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- Title
Seroprevalence of diphtheria toxoid IgG antibodies in the Malaysian population.
- Authors
Yusoff, Ahmad Faudzi; Mohd Sharani, Zatil Zahidah; Kee, Chee Cheong; Md Iderus, Nuur Hafizah; Md Zamri, Ahmed Syahmi Syafiq; Nagalingam, Tharmarajah; Mohamad Bashaabidin, Mohd Safrin; Wan Ibadullah, Wan Abdul Hannan; Ghazali, Sumarni Mohd; Yusof, Ainur Yusniza; Ching, Yee Ming; Mohamed Nor, Nurhanani; Kamarudin, Balqis; Ahmad, Norazah; Arip, Masita
- Abstract
<bold>Background: </bold>Despite high childhood immunization coverage, sporadic cases of diphtheria have been reported in Malaysia in recent years. This study aims to evaluate the seroprevalence of diphtheria among the Malaysian population.<bold>Methods: </bold>A total of 3317 respondents age 2 years old to 60 years old were recruited in this study from August to November 2017. Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IgG antibody against the toxoid of C. diphtheriae in the blood samples of respondents. We classified respondent antibody levels based on WHO definition, as protective (≥0.1 IU/mL) and susceptible (< 0.1 IU/mL) to C. diphtheriae infection.<bold>Results: </bold>Among the 3317 respondents, 57% were susceptible (38.1% of children and 65.4% of adults) and 43% (61.9% of children and 34.6% of adults) had protective antibody levels against diphtheria. The mean antibody level peaked among individuals aged 1-2 years old (0.59 IU/mL) and 6-7 years old (0.64 IU/mL) but generally decreased with age, falling below 0.1 IU/mL at around 4-6 years old and after age 20 years old. There was a significant association between age [Children: χ2 = 43.22(df = 2),p < 0.001)], gender [Adults: χ2 = 5.58(df = 1),p = 0.018] and ethnicity [Adults: χ2 = 21.49(df = 5),p = 0.001] with diphtheria toxoid IgG antibody level.<bold>Conclusions: </bold>About 57% of the Malaysian population have inadequate immunity against diphtheria infection. This is apparently due to waning immunity following childhood vaccination without repeated booster vaccination in adults. Children at age 5-6 years old are particularly vulnerable to diphtheria infection. The booster vaccination dose normally given at 7 years should be given earlier, and an additional booster dose is recommended for high-risk adults.
- Subjects
MALAYSIA; IMMUNOGLOBULIN G; DIPHTHERIA; IMMUNOGLOBULINS; ENZYME-linked immunosorbent assay; SEROPREVALENCE; ARTHRITIS Impact Measurement Scales; BACTERIAL antibodies; DIPHTHERIA vaccines; GRAM-positive bacteria; EPIDEMIOLOGICAL research
- Publication
BMC Infectious Diseases, 2021, Vol 21, Issue 1, p1
- ISSN
1471-2334
- Publication type
journal article
- DOI
10.1186/s12879-021-06285-3