Conclusion: Although tetanus is a preventive disease by the antibodies developed as a result

Transcription

1 Background: In Korea, vaccination against tetanus began in the mid-1950s. At present, there is a routine immunization schedule with diphtheria, pertussis, and tetanus (DPT) vaccines at 2,4,6 month after birth and booster at month and 4-6 years. However, further prophylactic programs according to guidelines of Center for Disease Control do not exist due to the absence of tetanus toxoid. And we have usually used only passive immunization, tetanus immunoglobulin, as a prophylactic regimen for injured patients. In this study, we aimed to determine the tetanus antibody titers levels of Koreans and point out problems of prophylactic programs after a routine immunization schedule. M e t h o d s: This study was conducted with 112 healthy adults from August 29, 2003 to September 19, No volunteers had unstable vital signs, or had taken any medication for chronic illnesses. A questionnaire was used for the volunteers to assess their knowledge about tetanus vaccination schedule, and the whole blood was withdrawn from each volunteer to determine qualitative anti-tetanus antibody titers using TQS (Tetanus Quick Stick). TQS had been introduced as a rapid, easy method to determine the immune status. Results: Of the 112 studied subjects, only 13 (11.6%) were found to have protective levels of anti-tetanus antibody titers. There was no association between quantitative antibody titers and age, sex, educational status, economy, place of birth or residence, military service, and vaccination. Conclusion: Although tetanus is a preventive disease by the antibodies developed as a result

2 of vaccination and its occurrence is not very common, it is associated with a rather high mortality rate. Recently, there has beena tetanus immunization shortage in Korea caused by an absence of tetanus toxoid. The effect of a tetanus shortage makes the tetanus antibody values go under the protective level for most adults. We recommend that tetanus prophylaxis in Korea should be performed following the guidelines of Center for Disease Control and Prevention. Key Words: Tetanus toxoid, Anti-tetanus antibody titers, Tetanus prophylaxis

3 Fig. 1. Tetanus Quick Stick (A) Before the test. Dispense 1 drop of sample and 3 drops of diluant in sample well. Read results after 20 minutes. (B) After the test. If one colored band appears in control(c) window, it is read as a NEGATIVE. If two colored bands appear in test(t) and control (C) windows, it is read as a POSI- TIVE.

4 Table 1. Antitoxin levels of the study group according to various factors Total number Having protective level of antitoxin Number % p value Age > Sex.105 Male Female Economy status.160 High Low Birth place.364 City Village Residental place.312 City Village Educational status.537 High school and below College and above Military service.214 No Yes History of recent trauma.592 None More than two months ago Within the last two months Number of vaccination.785 Unknown Vaccinated twice or less Vaccinated three time or more Last vaccination.287 Unknown Within the last 10 years More than 10 years ago

5 Table 2. General survey about tetanus vaccination program.. 1. ( : 2,4,6, 15~18, 4~6 ) Table 3. Antitoxin levels of the study group according to general survey number antitoxin positive p value Number % Question Incorrect Correct Question Incorrect Correct Question Yes No

6 Table 4. Descriptive character about antitoxin posivite group who has a preventable levels. No Age Sex Military History Number of recent of service trauma vaccination Last Economy Birth Residental Educational Remarkable vaccination status place place status note 1 42 M Yes none unknown unknown High City City C 2 28 M Yes 2 Mo < 3 times 10 Yr High City City C Booster F No 2 Mo < 3 times 10 Yr Low City City C Bite M Yes none unknown unknown Low City City C 5 40 M Yes 2 Mo unknown unknown High City City C 6 45 M Yes none unknown unknown High City City HS 7 17 M No none unknown unknown Low City City HS 8 30 M Yes none unknown unknown High City City C 9 34 M Yes none unknown unknown High City City C M Yes none unknown unknown Low Village City C M Yes none unknown unknown Low City City HS M Yes none unknown unknown High Village City C M Yes none unknown unknown High Village Village C Mo; month, Yr; year, C; college, HS; high school 1 ; He had tetanus toxoid booster because of laceration during military service. 2 ; She had been bitten by a dog, and got tetanus prophylaxis threatment.

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