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Papagiannis D, Thireos E, Mariolis A, Katsioulis A, Lampropoulos IC, Tsiaousi I, Gartzonika K, Malliaraki N, Malli F, Rouka EC, Marinos G, Symvoulakis EK, Rachiotis G, Gourgoulianis KI. Diphtheria and Tetanus Immunity Status among Greek Adults: Results from a Nationwide Seroprevalence Study. Vaccines (Basel) 2024; 12:378. [PMID: 38675760 PMCID: PMC11055123 DOI: 10.3390/vaccines12040378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Diphtheria and tetanus could lead to serious morbidity. We aimed to evaluate immunity levels by measuring specific IgG antibodies for diphtheria and tetanus in serum samples from a nationally expanded sample of the Greek population. A geographically stratified sampling approach based on regional units (NUTS level 2) was applied by considering variables such as age group (30-80+) and sex. In total, 1201 persons (47.7% males and 52.3% females) participated in the survey. Bivariate analysis revealed a negative relationship between diphtheria and tetanus median antibody titers and age. The overall seropositivity rate for diphtheria IgG antibodies (≥0.10 IU/mL) was estimated at 31.5%. Regarding tetanus, the total seropositivity rate was estimated at 59.5% (tetanus IgG antibodies ≥0.10 IU/mL). Logistic regression analysis indicated that age groups <40 years and 40-59 years were independently associated with tetanus seropositivity. Logistic regression also revealed that male sex and being aged 60-69 years were independent risk factors for diphtheria-related seropositivity. Lastly, being resident of some regions was an independent risk factor for both diphtheria- and tetanus-related seropositivity. The present study shows that Greek adults are still not completely immune to diphtheria and tetanus. It is likely possible to achieve optimal immunization coverage by implementing serviceable public health initiatives after comprehending real community needs.
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Affiliation(s)
- Dimitrios Papagiannis
- Public Health & Vaccines Laboratory, Faculty of Nursing, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (A.K.); (E.C.R.)
| | - Eleftherios Thireos
- National Health System of Greece, Primary Health Center of Vari, 16672 Athens, Greece;
| | - Anargiros Mariolis
- National Health System of Greece, Primary Health Center, 23062 Areopolis, Greece;
| | - Antonios Katsioulis
- Public Health & Vaccines Laboratory, Faculty of Nursing, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (A.K.); (E.C.R.)
| | - Ioannis Ch. Lampropoulos
- Respiratory Disorders Lab, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece; (I.C.L.); (F.M.)
| | - Ioanna Tsiaousi
- Private Primary Health Sector, Queen Sophia Avenue 123, 11521 Athens, Greece;
| | - Kostantina Gartzonika
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Niki Malliaraki
- Laboratory of Clinical Chemistry-Biochemistry, University Hospital of Heraklion, 71003 Crete, Greece
| | - Foteini Malli
- Respiratory Disorders Lab, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece; (I.C.L.); (F.M.)
| | - Erasmia C. Rouka
- Public Health & Vaccines Laboratory, Faculty of Nursing, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (A.K.); (E.C.R.)
| | - Georgios Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Emmanouil K. Symvoulakis
- Department of Social Medicine, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, Medical Faculty, School of Health Science, University of Thessaly, 42200 Larissa, Greece;
| | - Konstantinos I. Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece;
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