Role of Rapid Tetanus Antibody Test in Accident and Emergency Department

Abstract

Tetanus remains a problem of immense concern worldwide. Management of tetanus with its attendant complications are challenges to the physician and its prevention is the chief priority. The choice of tetanus prophylaxis for patients with wounds depends on obtaining their vaccination history, which has been demonstrated to be unreliable. The tetanus antibody test may avoid inadequate prophylactic measures and reduce costs. This study is conducted to determine the feasibility of rapid tetanus antibody test (SD Bioline) in the accident and emergency department. A randomized prospective study was conducted on 50 patients, divided into two groups-A and B with 25 patients each respectively. Group A had patients with a history of tetanus immunization <5years elapsed from the last booster dose. Group B had patients who did not know the immunization status or more than 5years elapsed from the last booster dose of tetanus immunization. Groups A and B were further classified into Group 1 and Group 2 based on whether the wound is tetanus prone or a clean wound respectively. Tetanus antibody test was done using whole-blood from the patients by finger prick. Among the 50 patients, 25 (50%) were classified as 'unprotected' according to the history. Thirteen of the 25 patients showed tetanus antibody positive. In Group A, only 9 of the 25 patients showed tetanus antibody positive. The rapid tetanus antibody test in the emergency room could make tetanus prevention more accurate with improved technical feasibility. The test may eliminate unnecessary injecting of vaccine, reduce the cost and can be performed at the hospital setting.