DIPHTHERIA AND TETANUS SEROEPIDEMIOLOGY AMONG CHILDREN AND YOUNG ADULTS IN TAJIKISTAN, 2010

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N. Khetsuriani, K. Zakikhany, A. Efstratiou, S. Jabirov, N. Saparova, N. Sinavbarova, K. Broughton, J. Glumac, K. Wannemuehler, R. Martin,

CDC, Health Protection Agency, Ministry of Health Tajikistan, WHO/Tajikistan, WHO Regional Office for Europe,

Diphtheria and tetanus seroepidemiology among children and young adults in Tajikistan, 2010

Nino Khetsuriani¹, Katherina Zakikhany^2,6, Androulla Efstratiou², Shamsiddin Jabirov³, Nargis Saparova⁴, Nukra Sinavbarova⁴, Karen Broughton², Jelena Glumac², Kathleen Wannemuehler¹, Rebecca Martin⁵

¹CDC, Atlanta, USA;²Health Protection Agency, London, UK; ³Tajikistan Ministry of Health, ⁴WHO/Tajikistan, Dushanbe, Tajikistan; ⁵WHO/Europe, Copenhagen, Denmark, ⁶The European Programme for Public Health Microbiology training (EUPHEM), ECDC, Stockholm, Sweden katherina.zakikhany@hpa.org.uk

Background

In the 1990’s a massive epidemic of diphtheria occurred in the Russian Federation and the Newly Independent States (NIS) of the former Soviet Union, with more than 150,000 cases and more than 4000 deaths.

A major diphtheria outbreak occurred in Tajikistan (TJK) between 1993-1998, as part of the resurgence of epidemic diphtheria in the former Soviet Union countries:

· more than 10,000 cases and 800 deaths were reported, many of which were in older children and young adults

· cases and deaths are likely underestimated due to disruption of surveillance caused by the ongoing

Outbreak control measures comprised nationwide SIA’s (Supplementary Immunization Actions):

9 SIA 1 (1995) 3-50 yrs

9 SIA 2 (1996) 15-50 yrs

Between 2000-2010, only 52 diphtheria cases and seven tetanus cases were reported in TJK

Quality of surveillance in TJK is uncertain due to high population mobility and uncertainties with target populations numbers, lack of laboratory capacity, human resources and training competency

Routine immunization is historically suboptimal in TJK due to severe disruptions during the civil war (1992-1997), persistent economic difficulties and technical challenges (lack of equipment, power shortage, etc.), including a suboptimal DT3 coverage for many years

Objective: to assess population immunity against diphtheria and tetanus across age groups and regions in Tajikistan