title: Determination of Tetanus Antibody Levels in Trauma Patients Referred To Shahid Beheshti Hospital in Kashan, Iran, 2014.
abstract: BACKGROUND
  There is a noticeable difference in serologic immune status against tetanus among different age and social groups in various countries due to different national vaccination policies and methods.
  
  
  OBJECTIVE
  Considering that the immunization status of trauma patients against tetanus is not-known or uncertain and they may need to receive the vaccine and tetabulin, this study was conducted to determine the tetanus antibody levels in patients referred to the trauma emergency ward of Shahid Beheshti Hospital in Kashan City, Iran.
  
  
  METHODS
  This cross-sectional study was performed on 204 trauma patients referred to the trauma emergency ward of Shahid Beheshti hospital in Kashan City, Iran, in 2014. After obtaining a written informed consent from the patients, a questionnaire consisted of demographic information and tetanus vaccination record was completed by the patients. Afterwards, a 4 - 5 mL venous blood sample was taken from each patient and the tetanus antibody level (IgG) was measured using the enzyme-linked immunosorbent assay method. The tetanus antibody levels equal or more than 0.1 IU/mL were considered protective. Data were analyzed using chi-square test, independent t-test and one-way ANOVA with SPSS software version 16.
  
  
  RESULTS
  From a total of 204 patients, 35 cases (16.7%) were females and 169 (83.2%) were males with the mean age of 40.9 ± 3.7 years. There was no statistically significant difference in the tetanus antibody levels between both sexes (P = 0.09). Moreover, there was no significant difference in immunization status between the patients who had a history of tetanus vaccination and those who had not received the vaccine before (P = 0.67). The antibody levels were significantly reduced with the passage of time since the last vaccination (P < 0.001). Also, 87.3% of the patients had the high protective level of immunity to tetanus.
  
  
  CONCLUSIONS
  The findings of the present study show a high level of tetanus antibody among trauma patients in this hospital; so, taking the tetanus vaccine history can be misleading. It is suggested that further studies be performed in different regions of our country and with larger sample sizes and detection of the immunization status of patients by measuring anti-tetanus antibody levels among trauma patients is recommended to make suitable policy for a national vaccine protocol in the future.
authors.affiliation: Department of Infectious Diseases, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Afzali
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Sharif
authors.affiliation: Student Research Committee, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Shamsaddin
authors.initials: S
authors.lastname: Mousavi
keywords: Tetabulin; Tetanus; Trauma; Vaccination