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Gembe M, Wosenyeleh T, Gezimu W. Protective doses of tetanus toxoid immunization and its associated factors among mothers in southern Ethiopia. Hum Vaccin Immunother 2024; 20:2320501. [PMID: 38466961 PMCID: PMC10936595 DOI: 10.1080/21645515.2024.2320501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/15/2024] [Indexed: 03/13/2024] Open
Abstract
The World Health Organization recommends tetanus toxoid immunization before or during pregnancy for all women of childbearing age. The goal is to reduce maternal and neonatal mortality due to tetanus. According to the 2016 Ethiopia Demographic and Health Survey (EDHS) report, more than half (51%) of women did not receive protective doses of tetanus immunization. To the best of our knowledge, this study uniquely tried to assess the level of protective doses of tetanus toxoid immunization in southern Ethiopia. A community-based cross-sectional study was conducted among 580 randomly selected participants. Variable with p-value of less than .25 in the bivariate analysis were included in the multivariable logistic regression analysis. Finally, statistical significance was declared at a p-value of less than .05. The proportion of protective doses of tetanus toxoid immunization uptake in the area was found to be 41.9% (95% CI: 38-46%). Being enrolled in formal education [AOR = 6.55, 95% CI: 3.23-9.01], having at least two postnatal care visits [AOR = 3.82; 95% CI: 1.78-6.40], having at least four antenatal care visits [AOR = 2.56; 95% CI: 1.41-4.34], and being visited by Health Extension Workers [AOR = 2.66; 95% CI: 1.42-4.01] were found to be factors enhancing the uptake of protective doses of tetanus toxoid immunization. Generally, the uptake or prevalence of the protective doses of tetanus toxoid immunization in the area was lower than the World Health Organization's target. Therefore, all responsible bodies, including healthcare providers, need to strengthen counseling mothers to enhance the uptake of tetanus toxoid immunization.
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Affiliation(s)
- Maycas Gembe
- Department of Nursing, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Teklu Wosenyeleh
- Department of Nursing, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Wubishet Gezimu
- Department of Nursing, College of Health Science, Mattu University, Mattu, Ethiopia
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Dessie AM, Zemene MA, Gebeyehu AA, Gebeyehu NA, Adella GA, Kassie GA, Mengstie MA, Seid MA, Abebe EC, Gesese MM, Kebede YS, Moges N, Bantie B, Feleke SF, Dejenie TA, Chanie ES, Bayih WA, Tesfa NA, Aychew EW, Mekuriaw BY, Anley DT. Hotspot areas of tetanus-unprotected births and its associated factors in Ethiopia: Spatial analysis of EDHS data. Hum Vaccin Immunother 2024; 20:2298062. [PMID: 38174411 PMCID: PMC10773712 DOI: 10.1080/21645515.2023.2298062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Neonatal tetanus persists as a public health problem in many developing countries including Ethiopia. Maternal tetanus toxoid vaccination is a cornerstone to prevent neonatal tetanus. However, its prevalence is low in Ethiopia, and little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting tetanus-unprotected births in Ethiopia. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a weighted sample of 7590 women was used for analysis. Spatial analysis was done using ArcGIS and SaTScan software. A binary logistic regression model was fitted to identify factors and variables with a p-value <.05 were considered as statistically significant. About 54.13% (95% CI: 53.01, 55.25) of births were not protected against neonatal tetanus, and spatial clustering of tetanus unprotected births was observed (Moran's I = 0.144, p-value = .028). The primary and secondary SaTScan clusters were detected in Northeastern Tigray, Eastern Amhara, and almost the entire Afar (RR = 1.34 & LLR = 66.5, p < .01), and in the Somali region, and the western border of Gambela (RR = 1.44 & LLR = 31.3, p < .01), respectively. Tetanus unprotected births were higher among women without formal education (AOR = 1.63; 95% CI: 1.29, 2.04), came from poor households (AOR = 1.27; 95% CI: 1.12, 1.45), who had no ANC contact (AOR = 6.97; 95% CI: 6.21, 7.88), and who were not exposed to the media (AOR = 1.26; 95% CI: 1.09, 1.47). Hence, tetanus-unprotected birth hotspots require priority interventions, and it is good if the targeted interventions consider the identified factors.
