[Pertussis seroprevalence and vaccination status in three selected provinces of Turkey]. / Seçilmis üç ilde bogmaca seroprevalansi ve asilanma durumu.

The aim of this community-based seroepidemiological survey was to assess the immune status against pertussis among the healthy population in three selected provinces with different geographical and socioeconomical status (Antalya, Diyarbakir and Samsun, located at Mediterrenean, Southeast Anatolia and Black Sea regions of Turkey, respectively) in relation with DwPT (whole cell pertussis vaccine combined with diphtheria and tetanus toxoids) vaccination status. A total of randomly selected 2085 subjects ages between 6 months to > 50 years were included to the study. Serum samples have been screened for the presence of pertussis antibodies by an in house ELISA method with the use of pertussis toxin (PT) and filamentous hemagglutinin (FHA) antigens. The levels of > or = 10 EU/mL was accepted as positive for anti-PT and anti-FHA. Vaccination rate with 3-4 doses among children under 15 years old was significantly lower in Diyarbakir compared to the other two provinces (p< 0.05). The antibody positivity was increased with age up to the 10-14 year group and was maintained among older groups. There was no statistically significant relationship between the vaccination rate and antibody prevalence (p> 0.05). Adult females showed a significantly higher antibody-positivity rate for anti-PT than the males (p< 0.05). Our study pointed out a high prevalence of pertussis infection in those selected provinces, suggesting that the adults play a role as potential reservoirs for B. pertussis. It can be concluded that adult immunization, especially of those who are likely to have close contact with infants, should be considered.

Community-based seroepidemiology of tetanus in three selected provinces in Turkey.

The aim of this study was to assess immunity levels against tetanus in the areas of 26 health centers in Samsun, Antalya, and Diyarbakir in Turkey in 2000 - 2001. The study group consisted of 2,465 healthy subjects aged 6 months old or above, randomly selected from each age group in the area. Of these, a total of 2,094 (85.0%) serum samples were assayed for tetanus antibody; 716 were from Antalya, 706 were from Diyarbakir, and 672 were from Samsun. The surveys were implemented in three steps: physical examination, interview, and blood collection. ELISA-in-house was used as a screening procedure and a particle agglutination test was used to reassess antibody titers of 1.0 IU/ml or below. It was revealed that 73.5% subjects had the full protection level (>/=0.1 IU/ml) of antibody in Antalya, 59.9% in Diyarbakir, and 75.0% in Samsun, indicating that protection against tetanus was significantly lower in Diyarbakir than in Antalya and Samsun. The results also showed that the percentage of protective levels decreased with increasing age in three provinces and was higher in rural areas than urban areas in Diyarbakir. The study indicates that the immunity levels against tetanus can be considered as satisfactory among children and adolescents but that it is necessary to increase immunity against tetanus among adults through effective vaccination of pregnant women and those in military service and also among people older than 40 years of age.

Measles seroepidemiology in 3 cities in Turkey.

OBJECTIVE: To evaluate immunity against measles and its relation with some variables among healthy subjects in 3 cities in Turkey. METHODS: We carried out a cross-sectional study on measles antibody titers in the serum samples of 712 people from Antalya, 696 from Diyarbakir and 667 from Samsun, Turkey using particle agglutination test between February 2000 and October 2001. The study groups, informed and asked for their consent by midwives, consisted of randomly selected subjects of all ages older than 6 months. We implemented the study in 3 steps: physical examination, interview and blood collection. RESULTS: We considered titers of > or = 1:16 as positive and we observed lower seropositivity in Diyarbakir (90.8%) than Antalya (95.9%), and Samsun (94.9%) (p=0.040). We also observed that seropositivity was lower among preschool group than older groups (p=0.006). The number of doses of measles vaccine (p=0.001) and measles infection history (p=0.003) were found as a factor increasing the seropositivity ratio. There was no statistically significant between age groups (p=0.219), gender (p=0.148), residence (p=0.537), and number per household (p=0.983) among the provinces. CONCLUSION: Based on the findings, measles infection still has a high incidence in Turkey and the second dose of measles vaccine is extremely important in the prevention of measles transmission among school children and the community. Furthermore, we must improve our regional differences in routine vaccination services.