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Diphtheria, pertussis, and tetanus serosurvey in Saudi children
Yagob Y Al-Mazrou1, Mohamed K Khalil, Sirag A Elgizouli
1Department of Curative Medicine, Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia. yalmazrou@hotmail.com
Insights
Saudi children aged one, six, and seventeen demonstrate robust immune protection against diphtheria and tetanus. Pertussis antibody levels indicate good, though slightly declining, protection with age.
Area of Science:
- Immunology
- Public Health
- Vaccinology
Background:
- The Expanded Program of Immunization (EPI) in Saudi Arabia aims to protect children from vaccine-preventable diseases.
- Evaluating immune status is crucial for assessing vaccine effectiveness and public health strategies.
Purpose of the Study:
- To assess the immune protection levels against diphtheria, tetanus, and pertussis in children within Saudi Arabia.
- To determine seroprevalence of antibodies targeted by the EPI.
Main Methods:
- A cross-sectional study conducted from September 2001 to February 2002.
- Multistage sampling collected sera from 12-month-olds, 6-year-olds, and 17-year-olds across five Saudi regions.
- Antibody titers for diphtheria, tetanus, pertussis (anti-PT), and anti-filament hemoagglutination (anti-FHA) were measured using seroneutralization and ELISA.
Main Results:
- Near-universal protection against diphtheria (93.7-100%) and tetanus (95.9-100%) was observed across all age groups.
- Geometric Mean Titers (GMTs) for anti-FHA were 22, 29, and 24 IU/ml for 1, 6, and 17-year-olds, respectively.
- GMTs for anti-PT were 36, 18, and 11 IU/ml for 1, 6, and 17-year-olds, indicating a decline in pertussis antibodies with age.
Conclusions:
- Children in Saudi Arabia aged one, six, and seventeen years exhibit strong serological protection against diphtheria and tetanus.
- While protection against pertussis is initially high, antibody levels decrease by age 17, suggesting potential waning immunity.
Objective:
To evaluate immune protection against vaccine-preventable diseases targeted by the Expanded Program of Immunization in Saudi Arabia.
Methods:
The study was carried out from September 2001 to February 2002. Using multistage sampling techniques, samples were collected from 5 regions of Saudi Arabia and sent for laboratory assay from the following age groups; 50 samples at 12 months, 50 at 6 years, and 100 at 17 years. Sera were assayed for diphtheria, tetanus, and pertussis. Sero neutralization was used for anti-diphtheria antibody assay, while enzyme linked immunoassay was used for anti-tetanus, anti-filament hemoagglutination (anti-FHA), and anti-pertussis titer (anti-PT) antibody assay.
Results:
This survey showed that 100% of children had protection levels (>/=0.01 IU/ml) against diphtheria at one year, 100% at 6 years, and 93.7% at 17 years. For tetanus, 95.9% had protection levels (>/=0.1 IU/ml) at one year, 100% at 6 years, and 98.9% at 17 years. The geometric mean titer (GMT) of anti-FHA is 22 at one year, 29 at 6 years, and 24 IU/ml at 17 years, while the GMT of anti-PT is 36 at one year, 18 at 6 years, and 11 IU/ml at 17 years.
Conclusion:
Children at one, 6, and 17 years are well protected against diphtheria, pertussis, and tetanus.
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