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Affiliation(s)
- Anteneh Mengist Dessie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Asaye Alamneh Gebeyehu
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health and Nutrition, School of Public Health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, School of Public Health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Physiology, Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molalegn Mesele Gesese
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yenealem Solomon Kebede
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Moges
- Department of Pediatrics and Child Health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Department of Comprehensive Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Child Health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Natnael Amare Tesfa
- School of Medicine,College of Health Science, Woldia University, Woldia, Ethiopia
| | - Eden Workneh Aychew
- Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Begizew Yimenu Mekuriaw
- Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Denekew Tenaw Anley
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Tamir TT, Kassie AT, Zegeye AF. Prevalence and determinants of two or more doses of tetanus toxoid-containing vaccine immunization among pregnant women in sub-Saharan Africa: Evidence from recent demographic and health survey data. Vaccine 2023; 41:7428-7434. [PMID: 37949753 DOI: 10.1016/j.vaccine.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Tetanus is a major public health problem in low and middle income countries including in sub-Saharan Africa. Tetanus toxoid vaccine immunization during pregnancy is a global strategy against mortality due to maternal and neonatal tetanus. Recent data on tetanus toxoid-containing vaccination during pregnancy provides insight to policymakers for better implementation of the vaccine. Hence, this study aimed to determine prevalence and determinants of immunization with tetanus toxoid containing vaccine among pregnant women in sub-Saharan Africa. METHODS Secondary analysis of the recent demographic and health survey data was done using a sample of 173,032 pregnant women. Stata 14 statistical software was used for analysis and multilevel logistic regression model was applied to determine associated factors of two or more tetanus toxoid-containing vaccine immunization. P-value less than 0.05 for adjusted odds ratio was used to identify factors significantly associated with the outcome. RESULT The prevalence of immunization with two and more doses of tetanus toxoid-containing vaccine in sub-Saharan Africa was found to be 49.8 %. Women's age 36-49, women's education, poor household wealth index, unwanted pregnancy, women's occupation, husband education, and community illiteracy were significantly associated with two or more doses of tetanus toxoid-containing vaccine immunization in sub-Saharan Africa. CONCLUSION In sub-Saharan Africa, less than half of pregnant women were immunized with two or more doses of tetanus toxoid-containing vaccine. Women's education and women's employment positively affected immunization with two or more doses of tetanus toxoid-containing vaccine. Women's age group of 36-49 years, unwanted pregnancy, poor household wealth index, husbands having no formal education, and community illiteracy negatively affected receipt of two or more doses of tetanus toxoid-containing vaccine. Therefore, policymakers should take into account the determinants of tetanus toxoid immunization throughout its implementation so as to boost the coverage of tetanus toxoid immunization in sub-Saharan Africa.
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Affiliation(s)
- Tadesse Tarik Tamir
- Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Alemneh Tadesse Kassie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Agbemavi W, Ayebeng C, Okyere J, Acheampong E, Bediako VB. Prevalence and factors associated with rural mothers' protection against tetanus: a cross-national analysis in 33 sub-Saharan African countries. Int Health 2023:ihad103. [PMID: 37923368 DOI: 10.1093/inthealth/ihad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/25/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) and South Asia account for most new cases of tetanus. Despite efforts by the World Health Organization to eradicate tetanus, it still causes many maternal mortalities. We examined the prevalence and risk factors associated with tetanus protection among rural mothers in 33 SSA countries. METHODS Data were extracted from the most recent Demographic and Health Surveys of 33 SSA countries. A sample of 162 601 women from rural areas was drawn. Both descriptive and binary logistic regression analyses were conducted. RESULTS Overall, approximately half (49.3%) of rural mothers were protected against tetanus. The association between maternal age, education, marital status, working status, distance to the health facility and number of antenatal visits were statistically significant with rural mothers' protection from tetanus. Also, relationship to the household head, household size and frequency of listening to radio, reading a newspaper and watching television were statistically significant in predicting rural mothers' protection from tetanus. CONCLUSIONS Policies and interventions by stakeholders must target high-risk populations, including adult women, those of poorer wealth status, those without media exposure and mothers with low educational attainment.
