Prevalence of protective tetanus antibodies and immunological response following tetanus toxoid vaccination among men seeking medical circumcision services in Uganda
Tetanus infection associated with men who had male circumcision has been reported in East Africa, suggesting a need for tetanus toxoid-containing vaccines (TTCV). This paper sought to determine the prevalence of tetanus toxoid antibodies following vaccination among men seeking circumcision. THis was done by enrolling 620 consenting men who completed a questionnaire and received TTCV at enrollment (day 0) prior to circumcision on day 28. Blood samples were obtained at day 0 from all enrollees and on days 14, 28 and 42 from a random sample of 237 participants. Tetanustoxoid (TT) IgG antibody levels were assayed using EUROIMMUN. Analyses includedprevalence of TT antibodies at enrollment and used a mixed effects model to determine the immunological response. The conclusion is that sufficient immunity was common prior to TTCV, and a protective immunological response was achieved by day 14. Circumcision may safely be provided 14 days after vaccination in HIV-uninfected men aged less than 35 years.