni  1   2 , C Louise Thwaites  1   2
Affiliations

Tetanus in Southern Vietnam: Current Situation

Duong Bich Thuy et al. Am J Trop Med Hyg. .

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 (P < 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.

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Figures

Figure 1.
Figure 1.
Birth year of tetanus admissions (≥ 1 year of age) admitted to the Hospital for Tropical Diseases by year. Effect of admission year on birth year was tested with a one-way analysis of variance (ANOVA) and a Kruskal–Wallis (KW) test. The birth cohorts that represent tetanus admissions do not appear to be changing over an 18-year period.
Figure 2.
Figure 2.
Anti-tetanus antibody protection in 90 males and 90 females from a bank of general-population serum samples for Ho Chi Minh City. Individuals are grouped into 4-year age bands. Confidence intervals are plotted with the exact binomial method.
See this image and copyright information in PMC

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