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Affiliation(s)
- Wonder Agbemavi
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- School of Demography, Australian National University, Canberra, Acton, ACT, Australia
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Vincent Bio Bediako
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Ewim Polyclinic, Ghana Health Service, Cape Coast, Ghana
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Asmamaw DB, Debebe Negash W, Aragaw FM, Eshetu HB, Asratie MH, Belachew TB. Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis. Front Glob Womens Health 2023; 4:1138579. [PMID: 37732165 PMCID: PMC10507278 DOI: 10.3389/fgwh.2023.1138579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/09/2023] [Indexed: 09/22/2023] Open
Abstract
Background Neonatal mortality from tetanus can be reduced by 94% when pregnant women receive at least two doses of tetanus toxoid. In Ethiopia, immunization programs are suboptimal despite their importance. Therefore, the aim of this study was to examine the geographic distribution and associated factors of poor tetanus toxoid (TT) immunization among pregnant women in Ethiopia. Methods Secondary data analysis was used using the 2016 Ethiopian Demographic and Health Survey (EDHS). ArcGIS version 10.8 statistical software was used to explore the spatial distribution of poor TT immunization and SaTScan version 9.6 software was used to identify significant hotspot areas of poor TT immunization. For associated factors, a multilevel binary logistic regression model was fitted using STATA version 14 software. In the multivariable multilevel analysis, adjusted OR (AOR) with 95% CI was reported to reveal significantly associated factors of poor TT immunization. Result In Ethiopia, the spatial distribution of poor tetanus toxoid immunization was clustered with Global Moran's I = 0.59 at p-value of <0.0001. The highest poor TT immunization clusters were observed in the East and South Tigray, the central part of Amhara, West Afar, East Somali, and West Gambella. Pregnant women with no Antenatal care (ANC) visits [Adjusted Odds Ratio (aOR) = 10.46, 95% CI: (8.82, 12.41))], pregnant women with 1-3 ANC visits [aOR = 1.51, 95% CI: (1.31, 1.73)], media exposure [aOR = 1.45, 95% CI: (1.26, 1.67)], poor wealth index [aOR = 1.22; 95% CI: (1.03, 1.45)], middle wealth index [aOR = 1.23; 95% CI: (1.03, 1.47)], family planning use [aOR = 1.28; 95% CI: (1.11, 1.57)] and community level education [aOR = 1.43, 95% CI: (1.14, 1.80)] were significantly associated with poor tetanus toxoid immunization. Conclusion Poor tetanus toxoid immunization among pregnant women varies in Ethiopia. It was highest in East and South Tigray, the central part of Amhara, West Afar, East Somali, and West Gambella. Therefore, public health programs should design targeted interventions in identified hot spots to improve tetanus toxoid immunization. Health programmers should be promoting optimal ANC visits, women's education, and family planning use.
