Abstract
Tetanus is a major cause of morbidity and mortality in developing countries. Nigeria is aiming to eliminate tetanus by maintaining coverage of routine vaccinations for infants and pregnant women, but little attention is given to the adolescents’ needs. This study assessed the understanding of adolescent girls about tetanus infection and prevention in order to provide information that may foster better policy. In this cross-sectional analytical study, 851 female adolescents were selected from eight secondary schools in Ibadan, south-west of Nigeria using a three-stage random sampling technique. A pre-tested structured questionnaire was used to obtain information on demographic and socio-economic characteristics, history of tetanus vaccination, and adolescents’ knowledge of tetanus infection. Mean age of respondents was 14.3 ± 1.9 years. Only 3.1% had received tetanus toxoid injection 1 year prior to the study, most frequently following a “wound or injury” (65.4%). Though 344 (40.4%) respondents claimed that they knew about tetanus as a “serious neurological disease,” only 46.5% correctly defined tetanus. Overall, the mean knowledge score was 4.8 ± 3.1 and 64.7% of the respondents had poor knowledge. Academic class was significantly associated with knowledge; higher mean score among the senior (5.3 ± 5.3) than junior classes (4.4 ± 3.2); p < 0.001. Over half (56.2%) of the adolescents disagreed with the statement that “tetanus immunization can be given to students in the school premises.” There is the need to improve immunization campaigns against tetanus among adolescent girls and consider the introduction of school-based immunization programs if the elimination of maternal and neonatal tetanus is to be achieved.
Highlights
The purpose of this study is to evaluate the understanding of adolescent girls in high school about tetanus and identify factors associated with knowledge of the disease
Ibadan North Local Government Area (IBNLGA) was purposively selected for this study because the majority of cases of neonatal tetanus seen at the University College Hospital, Ibadan in the 2 years preceding this study resided in the area
Among the most neglected population, but with the potential for passing the right information about tetanus to the Nigerian communities, are the adolescent girls in schools. If this group of individuals could be reached with correct information and given access to vaccination in school as it is the case in countries like Malaysia, Indonesia, Sri Lanka, and Tunisia [19], the goal of eradicating tetanus may be achieved faster than currently imagined. It was on this premise that this study evaluated the understanding of high school girls about tetanus in a local government area in the south-west of Nigeria
Summary
The purpose of this study is to evaluate the understanding of adolescent girls in high school about tetanus and identify factors associated with knowledge of the disease. Tetanus is an acute neurological disease caused by Clostridium tetani, a non-invasive, and spore-bearing anaerobic bacilli bacterium. Though tetanus affects all ages, it occurs more frequently in children than adults. Tetanus accounted for 20,000– 276,000 of neonatal deaths (1% of all child mortality) globally in 2010 [2]. In Nigeria, the incidence tetanus ranges from 14.6 to 20 per 1000 live births and it is the leading cause of death in the neonatal age group [3,4,5]. Neonatal tetanus occurs as a result of unhygienic birth practices, most commonly when the spores of C. tetani contaminate the umbilical cord stump at the time it is cut or dressed after birth [1]. The portal of entry is usually a contaminated wound or otitis media and it may not be obvious [7]
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