Évaluation d’un test rapide immuno-chromatographique comme aide à la prophylaxie antitétanique dans un service d’urgences

Cavenaile, Jean Christophe; Gérard, Paul; Duchateau, Jean

doi:10.1016/j.immbio.2012.01.011

Cited by 7 publications

(10 citation statements)

References 8 publications

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“…Numerous studies have shown that vaccination history does not predict the protection against tetanus [12][13][14]. In recent years, it has been shown that a rapid tetanus antibody test (Tetanus Quick Stick test or TQS) can help identify patients without evidence of recent tetanus toxoid vaccination requiring tetanus boosting.…”

Section: Introductionmentioning

confidence: 99%

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Tetanus seroprotection in people living with HIV: Risk factors for seronegativity, evaluation of medical history and a rapid dipstick test

Gobert

Hauwermeiren

Quoidbach

et al. 2021

Vaccine

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Objectives: Tetanus is a vaccine-preventable disease. Booster immunization is required in order to induce long-lived tetanus-toxoid (TT) specific antibody response. We investigated the prevalence and risk factors of TT seronegativity in a cohort of people living with HIV (PWH) in Belgium along with the respective performance of vaccine history and a rapid dipstick test (Tetanus Quick Stick Ò or TQS) compared to ELISA testing. Methods: PWH were prospectively enrolled and answered a questionnaire. ELISA was performed on serum or plasma using a commercial kit. A TT antibody level ! 0.15 IU / mL was considered protective. The TQS test was performed on a limited number of subjects. Results: Three-hundred forty-four subjects were included. The prevalence of tetanus seroprotection was 84,9%. Median age was 46.7 and 68% were born outside Belgium. Antiretroviral therapy coverage was almost universal (98.5%). After multivariable analysis, two risk factors were independently associated with TT seronegativity: an education level equivalent or below than secondary school and being born outside Europe. Vaccine history was shown to be unreliable (sensitivity: 43.8%; specificity: 76.5%; positive predictive value: 91.4% and negative predictive value :19.3%). The correlation between vaccine history and tetanus seroprotection was low (kappa coefficient = 0.09). The TQS performances were good (sensitivity 86.4%, specificity 96.0%, positive predictive value 99.3%, negative predictive value 52.17%). The correlation between TQS and tetanus seroprotection was substantial (kappa coefficient = 0.61). Conclusions: In this cohort of PWH with a high proportion of migrants, socio-demographic and educational factors were associated with TT seronegativity while HIV-related factors were not, indicating that vaccine information should be tailored to cultural and educational background. As vaccine history is not reliable, TQS could represent an efficient tool for screening of TT-seronegativity.

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Section: Introductionmentioning

confidence: 99%

“…This test is performed by immunochromatography with a blood sample from the finger. It has been validated in the general population, mostly in patients attending emergency departments, but there is no study validating its use in PWH subjects [12,13,15,16].…”

Section: Introductionmentioning

confidence: 99%

Tetanus seroprotection in people living with HIV: Risk factors for seronegativity, evaluation of medical history and a rapid dipstick test

Gobert

Hauwermeiren

Quoidbach

et al. 2021

Vaccine

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“…Bien que le test Elisa soit considéré par l'Organisation mondiale de la santé comme la référence pour juger de l'état d'immunisation contre le téta-nos, l'utilisation du TQS a été proposée en raison de la rapidité d'obtention du résultat compatible avec son utilisation dans un contexte d'urgence (10 minutes contre 48 à 72 heures), de sa grande facilité de réalisation, d'un coût faible et de l'absence de contreindication à son utilisation. De plus, sa fiabilité (sensibilité 87 % et spécificité 100 %), bien supérieure aux données de l'interrogatoire ont permis sa démocratisation dans les services d'urgences [9][10][11][12][13][14]. Actuellement, ces tests sont disponibles uniquement en secteur hospitalier et aucune étude n'est disponible en médecine ambulatoire.…”

Section: Introductionunclassified

Évaluation du risque tétanique chez les sujets âgés en médecine ambulatoire : intérêt du « Tétanos Quick Stick® » ?

Nicolai¹,

Farcet²,

Molines³

et al. 2015

La Revue de Médecine Interne

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“…Currently, in emergency departments (EDs), healthcare workers assess tetanus immunization status by asking for the patient's vaccination card or through a medical interview retracing the patient's vaccination history. However, patients rarely bring their vaccination cards, and multiple studies have shown that medical interviews lack accuracy [ 4 ]-[ 8 ]. For example, Colombet et al reported that the sensitivity and specificity of this practice was 62% and 79%, respectively [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments

et al. 2014

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BackgroundTétanos Quick Stick® (TQS) is a test for tetanus immunity screening for wounded patients in emergency departments (EDs), but represents additional costs compared with a medical interview on vaccination history. The study objective was to assess the effectiveness and cost of the TQS in French EDs.MethodsWe performed a model-based analysis that simulates screening of tetanus immunity and risk of tetanus based on prophylaxis administration. Strategies compared were: i) diagnosis of tetanus immunity by “TQS”; ii) “Medical Interview” (current practice). The study population was 1,658,000 French adults seeking ED care for a wound in 2012. Model parameters were estimated based on French national surveillance data, and published literature. Outcome measures were number of tetanus cases, life years gained and costs (2012 €) from a societal perspective.ResultsUse of TQS had negligible impact on health outcomes (0.02 tetanus cases/year in France vs. 0.41 for “Medical Interview”), but resulted in a decrease in annual costs of €2,203,000 (-42%). Base case and sub-group analysis showed that with the same effectiveness, the average cost per patient was: €13 with “Medical Interview” vs. €11.7 with TQS for the overall cohort; €28.9 with “Medical Interview” vs. €21 with “TQS” for tetanus-prone wounds; €15 with “Medical Interview” vs. €14.1 with “TQS” for patients aged ≥65 years; and €6.2 with “Medical Interview” vs. €7.8 with “TQS” for non-tetanus-prone wounds.ConclusionsUse of TQS is as effective and less costly than “Medical Interview” when applied in ED to wounded patients with tetanus-prone wounds or aged ≥65 years. However, it is more expensive in patients with non-tetanus-prone wounds.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0603-3) contains supplementary material, which is available to authorized users.

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Évaluation d’un test rapide immuno-chromatographique comme aide à la prophylaxie antitétanique dans un service d’urgences

Cited by 7 publications

References 8 publications

Tetanus seroprotection in people living with HIV: Risk factors for seronegativity, evaluation of medical history and a rapid dipstick test

Tetanus seroprotection in people living with HIV: Risk factors for seronegativity, evaluation of medical history and a rapid dipstick test

Évaluation du risque tétanique chez les sujets âgés en médecine ambulatoire : intérêt du « Tétanos Quick Stick® » ?

Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments

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