Abstract
BackgroundEven though there have been tremendous strides globally in reducing the burden of tetanus, neonatal deaths due to tetanus have reported annually, and most deaths occur in sub-Saharan Africa which accounts for nearly half of the global neonatal mortality by tetanus. Immunization of pregnant women or women of childbearing age with at least two doses of tetanus toxoid is estimated to reduce mortality from neonatal tetanus by 94%. Despite its importance, immunization programs are suboptimal in Ethiopia, where more than 85% of the population have resides in rural districts. Therefore, this study has been used to determine the coverage and determinants of protective dose tetanus vaccine among postnatal women and design a strategy to maximize the service. MethodsInstitution-based cross-sectional study was conducted from December 20-June 20, 2019. The sample was taken using a systematic random sampling method. To collect data from the study participants, a semi-structured interviewer-administered and pre-tested questionnaire was used. The data were entered into Epi info version 7.0 and then exported to SPSS version 20.0 for analysis. Logistic regressions analysis was conducted and the level of statistical significance was determined by a p-value of less than 0.05. ResultsThe proportion of immunization with Tetanus toxoid protective dose was 69.8% (95% CI: 65.2–74.0). Urban residence (AOR = 3.626, 95%CI: 1.510–8.707), husband's having secondary education (AOR = 7.397, 95%CI: 1.873–29.211), husband's having tertiary education (AOR = 9.539, 95%CI: 2.277–39.969), women stated that the provision of TT vaccine service was good (AOR = 3.978, 95%CI 1.303–12.146) and mother stated health care workers who provide TT vaccine were good in their behavior (AOR = 4.259, 95%CI: 1.913–9.484) were factors influencing utilization of TT protective dose immunization. ConclusionThe proportion of TT protective dose immunization in the study area was found to be low. Being Urban residence, secondary and tertiary levels of the husband's educational status, women who stated that ‘the provision of TT vaccine service was good’ and “health care workers who provide TT vaccine were good in their behavior were statistically significant factors influencing TT protective dose immunization. Thus, it is better to strengthening education and empowering women to enhance vaccine utilization. Besides, promoting husband's education and creating community awareness particularly rural residents are better options to increase utilization of TT protective dose vaccine.
Highlights
Tetanus is a bacterial disease caused by Clostridium tetanus in individuals without protective circulating antibodies
The final multivariable logistic regression model showed that variables such as clients “stated that the provision of TT vaccine service was good”, clients said that “health care workers who provide TT vaccine were good in their behavior”, Husband educational status, and residence were sig nificant determinants of tetanus toxoid vaccination at a 5% level of significance
The odds of TT protective dose immunization were 4.26 times higher among mothers said that “health care workers who provide TT vaccine were good in their behavior” than their counterparts (AOR = 4.259, 95%CI: 1.913–9.484) (Table 3)
Summary
Tetanus is a bacterial disease caused by Clostridium tetanus in individuals without protective circulating antibodies. Delivery via umbilical stump.[1,2] Death from tetanus disease is protected by at least two doses of tetanus toxoid immunization of pregnant women or women of reproductive age.[3,4] Even though there have been tremendous strides globally in reducing the burden of tetanus, 25,000 unnecessary neonatal deaths reported annually,[5] and most deaths occur in sub-Saharan Africa which accounts for nearly half of the global neonatal mortality by tetanus.[6] In Somalia, South Sudan, Afghanistan, and Kenya, the highest rates of neonatal tetanus mortality were recorded (1000 deaths per 100,000 populations). Being Urban residence, secondary and tertiary levels of the husband’s educational status, women who stated that ‘the provision of TT vaccine service was good’ and “health care workers who provide TT vaccine were good in their behavior were statistically significant factors influencing TT protective dose immunization. Promoting husband’s education and creating community awareness rural residents are better options to increase utiliza tion of TT protective dose vaccine
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