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Affiliation(s)
- Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ibrahim ZA, Sabahelzain MM, Elhadi YAM, Malande OO, Babiker S. Predictors of Tetanus Vaccine Uptake among Pregnant Women in Khartoum State, Sudan: A Hospital-Based Cross-Sectional Study. Vaccines (Basel) 2023; 11:1268. [PMID: 37515083 PMCID: PMC10386498 DOI: 10.3390/vaccines11071268] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/30/2023] Open
Abstract
Tetanus toxoid (TT) vaccination during pregnancy has been proven as an effective preventative measure to reduce the incidence of maternal and neonatal morbidity and mortality worldwide. This study aimed to assess the determinants of TT vaccine uptake among pregnant women at two public maternity specialized hospitals in Sudan. A hospital-based cross-sectional study was conducted at two public hospitals, Omdurman Maternity Hospital and Al Saudi Hospital in Omdurman, Khartoum State, in Sudan from February to April 2020. Logistic regression analysis was carried out to identify factors associated with receiving three or more doses of the TT vaccine among pregnant women, presented as odds ratios, with p-values < 0.05 considered significant (at a 95% confidence interval). The study recruited 350 pregnant women, with 313 participants included in the analysis. This study found that only 40% of the pregnant women had received three doses or more of the TT vaccine. Pregnant women who attended Al Saudi Hospital were less likely to be vaccinated with the recommended dose of the TT vaccine in districts at high risk (received ≥3 doses) compared to those who attended Omdurman Hospital [OR = 0.49 (95% C.I. 0.29-0.82), p-value < 0.05]. Furthermore, the number of children at home was a significant predictor of the mothers' immunization status as those with five children or more were ten times more likely to be vaccinated with three doses or more [OR = 10.54 (95% C.I. 4.30-25.86), p-value < 0.05]. We conclude that this low rate of TT vaccine uptake found in this study among pregnant women increases the number of newborn babies susceptible to contracting neonatal tetanus. The findings of this study should be considered in the development of communication strategies targeting and prioritizing at-risk groups to increase TT vaccine uptake among pregnant women in Sudan.
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Affiliation(s)
| | - Majdi M Sabahelzain
- Nutrition and Health Center for Training and Research, Ahfad University for Women, Omdurman P.O. Box 167, Sudan
| | | | - Ombeva Oliver Malande
- Department of Child Health and Paediatrics, Egerton University, Nakuru P.O. Box 3366-20100, Kenya
- East Africa Centre for Vaccines and Immunization (ECAVI), Namela House, Kampala P.O. Box 3040, Uganda
- Department of Paediatrics & Child Health, Makerere University, Kampala P.O. Box 3040, Uganda
| | - Suad Babiker
- School of Medicine, Ahfad University for Women, Omdurman P.O. Box 167, Sudan
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Doğan A, Mohamed Alİ A, Abdullahi Alİ M, Orul H. Assessment of tetanus Immunization among healthcare workers in Mogadishu, Somalia. Hum Vaccin Immunother 2023:2202128. [PMID: 37133877 DOI: 10.1080/21645515.2023.2202128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Tetanus is still a major problem in sub-Saharan African countries. This study aims to evaluate tetanus disease and vaccine awareness among healthcare workers in Mogadishu. This descriptive, cross-sectional study was scheduled for January 2-7, 2022. A questionnaire consisting of 28 questions was applied in a face-to-face manner to 418 healthcare workers. Only health workers aged≥18 living in Mogadishu were included. Questions about sociodemographic characteristics, tetanus disease, and vaccines were developed. 71.1% of the participants were female, 72% were ˂25 years old, 42.6% were nursing students, and 63.2% had a university education. It was observed that 46.9% of the volunteers had an income level of <$250, and 60.8% resided in the city center. 50.5% of the participants received a tetanus vaccine in their childhood. Questions to determine participants' level of knowledge about tetanus and the tetanus vaccine were responded to with an accuracy of between 44 and 77%. Although 38.5% of the participants reported that they were exposed to trauma at least once a day, the rate of those who had three or more doses of the vaccine was only 10.8%. On the other hand, 51.4% reported that they had received training about tetanus and vaccination. There was a significant difference (p < .001) in terms of knowledge level among sociodemographic characteristics. The fear of side effects was the most important reason for not being vaccinated. Healthcare workers in Mogadishu have little awareness of tetanus disease and vaccines. Efforts to improve education and other factors will be sufficient to eliminate the disadvantage brought about by the socio-demographic structure.
