Pretravel consultation: rapid dipstick test as a decision guidance for the application of tetanus booster vaccinations.

BACKGROUND: When deciding whether to administer a tetanus vaccination--for international travel or injury--a subject's vaccination certificate should be investigated. As many people lack valid vaccination cards and are unable to recall their vaccination history, the Tetanos Quick Stick (TQS) test rapidly detects protective tetanus immunoglobulin IgG antibodies in whole blood, serum, or plasma. This immunochromatographic dipstick test yields a positive or negative result.

METHODS: Our study evaluates the effectiveness of the TQS test by comparing the binary TQS test results of 100 sera with the tetanus antibody levels as measured by the standardized enzyme-linked immunosorbent assay (ELISA) method. We used the TQS test to determine whether a person needed a tetanus booster vaccination. If the test showed a clearly visible line that was similar to the control line, the result was determined to be positive.

RESULTS: All positive TQS test results had a concentration of IgG antibodies above 0.5 IU/mL as measured by ELISA, indicating that no booster vaccination was required. Similarly, in all cases with an antibody level below 0.1 IU/mL, where a vaccination would have been recommended based on the ELISA test result, the TQS test yielded a negative result. The positive predictive value and the specificity for the dipstick test were therefore 100%.

CONCLUSIONS: The TQS test is a reliable, fast, and cost-effective means of identifying subjects with a preexisiting level of tetanus IgG antibodies above approximately 0.5 IU/mL. This can help to avoid unnecessary tetanus vaccinations in travel clinics, emergency departments, and practices of family doctors.