Susceptibility to tetanus and diphtheria in recently arrived adult immigrants and refugees to Montreal, Quebec

Background: Adult immigrants may have been under-immunized in their countries of origin.We estimated the seroprevalence and examined risk factors for susceptibility to diphtheria and tetanus.Methods: 1480 newly-arrived adult immigrants were recruited in Montreal, 2002-2004.We collected socio-demographic information and vaccination history, and measured serum antibodies to tetanus and diphtheria by EIA to identify susceptibility, defined as ≤0.15 IU/ml and ≤0.10 IU/ml, respectively.Results: 45% (95% CI, 42%-48%) of immigrants, mean age 318.6 years, lacked immunity to either tetanus or diphtheria, ranging by region of origin (23%-79%).32% (95% CI, 30%-34%) were susceptible to tetanus and susceptibility increased with age.Susceptibility to diphtheria was less prevalent [26% (95% CI, 24%-28%)] and decreased with age.Conclusions: Many adult immigrants would benefit from diphtheria/tetanus vaccine.Susceptibility to tetanus suggests under-vaccination, while decreasing susceptibility to diphtheria with age suggests that immunity has been boosted from ongoing transmission in some countries of origin. ABRÉGÉIntroduction: Les immigrants adultes sont peut-être sous-immunisés dans leurs pays d'origine.Nous avons effectué une étude de la prévalence de la susceptibilité au tétanos et à la diphtérie et nous avons examiné les indicateurs potentiels de cette susceptibilité.Méthodes: 1480 adultes ayant immigré récemment ont été recrutés à Montréal entre 2002 et 2004.Nous avons obtenus des informations sociodémographiques et l'histoire de vaccination et nous avons mesuré les anticorps sériques contre le tétanos et la diphtérie avec le test EIA; la susceptibilité était définie comme ≤0.15 IU/ml et ≤0.10 IU/ml, respectivement.Résultats: Quarante-cinq pour cent (95% IC, 42%-48%) des immigrants, avec un âge moyen de 318.6 ans, n'étaient pas immuns soit contre le tétanos ou la diphtérie, avec des variations selon la région d'origine (23%-79%).Trente-deux pour cent (95% IC, 30%-34%) étaient susceptibles au tétanos et la susceptibilité augmentait avec l'âge.La susceptibilité à la diphtérie était moins prévalente [26% (95% IC, 24%-28%)] et diminuait avec l'âge.Conclusions: Plusieurs immigrants adultes bénéficieraient du vaccin contre le tétanos et la diphtérie.La susceptibilité au tétanos suggère la présence de sous-vaccination, tandis que la susceptibilité à la diphtérie, qui diminue avec l'âge, suggère que l'immunité a été stimulée par la transmission continue de l'infection dans certains pays d'origine.Greenaway and Dr. Kevin Schwartzman, who as a team provided a strong professional model in guiding my academic work and taught me a great deal.I am especially thankful for their continued support, encouragement, and patience, even when I became discouraged and began to lose sight of the big picture.I am also grateful towards the members of my Thesis Committee, who were helpful in giving their time and suggestions.In addition to the support provided for statistical analyses by Dr. Andrea Benedetti, Hani Kabbara was an indispensable resource for constructing the models.Also helpful were other members of the Centre for Clinical Epidemiology and Community Studies, who provided resources within a warm working atmosphere, and the many dedicated staff members of McGill's Department of Epidemiology, Biostatistics, and Occupational Health.I wish to thank Fran, who helped me to keep an even keel, by offering many tools to cope and a committed level of support to do so.I would also like to thank my family and friends, especially my mother and Saïd, who were my emotional support.Finally,

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.