2012 Volume 26 Issue 3 Pages 314-319
Tetanus prophylaxis in adults varies among individuals or institutions in Japan. In this study, we aimed to examine the accuracy of the Tetanus Quick Stick (TQS), which is a rapid tetanus test kit, and to establish a tetanus prophylaxis algorithm for trauma in Japan. In 182 trauma cases brought to our hospital by ambulance from October 2009 to March 2010, we measured tetanus antibody titers (IU/mL) with TQS and enzyme-linked immunosorbent assay (ELISA). We also recorded age, vaccination history, etc. In 114 (62.6%) of 182 cases, the tetanus antibody titer was >0.1 IU/mL, which that is a sufficient protection level against tetanus. The accuracy of TQS was 66.7% sensitivity, 97.1% specificity, and 97.4% positive predictive value. We compared tetanus antibody titers in cases born before and after 1968 when tetanus toxoid was introduced into routine immunization in Japan. As a result, patients with a sufficient antibody titer accounted for 35% of those born before 1967 and over 90% of those born after 1968. We consider that TQS and the difference in the prevalence of tetanus antibody due to age as an important factor for establishing a tetanus prophylaxis algorithm in Japan.
