Age-stratified seroprevalence of vaccine-preventable infectious disease in Saravan, Southern Lao People's Democratic Republic

Background: Lao People's Democratic Republic has frequent outbreaks of vaccine-preventable diseases (VPD). This study aimed to determine susceptibility and exposure to VPD in Saravan, a rural province with high ethnic diversity and some of the poorest health indicators nationwide. Methods: Patients from three district hospitals and one provincial hospital were enrolled. Serum was tested by ELISA for IgG against hepatitis B virus (HBV), tetanus, diphtheria, measles, and rubella. Results: The study enrolled 2463 participants aged 5-90 years. Exposure to HBV was 33.2% and increased with age up to 62.4% of those aged >50 years. HBV surface antigen prevalence was 5.7% in males and 2.4% in females; 9.9% had serology compatible with vaccination. Seroprevalence of protective anti-tetanus antibodies was 46.3% overall. Protective anti-diphtheria seroprevalence was 40.5%. Anti-measles seroprevalence increased from 16.7% in those aged 5-10 years to 97.7% in those aged >50 years. Anti-rubella seroprevalence was 93.0% overall. There were differences in seroprevalences between sex, districts and ethnicity. Conclusions: Routine infant vaccination needs strengthening in order to close the immunity gaps. High burden of HBV infection should be addressed by increasing birth dose vaccine coverage. Regional and ethnic differences need to be investigated to enable a targeted approach to vaccination. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Automated summary

The study in Saravan, Laos, found high risk of hepatitis B virus infection, with protective antibody seroprevalence rates of 46.3% for tetanus and 40.5% for diphtheria. Seroprevalence of anti-measles and anti-rubella antibodies increased with age. Variations in seroprevalence were observed between gender, districts, and ethnicities. Recommendations include strengthening infant vaccination programs, improving newborn vaccine coverage, and investigating regional and ethnic differences for targeted vaccination strategies.