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Fulltext Parental refusal to diphtheria vaccine: a fatal outcome

Syafinaz Amin N, Faridah I, Rukman AH, Fathinul Fakri AS, Malina O, Fadzillah G, et al.

Med J Malaysia, 2013 Oct;68(5):435-6.
PMID: 24632874 MyJurnal

We present a case of a four-year-old boy who succumbed to diphtheria following incomplete course of immunisation, which included diphtheria vaccine. This case report focuses on the issues of parental refusal to vaccines and the development of "halal" vaccines for the prevention of infectious diseases.

Matched MeSH terms: Diphtheria Toxoid
Expanded programme on immunization. Diphtheria control

Wkly. Epidemiol. Rec., 1990 Feb 9;65(6):41-2.
PMID: 2386719
Matched MeSH terms: Diphtheria Toxoid/therapeutic use*
The early immunisation of infants in Malaysia

Chen ST, Choong MM

Med J Malaya, 1971 Sep;26(1):15-9.
PMID: 4258569
Matched MeSH terms: Diphtheria Toxoid*
Fulltext Seroprevalence of diphtheria toxoid IgG antibodies in the Malaysian population

Yusoff AF, Mohd Sharani ZZ, Kee CC, Md Iderus NH, Md Zamri ASS, Nagalingam T, et al.

BMC Infect Dis, 2021 Jun 16;21(1):581.
PMID: 34134646 DOI: 10.1186/s12879-021-06285-3

BACKGROUND: Despite high childhood immunization coverage, sporadic cases of diphtheria have been reported in Malaysia in recent years. This study aims to evaluate the seroprevalence of diphtheria among the Malaysian population.
METHODS: A total of 3317 respondents age 2 years old to 60 years old were recruited in this study from August to November 2017. Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IgG antibody against the toxoid of C. diphtheriae in the blood samples of respondents. We classified respondent antibody levels based on WHO definition, as protective (≥0.1 IU/mL) and susceptible (diphtheria toxoid IgG antibody level.
CONCLUSIONS: About 57% of the Malaysian population have inadequate immunity against diphtheria infection. This is apparently due to waning immunity following childhood vaccination without repeated booster vaccination in adults. Children at age 5-6 years old are particularly vulnerable to diphtheria infection. The booster vaccination dose normally given at 7 years should be given earlier, and an additional booster dose is recommended for high-risk adults.

Matched MeSH terms: Diphtheria Toxoid/immunology*
Fulltext Diphtheria anti-toxoid antibody levels among pre-clinical students and staff in an institute of higher learning in Malaysia: are they protected?

Hamat, R.A., Malina, O., Chua, Y.J., Seng, K.L., Zubaidah, M., Norhanim, K., et al.

Malaysian Journal of Medicine and Health Sciences, 2011;7(1):-.
MyJurnal

Little is known about the sero-prevalence of diphtheria anti-toxoid antibody levels among medical students in Malaysia. They too, just like other health care workers (HCWs) are at risk of contracting and transmitting diphtheria. Fortunately, this can be prevented by giving a specific vaccine: the diphtheria, tetanus and pertussis (DTP) vaccine. Nonetheless, data from local or regional surveys are needed before any decision is made by the respective authorities. General objective: We studied the epidemiology of diphtheria anti-toxoid antibody levels and vaccination history amongst medical students and staff in Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. Specific objectives: We determined the level of diphtheria anti-toxoid antibodies amongst pre-clinical students and staff. Methodology: A total of 152 sera were collected from subjects aged 19 to 63, and diphtheria anti-toxoid levels were measured by an enzyme-linked immunosorbent assay. Results: One hundred and fifty-two (94.4%) blood samples out of 161 participants were successfully withdrawn, which comprised 105 (69.1%) and 47 (30.9%) medical students and staff, respectively. A total of 77.6% and the other 22.4% of the subjects had full and basic protection, respectively. Higher levels were predominant amongst males and they were 1.3 times more protected than females in 20-29 year-old group (85.1% vs 66.2%; odd ratios 1.25 [95% CI 1.03-1.50]; P=0.03). No significant difference in the levels of immunity among subjects for ethnicity and academic position (P>0.05). Recommendations: Level of full protection against diphtheria toxin should be clearly defined by broad population based studies using several comparable detection methods. Medical students and staff with basic protection should be closely monitored or should be given a booster dose for those who are at high risk of acquiring the disease. Thus, a standard degree of coverage should be clearly determined for health workers to prevent a potential outbreak. Conclusion: Students and staff possess immunity towards diptheria toxin however the level of full protective antibody is yet to be determined in future.

Matched MeSH terms: Diphtheria Toxoid
Fulltext Cost of management of adverse events of pertussis vaccine

Siti Haniza, M., Syed Aljunid, Haniza, M.A.

Malaysian Journal of Public Health Medicine, 2010;10(1):47-56.
MyJurnal

Whole-cell Pertussis (wcPertussis) vaccines combined with diphtheria and tetanus toxoids are effective in preventing clinical pertussis. The study aimed at determining the cost of managing fever and convulsions and cost of adverse events associated with wcPertussis. Parents who brought their children to health clinics and parents of children who were admitted for febrile convulsions were interviewed using structured questionnaire and the information were used to determine the cost of managing adverse events. Mean cost of managing mild fever per case was RM249, mean cost of managing high fever per case was RM1,036 and mean cost of managing convulsions was RM1,225. Total cost of managing adverse events was RM261 million for mild fever, RM66.7 million for high fever and RM1.3 million for convulsions. Costs of managing mild and high fever were less than the cost of managing convulsions. Total cost of managing mild fever was highest at RM261 million compared with RM66.7 million for high fever and RM1.3 million for convulsions. Thus, lower risk of adverse events actually contributed to higher costs of managing the adverse event.

Matched MeSH terms: Diphtheria Toxoid