Seroprevalence of anti-diphtheria toxoid antibody and implications for vaccination policy in Vietnam's South-central coast: a cross-sectional study

BMC Infect Dis. 2024 Aug 12;24(1):813. doi: 10.1186/s12879-024-09688-0.

Abstract

Background: Diphtheria is a re-emerging infectious disease and public health concern worldwide and in Vietnam with increasing cases in recent years. This study aimed to assess the anti-diphtheria toxoid antibodies status in Khanh Hoa Province and identify factors contributing to the vaccination policy in the south-central coast of Vietnam.

Methods: This was a cross-sectional study to evaluate the seroprevalence of anti-diphtheria toxoid antibodies among 1,195 participants, aged 5 - 40 years in Khanh Hoa Province, Vietnam. Immunoglobulin G antibody levels against diphtheria were detected using a commercial anti-diphtheria toxoid enzyme-linked immunosorbent assay (SERION ELISA classic Diphtheria Immunoglobulin G) and were categorized following the World Health Organization guidelines.

Results: The mean anti-diphtheria toxoid antibody levels were 0.07 IU/ml (95% Confidence Interval: 0.07-0.08). Anti-diphtheria toxoid antibody levels were found to be associated with age and history of diphtheria vaccination. The 5-15 years age group had the highest levels (0.09 IU/ml), while the older age group had the lowest antibody level (p < 0.001). Individuals who received three doses (adjusted Odds ratio: 2.34, 95%CI: 1.35 - 4.07) or 4+ doses (adjusted Odds ratio: 2.45, 95%CI: 1.29 - 4.64) had a higher antibody level compared to those who received only one dose regardless of age.

Conclusion: It is crucial to promote routine vaccination coverage to over 95% for children under one year of age with three primary doses of the diphtheria-containing vaccine, including additional doses at 18 months and 7 years of age. Booster doses should be promoted and administered to adolescents and adults every 10 years.

Keywords: Anti-diptheria toxoid antibody; Seroprevalence; Vietnam.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Bacterial* / blood
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diphtheria Toxoid* / administration & dosage
  • Diphtheria Toxoid* / immunology
  • Diphtheria* / epidemiology
  • Diphtheria* / immunology
  • Diphtheria* / prevention & control
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Seroepidemiologic Studies
  • Vaccination* / statistics & numerical data
  • Vietnam / epidemiology
  • Young Adult

Substances

  • Antibodies, Bacterial
  • Diphtheria Toxoid
  • Immunoglobulin G