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© Institut Pasteur/Antoinette Ryter
Salmonella spp. Bactéries à Gram négatif, aérobies ou anaérobies facultatifs à transmission orofécale. Les salmonelles majeures (sérotype typhi et sérotype paratyphi) sont responsables des fièvres typhoïde et paratyphoïde chez l'homme uniquement ; les salmonelles mineures (sérotype typhimurium et sérotype enteritidis) sont impliquées dans 30 à 60 % des gastroentérites et toxiinfections d'origine alimentaire. Image colorisée.
Publication : Epidemiology and infection

Leveraging serology to titrate immunisation programme functionality for diphtheria in Madagascar.

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Epidemiology and infection - 13 Jan 2022

Razafimahatratra SL, Menezes A, Wesolowski A, Rafetrarivony L, Cauchemez S, Razafindratsimandresy R, Harimanana A, Crucitti T, Collard JM, Metcalf CJE,

Link to Pubmed [PMID] – 35229710

Link to DOI – e3910.1017/S0950268822000097

Epidemiol Infect 2022 Jan; 150(): e39

Diphtheria is a potentially devastating disease whose epidemiology remains poorly described in many settings, including Madagascar. Diphtheria vaccination is delivered in combination with pertussis and tetanus antigens and coverage of this vaccine is often used as a core measure of health system functioning. However, coverage is challenging to estimate due to the difficulty in translating numbers of doses delivered into numbers of children effectively immunised. Serology provides an alternative lens onto immunisation, but is complicated by challenges in discriminating between natural and vaccine-derived seropositivity. Here, we leverage known features of the serological profile of diphtheria to bound expectations for vaccine coverage for diphtheria, and further refine these using serology for pertussis. We measured diphtheria antibody titres in 185 children aged 6-11 months and 362 children aged 8-15 years and analysed them with pertussis antibody titres previously measured for each individual. Levels of diphtheria seronegativity varied among age groups (18.9% of children aged 6-11 months old and 11.3% of children aged 8-15 years old were seronegative) and also among the districts. We also find surprisingly elevated levels of individuals seropositive to diphtheria but not pertussis in the 6-11 month old age group suggesting that vaccination coverage or efficacy of the pertussis component of the DTP vaccine remains low or that natural infection of diphtheria may be playing a significant role in seropositivity in Madagascar.