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SEROLOGICAL MONITORING OF LEVELS OF ANTIBODIES TO PATHOGENS OF TETANUS, DIPHTHERIA AND PERTUSSIS IN SCHOOLCHILDREN AGED OF 11-17 YEARS IN SEVEN REGIONS OF THE RUSSIAN FEDERATION


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Abstract

Background. Diphtheria, tetanus, and pertussis vaccination is the most effective method of infection prevention. It is recommended to monitor vaccination coverage and perform serological monitoring in decreed population groups to immunization quality assessment. Aim. To manage serological monitoring of the level antibodies to diphtheria, tetanus, and pertussis among school children of 11-17 years in seven regions of the Russian Federation and to assess diphtheria, tetanus, and pertussis vaccination coverage in two regions. Materials and methods. Antibodies against diphtheria toxin (DTx), tetanus toxoid (TTx) and pertussis toxin (PTx) were explored by enzyme-linked assay in 1774 sera from school children aged of 11-12 years (n = 944) and 15-17 years (n = 830) in seven regions of the Russian Federation. Diphtheria, tetanus, and pertussis vaccination status was assessed in 418 students group from Smolensk and Yakutsk on the basis of the retrospective analysis of individual medical records (certificate of preventive vaccinations). Results and discussion. A protective level of anti- DTx and anti- TTx was found in more than 95% of children in all regions. The level of seroprotection was significantly different depending on the region (χ2 = 16.1; p = 0.013 and χ2= 12.7; p = 0.049, respectively). In Rostov-on-Don, the proportion of anti- DTx-negative individuals was significantly higher compared to other regions, although it was <5%. In Yakutsk, a similar situation was observed for anti-TTx antibodies. The level of anti-pertussis seroprotection in the whole sample accounted for 63.1%. The frequency of detection of anti-PTx was also significantly differed depending on the region (χ2= 19.9; p = 0.003). The proportion of anti- PTx-positive samples was higher in Rostov-on-Don (72.8%; z = 3.3; p = 0.001), but lower in Yakutsk (56.8%; z = -2.2; p = 0.027) compared to other regions. 56.2% of children aged 11-12 years and 71.1% of children 15-17 years old had a protective level of anti- PTx, which indicates the formation of post-infectious immunity in the population due to pertussis. The basic triple vaccination of DTP and one-time revaccination with this vaccine, as well as the second revaccination against diphtheria and tetanus, with ADS-M vaccine at the age of 7, received 97.6% and 95.7% of persons, respectively. The third revaccination of ADS-M at the age of 14 years was performed by 87.2% of individuals in the age group of 15-17 years. A decrease in the share of ADS-M vaccinated cases was observed mainly in Yakutsk (75% compared to 94.2% in Smolensk, p <0.001), which may lead to the emergence of a non-immune layer of adults in the near future. Serological monitoring and vaccination analysis coverage should be carried out in a wide range of regions to obtain reliable information on immunization at the national level.


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