Tetanus in Southern Vietnam: Current Situation.
In Vietnam, there are no accurate data on tetanus incidence to allow assessment of disease burden or vaccination program efficacy. We analyzed age structure of 786 tetanus cases admitted to a tertiary referral center in Vietnam for three separate years during an 18-year period to examine the impact of tetanus prevention programs, namely the Expanded Program on Immunization (EPI) and the Maternal and Neonatal Tetanus (MNT) initiative. Most cases were born before the initiation of EPI. Median age increased from 33 (interquartile range: 20-52) in 1994, to 46 (32-63) in 2012 (P < 0.001). Birth-year distribution was unchanged, indicating the same birth cohorts presented with tetanus in 1994, 2003, and 2012. Enzyme-linked immunosorbent assay measurements in 90 men and 90 women covered by MNT but not EPI showed 73.3% (95% confidence interval [CI]: 62.9-82.1%) of women had anti-tetanus antibody compared with 24.4% (95% CI: 15.9-34.7%) of men, indicating continued tetanus vulnerability in older men in Vietnam.
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.|Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.|Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Duong Bich
DB
Thuy
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.|Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
James I
JI
Campbell
Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Tran Tan
TT
Thanh
Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Cao Thu
CT
Thuy
Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Huynh Thi
HT
Loan
Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Nguyen Van
NV
Hao
Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Yen Lam
YL
Minh
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.|Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Le Van
LV
Tan
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.|Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Maciej F
MF
Boni
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.|Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
C Louise
CL
Thwaites
D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011635:Public Health Administration; D013742:Tetanus / Q000453:epidemiology* / Q000517:prevention & control*; D013745:Tetanus Toxoid / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
D013745:Tetanus Toxoid