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Affiliation(s)
- Ahmet Doğan
- Department of Infectious Diseases and Clinical Microbiology, Somalia-Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Ahmed Mohamed Alİ
- Department of Infectious Diseases and Clinical Microbiology, Somalia-Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Mukhtar Abdullahi Alİ
- Department of Infectious Diseases and Clinical Microbiology, Somalia-Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Havva Orul
- Infection Committee Control Nurse, Somalia-Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
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De-Simone SG, Napoleão-Pêgo P, Lechuga GC, Carvalho JPRS, Gomes LR, Cardozo SV, Morel CM, Provance DW, Silva FRD. High-Throughput IgG Epitope Mapping of Tetanus Neurotoxin: Implications for Immunotherapy and Vaccine Design. Toxins (Basel) 2023; 15:toxins15040239. [PMID: 37104177 PMCID: PMC10146279 DOI: 10.3390/toxins15040239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 04/28/2023] Open
Abstract
Tetanus is an acute, fatal disease caused by exotoxins released from Clostridium tetani during infections. A protective humoral immune response can be induced by vaccinations with pediatric and booster combinatorial vaccines that contain inactivated tetanus neurotoxin (TeNT) as a major antigen. Although some epitopes in TeNT have been described using various approaches, a comprehensive list of its antigenic determinants that are involved with immunity has not been elucidated. To this end, a high-resolution analysis of the linear B-cell epitopes in TeNT was performed using antibodies generated in vaccinated children. Two hundred sixty-four peptides that cover the entire coding sequence of the TeNT protein were prepared in situ on a cellulose membrane through SPOT synthesis and probed with sera from children vaccinated (ChVS) with a triple DTP-vaccine to map continuous B-cell epitopes, which were further characterized and validated using immunoassays. Forty-four IgG epitopes were identified. Four (TT-215-218) were chemically synthesized as multiple antigen peptides (MAPs) and used in peptide ELISAs to screen post-pandemic DTP vaccinations. The assay displayed a high performance with high sensitivity (99.99%) and specificity (100%). The complete map of linear IgG epitopes induced by vaccination with inactivated TeNT highlights three key epitopes involved in the efficacy of the vaccine. Antibodies against epitope TT-8/G can block enzymatic activity, and those against epitopes TT-41/G and TT-43/G can interfere with TeNT binding to neuronal cell receptors. We further show that four of the epitopes identified can be employed in peptide ELISAs to assess vaccine coverage. Overall, the data suggest a set of select epitopes to engineer new, directed vaccines.
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Affiliation(s)
- Salvatore G De-Simone
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Epidemiology and Molecular Systematics (LESM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Post-Graduation Program in Science and Biotechnology, Department of Molecular and Cellular Biology, Biology Institute, Federal Fluminense University, Niterói 22040-036, RJ, Brazil
| | - Paloma Napoleão-Pêgo
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Epidemiology and Molecular Systematics (LESM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
| | - Guilherme C Lechuga
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Epidemiology and Molecular Systematics (LESM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
| | - João P R S Carvalho
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Epidemiology and Molecular Systematics (LESM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Post-Graduation Program in Science and Biotechnology, Department of Molecular and Cellular Biology, Biology Institute, Federal Fluminense University, Niterói 22040-036, RJ, Brazil
| | - Larissa R Gomes
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Epidemiology and Molecular Systematics (LESM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
| | - Sergian V Cardozo
- Department of Health, Graduate Program in Translational Biomedicine (BIOTRANS), University of Grande Rio (UNIGRANRIO), Caxias 25071-202, RJ, Brazil
| | - Carlos M Morel
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
| | - David W Provance
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Epidemiology and Molecular Systematics (LESM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
| | - Flavio R da Silva
- Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Diseases of Neglected Populations (INCT-IDPN), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Epidemiology and Molecular Systematics (LESM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, RJ, Brazil
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