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Tetanus Quick Stick as an applicable and cost-effective test in assessment of immunity status.
MedLine Citation:
PMID:  20825874     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Tetanus vaccine and immunoglobulin administration are challenging decisions mostly because of the fact that the current protocol for immunization against tetanus is based on 2 variables: the vaccination status of the patient and the nature of wound and its exposure. To solve this problem, Tetanus Quick Stick (TQS; Nephrotek Laboratory, Rungis, France), an immunochromatographic dipstick test, was developed to determine the tetanus immunity of the patients. The aim of this present study was to investigate the sensitivity, specificity, and the positive and negative predictive values and cost-effectiveness of TQS in the emergency department (ED) setting.
METHODS: Blood samples were collected from 200 patients presenting to our ED. Information including demographic information, tetanus immunization status, wound description, and the preventive measures taken by the emergency physician were gathered by a preeducated nurse. Tetanus Quick Stick test and enzyme-linked immunosorbent assay were performed as the standard diagnostic test by an emergency physician and a laboratory technician, respectively; and results of the 2 techniques were compared.
RESULT: Overall, tetanus vaccine was administered to 141(70.5%) patients and immunoglobulin to 105 (52.5%) patients. The analysis revealed 88.1% sensitivity and 97.6% specificity for the TQS test. The positive and negative predictive values of TQS test were 99.3% and 66.1%, respectively. Our analysis is also showed a significant decrease in cost when TQS was applied for patients with dirty, tetanus prone wounds or injuries and unknown or incomplete vaccination history (€ 9.48 versus € 12.1).
CONCLUSION: This study revealed TQS test to be appropriate and cost-effective for ED use especially in evaluating patients who do not remember or cannot give their tetanus immunization history.
Authors:
Hamid Reza Hatamabadi; Ali Abdalvand; Saeed Safari; Hamid Kariman; Ali Arhami Dolatabadi; Ali Shahrami; Hossein Alimohammadi; Mostafa Hosseini
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Publication Detail:
Type:  Journal Article     Date:  2010-05-01
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  29     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  717-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Emergency Medicine, Imam Hosain Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1617763141, Iran; Intentional Injury Unit, Safety Promotion and Injury Prevention Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences,Tehran, Iran.
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