Antibodies to tetanus toxoid in women of childbearing age in Dar es Salaam and Bagamoyo, Tanzania

Abstract

SummaryOur aim was to determine tetanus immunity in women of childbearing age (15±44 years) with histories and/or documentation of having been vaccinated with Tetanus Toxoid (TT) under the Expanded Programme on Immunization in Dar es Salaam and Bagamoyo, Tanzania. Using an ELISA technique, serum levels of TT antibody, antibody avidity and distribution of TT IgG subclass antibodies were determined in 207 apparently healthy women. A TT antibody level of 0.1 IU/ml was considered protective. 99% and 100% of women in Dar es Salaam and Bagamoyo, respectively, had a TT antibody level ³0.1 IU/ml. Anti-toxin binding avidity was found to be high in most of the women. In addition to TT IgG3 subclass antibody, TT IgG1 subclass antibody was the most dominant subclass type. A substantial number of women also had TT IgG2 and TT IgG4 subclass antibody responses. A better recording system on TT immunization is recommended to avoid hyper-immunization of women and to optimize the cost-effectiveness of the immunization programme.

Non-protective immunity against tetanus in primiparous women and newborns at birth in rural and urban settings in Ibadan, Nigeria

“…Just as stated in the 2013 National Demographic Health Survey report [ 3 ], verbal report from mothers was used to estimate tetanus immunisation uptake among our study participants. The 71.3% overall prevalence of mothers' protective immunity against tetanus was close to 69% reported by Kurtzhals et al [ 14 ] among women of child-bearing age in Kenya but lower than approximately 100% protection reported in Tanzania [ 15 ], Portugual [ 16 ], and Vietnam [ 17 ]. A probable explanation could be that the introduction of the immunisation programme in these three countries was earlier than in Nigeria and Kenya [ 18 ].…”

“…A probable explanation could be that the introduction of the immunisation programme in these three countries was earlier than in Nigeria and Kenya [ 18 ]. This massive tetanus toxoid vaccination campaigns in Tanzania [ 15 ], Portugual [ 16 ], and Vietnam [ 17 ] might have influenced the observed high level of protective immunity against tetanus. The present study further demonstrated substantial disparity between the prevalence of protective immunity against tetanus among women in the local government areas designated as “urban LGAs” and “rural LGAs” in Ibadan, Nigeria.…”

Long-Term Immunogenicity upon Pertussis Booster Vaccination in Young Adults and Children in Relation to Priming Vaccinations in Infancy

“…However, Ttx antibody concentrations decrease much more slowly and IgG-Ttx concentration seems sufficient for a much longer period. Furthermore, tetanus hyper-immunisation could lead to hypersensitivity responses [ 48 , 49 ]. Our results seem to substantiate a tetanus booster approximately every 35 years for adult individuals who participated in the NIP, in line with Hammarlund et al who also found protective immunity against tetanus for more than 30 years [ 50 ].…”

Maternal immunisation to improve the health of HIV-exposed infants

“…However, in both studies, antibody levels among WLWH were above the protective level of 0⋅1 IU/mL. 36,37 In a study of 162 women published in 2016, eight of ten HIV-infected women remained seronegative (antibody titre <0⋅1 IU/mL) after tetanus vaccination during or before the index pregnancy. 38 HIV infection has also been linked to suboptimal transfer of antipertussis and antitetanus antibodies to infants.…”

“…Tetanus toxoid: possibly-in populations with routine maternal tetanus vaccination [36][37][38] No data available for Tdap.…”