title: Tetanus Immunity Gaps in Children 5-14 Years and Men ≥ 15 Years of Age Revealed by Integrated Disease Serosurveillance in Kenya, Tanzania, and Mozambique.
abstract: Recent tetanus cases associated with male circumcision in Eastern and Southern Africa (ESA) prompted an examination of tetanus immunity by age and sex using multiplex serologic data from community surveys in three ESA countries during 2012-2013. Tetanus seroprotection was lower among children 5-14 years versus 1-4 years of age in Kenya (66% versus 90%) and Tanzania (66% versus 89%), but not in Mozambique (91% versus 88%), where children receive two booster doses in school. Among males ≥ 15 years of age, tetanus seroprotection was lower than females in Kenya (45% versus 96%), Tanzania (28% versus 94%), and Mozambique (64% versus 90%). Tetanus immunity from infant vaccination doses wanes over time, and only women of reproductive age routinely receive booster doses. To prevent immunity gaps in older children, adolescents, and adult men, a life-course vaccination strategy is needed to provide the three recommended tetanus booster doses.
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia. hscobie@cdc.gov.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Scobie
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Minal
authors.initials: M
authors.lastname: Patel
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Diana
authors.initials: D
authors.lastname: Martin
authors.affiliation: Kongwa Trachoma Project, Kongwa, Tanzania.
authors.forename: Harran
authors.initials: H
authors.lastname: Mkocha
authors.affiliation: Eastern and Southern Africa Centre of International of Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Sammy M
authors.initials: SM
authors.lastname: Njenga
authors.affiliation: Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Maurice R
authors.initials: MR
authors.lastname: Odiere
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Pelletreau
authors.affiliation: Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Priest
authors.affiliation: Instituto Nacional de Saúde, Maputo, Mozambique.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Thompson
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kimberly Y
authors.initials: KY
authors.lastname: Won
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Lammie
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007630:Kenya; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D012698:Serologic Tests; D012737:Sex Factors; D013636:Tanzania; D013742:Tetanus / Q000276:immunology*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial