ArticleBMC infectious diseases2021
Seroprevalence of diphtheria toxoid IgG antibodies in the Malaysian population.
Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Mapping anti-diphtheria toxin antibody: a systematic review and meta-analysis with multi-level meta-regression.Pathogens and global healthPooled it
- Critical immunity gaps: Waning diphtheria protection among Yemen's displaced populations calls for urgent booster strategies.IJID regions · 2026Article
- Diphtheria seroprotection among Indonesian children: Community Health Surveys Riskesdas 2007, 2013 and 2018.PloS one · 2026Article
- The evaluation of anti-diphtheria toxoid antibodies in healthy population in Kon Tum, Vietnam: a population-based study.IJID regions · 2022Article
- Putting Out the Fire before it becomes an Inferno: Responding to an Outbreak of Diphtheria in Edo State, Nigeria.Nigerian medical journal : journal of the Nigeria Medical AssociationReview
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Authors and funding
15 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite 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.
methodsA 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 (< 0.1 IU/mL) to C. diphtheriae infection.
resultsAmong the 3317 respondents, 57% were susceptible (38.1% of children and 65.4% of adults) and 43% (61.9% of children and 34.6% of adults) had protective antibody levels against diphtheria. The mean antibody level peaked among individuals aged 1-2 years old (0.59 IU/mL) and 6-7 years old (0.64 IU/mL) but generally decreased with age, falling below 0.1 IU/mL at around 4-6 years old and after age 20 years old. There was a significant association between age [Children: χ
conclusionsAbout 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.
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