The Antidiphtheria Antibodies of Seroepidemiology Survey Among Adolescents in Bangkalan and Kediri Districts

Abstract

Background: An increase in diphtheria cases has occurred in East Java Province since 2011. The resistance level to diphtheria is considered as the most important cause. Purpose: The study aims analyzed the immunity level immunity to diphtheria in adolescents aged 16-18 years old in Bangkalan and Kediri Districts. Methods: This study was a cross-sectional study, conducted on students in eleven grade of senior high schools (SMAN) from both districts. The inclusion criteria included being 16-18 years old and students in eleven grades of senior high schools in Bangkalan and Kediri. This study was approved by their parents/guardians. The exclusion criteria included immunocompromised students and those who have a history of diphtheria infection. The data were obtained from 204 samples, 89 samples in Bangkalan, and 115 samples in Kediri. The antidiphtheria antibodies examination was carried out by the Vero cell method. The antibodies levels were grouped according to WHO standard, consist of vulnerable, basic, full, and long-term. Further analysis was done with 2 tiers of immunity, consist of immune and vulnerable. Results: The immunization coverage for basic and booster diphtheria vaccine is better in Kediri than in Bangkalan. In contrast, levels of antibodies samples in Bangkalan District is better. The participants who were immune in Bangkalan were higher than those in Kediri (91% vs. 44.3%). Conclusion: The immunity adolescents of Bangkalan is higher than in adolescent Kediri District. The adolescents in Kediri have a greater risk to get infected by the disease

Diphtheria serology in adults in Central Java and East Java, Indonesia: the importance of continuous diphtheria vaccination

“…Samples were not selected proportionally by district. It predicted influence the result which is different to the previous study, considering that prevalence of diphtheria in each district were different 17 , 19 . The data was not analyzed by immunization history and history of the exposure to the diphtheria cases because of data limitation.…”

“…Samples were not selected proportionally by district. It predicted influence the result which is different to the previous study, considering that prevalence of diphtheria in each district were different 17,19 .…”

“…Two studies conducted by Hughes, et al and Husada, et al in low cases district (Kediri) and high cases district (Bangkalan) also found out the same pattern 17,19 .…”

“…A history of vaccination will affect immune status. Likewise, a history of exposure to disease agents will also affect the maintenance of immunity in the natural state [17][18][19] . The interesting concern found here was when data of full protective immune status are categorized into two groups (not shown in the result), that were full protective (0.1-0.9 IU/ml) and long term protective (> 1 IU/ml).…”

Microbiological and Clinical Aspects of Diphtheria-Confirmed Cases from Capital City of Indonesia, Jakarta, and Surrounding Areas in 2017

“…Although an annual report revealed its high coverage, we predicted the real condition to be different. A previous study showed that the high seroprotective level of antibodies was induced by natural immunity rather than vaccination coverage (18,19). Furthermore, we detected no definite cause of its high distribution in females.…”