ArticleEmerging infectious diseases2023
Seroepidemiology and Carriage of Diphtheria in Epidemic-Prone Area and Implications for Vaccination Policy, Vietnam.
Article in Emerging infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Modeling the transmission dynamics and control strategies during the 2017 diphtheria outbreak in Jakarta, Indonesia.Infectious Disease Modelling · 2026Article
- A population-level analysis of armed conflict and diphtheria at the subnational level in the WHO African Region 2017-2024.BMC global and public health · 2025Article
- Seroprevalence of Diphtheria in Antananarivo, Madagascar, and Cambodia.Open forum infectious diseases · 2025Article
- Article
- Seroprevalence of anti-diphtheria toxoid antibody and implications for vaccination policy in Vietnam's South-central coast: a cross-sectional study.BMC infectious diseases · 2024Article
- Assessing the impact of booster vaccination on diphtheria transmission: Mathematical modeling and risk zone mapping.Infectious Disease Modelling · 2024Article
- Article
- Modifiable risk factors for diphtheria: A systematic review and meta-analysis.Global epidemiology · 2023Review
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Authors and funding
19 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In 2019, a community-based, cross-sectional carriage survey and a seroprevalence survey of 1,216 persons 1-55 years of age were conducted in rural Vietnam to investigate the mechanism of diphtheria outbreaks. Seroprevalence was further compared with that of an urban area that had no cases reported for the past decade. Carriage prevalence was 1.4%. The highest prevalence, 4.5%, was observed for children 1-5 years of age. Twenty-seven asymptomatic Coerynebacterium diphtheriae carriers were identified; 9 carriers had tox gene-bearing strains, and 3 had nontoxigenic tox gene-bearing strains. Child malnutrition was associated with low levels of diphtheria toxoid IgG, which might have subsequently increased child carriage prevalence. Different immunity patterns in the 2 populations suggested that the low immunity among children caused by low vaccination coverage increased transmission, resulting in symptomatic infections at school-going age, when vaccine-induced immunity waned most. A school-entry booster dose and improved infant vaccination coverage are recommended to control transmissions.
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