Immunity against diphtheria among children aged 5–17 years in India, 2017–18: a cross-sectional, population-based serosurvey
| Autor: | Muthusamy Santhosh Kumar, C Govindhasamy, T Karunakaran, Pavan Kumar, R. Sabarinathan, Uday Mohan, A Jeyakumar, Sailaja Bitragunta, P. K. Sahoo, Chander Prakash Yadav, T Daniel Rajasekar, A. Suresh, Suman Sundar Mohanty, Dominic Augustine, Nivedita Gupta, G S Toteja, P Kamaraj, Vivek Sagar, C. P. Girish Kumar, Bhagirathi Dwibedi, Subarna Roy, Pradip V Barde, Deepali Savargaonkar, Provash Chandra Sadhukhan, P V M Lakshmi, Shanta Dutta, Sanjay Mehendale, Chandra Mauli Mishra, J.W. Banerjee John, Annamma Jose, R. Sivakumar, Gagandeep Singh Grover, Shivendra Kumar Singh, Rajesh Kumar, Manoj V Murhekar, Babasaheb V. Tandale, Ramesh Reddy Allam, Suman Kanungo, Siraj Ahmed Khan, Roshan Kamal Topno |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Rural Population Diphtheria vaccine Adolescent Urban Population Diphtheria Toxoid 030231 tropical medicine Population India Dengue fever 03 medical and health sciences 0302 clinical medicine Seroepidemiologic Studies Immunity medicine Humans Seroprevalence 030212 general & internal medicine Child education Diphtheria toxin education.field_of_study business.industry Diphtheria Vaccination medicine.disease Antibodies Bacterial Cross-Sectional Studies Infectious Diseases Child Preschool Population Surveillance Female Rural area business medicine.drug Demography |
| Zdroj: | The Lancet Infectious Diseases. 21:868-875 |
| ISSN: | 1473-3099 |
| DOI: | 10.1016/s1473-3099(20)30595-8 |
| Popis: | Summary Background Diphtheria is re-emerging as a public health problem in several Indian states. Most diphtheria cases are among children older than 5 years. In this study, we aimed to estimate age-specific immunity against diphtheria in children aged 5–17 years in India. Methods We used residual serum samples from a cross-sectional, population-based serosurvey for dengue infection done between June 19, 2017, and April 12, 2018, to estimate the age-group-specific seroprevalence of antibodies to diphtheria in children aged 5–17 years in India. 8309 serum samples collected from 240 clusters (122 urban and 118 rural) in 60 selected districts of 15 Indian states spread across all five geographical regions (north, northeast, east, west, and south) of India were tested for the presence of IgG antibodies against diphtheria toxoid using an ELISA. We considered children with antibody concentrations of 0·1 IU/mL or greater as immune, those with levels less than 0·01 IU/mL as non-immune (and hence susceptible to diphtheria), and those with levels in the range of 0·01 to less than 0·1 IU/mL as partially immune. We calculated the weighted proportion of children who were immune, partially immune, and non-immune, with 95% CIs, for each geographical region by age group, sex, and area of residence (urban vs rural). Findings 29·7% (95% CI 26·3–33·4) of 8309 children aged 5–17 years were immune to diphtheria, 10·5% (8·6–12·8) were non-immune, and 59·8% (56·3–63·1) were partially immune. The proportion of children aged 5–17 years who were non-immune to diphtheria ranged from 6·0% (4·2–8·3) in the south to 16·8% (11·2–24·4) in the northeast. Overall, 9·9% (7·7–12·5) of children residing in rural areas and 13·1% (10·2–16·6) residing in urban areas were non-immune to diphtheria. A higher proportion of girls than boys were non-immune to diphtheria in the northern (17·7% [12·6–24·2] vs 7·1% [4·1–11·9]; p=0·0007) and northeastern regions (20·0% [12·9–29·8] vs 12·9% [8·6–19·0]; p=0·0035). Interpretation The findings of our serosurvey indicate that a substantial proportion of children aged 5–17 years were non-immune or partially immune to diphtheria. Transmission of diphtheria is likely to continue in India until the immunity gap is bridged through adequate coverage of primary and booster doses of diphtheria vaccine. Funding Indian Council of Medical Research. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|