title: High tetanus antitoxin antibody concentrations in the Netherlands: a seroepidemiological study.
abstract: We assessed the level and determinants of tetanus-antitoxin (TT)-antibodies in the Dutch population. Additionally, we evaluated the national guidelines for post-exposure prophylaxis. Serum samples and questionnaire data from a cross-sectional, population-based study were obtained from 7903 individuals. Serum antitoxin antibodies were assessed with a multiplex immunoassay. Multivariable linear regression was used to explore factors associated with antibody concentration. The overall seroprevalence was 94% with a geometric mean concentration (GMC) of 0.91 IU/ml. The TT-GMC increased with age in the age-cohorts of 13-23 years, which coincides with the meningococcal C conjugate mass-vaccination in 2002. Lower seroprevalences were found in individuals born before introduction of routine vaccination, first-generation migrants from non-Western countries born before 1984, and conservative Protestants living in the Dutch 'Bible belt'. Only 10% of those eligible for post-exposure prophylaxis were not sufficiently protected against tetanus.
authors.affiliation: Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and Environment, Bilthoven, The Netherlands. anneke.steens@rivm.nl
authors.forename: Anneke
authors.initials: A
authors.lastname: Steens
authors.forename: L
authors.initials: L
authors.lastname: Mollema
authors.forename: G A M
authors.initials: GA
authors.lastname: Berbers
authors.forename: P G M
authors.initials: PG
authors.lastname: van Gageldonk
authors.forename: F R
authors.initials: FR
authors.lastname: van der Klis
authors.forename: H E
authors.initials: HE
authors.lastname: de Melker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D007117:Immunization, Secondary; D007223:Infant; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D013742:Tetanus / Q000097:blood* / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D013743:Tetanus Antitoxin / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D013743:Tetanus Antitoxin; D013745:Tetanus Toxoid