Tetanus Toxoid Vaccination Coverage Research Articles

Maternal Tetanus Toxoid Vaccination in Benin: Evidence from the Demographic and Health Survey.

Tetanus toxoid vaccination is critical for improving maternal and child health. Yet, the prevalence and correlates of maternal tetanus toxoid vaccination coverage remain largely underexplored in Benin where infant and child mortality rates are high. Using the 2017-18 Benin Demographic and Health Survey, we apply logistic regression analysis to address this void in the literature. We find that overall maternal vaccination coverage is 69%. A range of demographic, health care, and socioeconomic factors are associated with maternal tetanus toxoid vaccination coverage. Women aged 20-34 (OR = 0.84, p < 0.05) and 35-49 (OR = 0.63, p < 0.01) are less likely to receive tetanus toxoid vaccination in comparison to those aged 15-19. Health care factors are also significantly associated with maternal tetanus toxoid vaccination, indicating that women who deliver at home (OR = 0.20, p < 0.001) and visit antenatal care fewer than eight times (OR = 0.62, p < 0.001) are less likely to receive tetanus toxoid vaccination than their counterparts who deliver in a health facility and visit antenatal care eight times or more. We also find that women with secondary (OR = 0.54, p < 0.05), primary (OR = 0.47, p < 0.01), and no education (OR = 0.47, p < 0.01) are less likely to receive tetanus toxoid vaccination compared to their counterparts with higher education. Based on these findings, we discuss several implications for policymakers.

Urban rural differentials in spatial distribution of pregnant women having received Tetanus Toxoid injection by district in Punjab: Results from Pakistan Social and Living Standards Measurements Survey 2014-15.

Dear Madam, Tetanus is a potentially fatal infection caused by Clostridium tetani bacteria, and during childbirth it can infect wounds and results in maternal death.1,2 Tetanus Toxoid (TT) vaccination is a simple, effective and freely available preventive measure available in public sector health facilities in Pakistan for pregnant women that can protect pregnant women and their newborns. Globally, TT vaccination is a standard preventive tool in the arsenal of primary health care service providers. In this study, district level TT vaccination coverage in pregnant women during their last pregnancy, in the Punjab province was mapped using Geographic information Systems to highlight its spatial distribution disaggregated by urban, rural residencystatus and the differences between the two types of dwellers.
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Tetanus Toxoid Vaccination Coverage and Associated Factors among Childbearing Women in Ethiopia: A Systematic Review and Meta-Analysis.

Background Tetanus is a bacterial disease caused by the Clostridium tetani, which is a highly fatal, noncommunicable, and toxin-mediated disease. Globally, maternal and neonatal tetanus is a public health problem due to low maternal tetanus toxoid immunization. Ethiopia has the highest neonatal mortality and morbidity related to tetanus due to low tetanus toxoid immunization and the high number of home deliveries. The main objective of this systematic review and meta-analysis was to estimate the pooled coverage of at least two doses of tetanus toxoid immunization, and the pooled effect sizes of associated factors in Ethiopia. Methods Primary studies for this review were searched from the PubMed/MEDLINE online, ScienceDirect, Hinari, Google, and Google Scholar databases. Primary articles published from 2010 up to August 30, 2020, were included in this meta-analysis. Data were extracted in Microsoft Excel format and exported to STATA Version 14.0. A random-effects meta-analysis model was used to estimate the pooled coverage of two or more tetanus toxoid immunizations and its associated factors. Heterogeneity was evaluated by the I2 test. Egger's weighted regression test was used to assess publication bias. Results We retrieved 212 records; of these, 199 articles were excluded for reasons. Finally, 14 studies were included in this meta-analysis. The pooled estimate of receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia was 52.2% (95% CI: 42.47-61.93, I2 = 98.4%). Antenatal care (OR = 7.8 (95% CI: 3.2, 19.2), I2 = 96.3%), media exposure (OR = 8.3 (95% CI: 2.1, 33.3), I2 = 98.1%), distance from the health facility (OR = 2.64 (95% CI: 1.1, 6.6), I2 = 94.1%), educational status of women (OR = 4.7 (95% CI: 2.07, 9.56), I2 = 94.2%), and educational status of husbands (OR = 2.995 (95% CI: 1.194, 7.512), I2 = 92.5%) were factors significantly associated with receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia. Conclusions The coverage of tetanus toxoid immunization among childbearing women was low in Ethiopia. Strengthening maternal health service utilization (antinatal care and institutional delivery) to the nearest health facility even in health posts and empowering education for both women and their husbands is recommended to increase tetanus toxoid immunization coverage in Ethiopia.

Tetanus Toxoid Vaccination Status of Women of child bearing age in Rangamati Pourashava

Tetanus Toxoid (TT) is a routine vaccination activity under Expanded Program on Immunization (EPI) in Bangladesh. This was a descriptive type of cross-sectional study with a sample size of 110, selected purposively by non-probability sampling technique. Data were collected through a pretested questionnaire. The aim of this study was to assess TT vaccination coverage among the women of child bearing age, Rangamati Pourashava. As per survey, among 110 respondents, 29 (26.4%) were of 15-25 years, 52 (47.3%) were of 26-35 years, 25(22.7%) were of 36-45 years & only 4(3.6%) were of >45years. In this study, the major group, 86(78.2%) were married, 17(15.4%) were unmarried & only 7 (6.4%) were widow. Most of the respondents considered vaccination as the way of disease prevention, so that the coverage being 92 (83.6%) in case of TT vaccination. It was found that 70% women received TT vaccine from Government EPI centers followed by 23.6% from NGO facilities and only6.4% from private clinics. Among the respondents, 56.3% respondents had completed their dose schedule of TT vaccine respectively. Most of the respondents had their vaccination card. The percentage was 70 for TT respectively. Among others, 20% failed to follow it because of forgetfulness of doses and 3.34% because of losing their card. So, TT vaccination coverage among the women of child bearing age was satisfactory but it also suggests that more awareness campaign for vaccination is sensational among the mass people of our country. This study TT vaccination status among women of child bearing age will help to get idea about the woman of our country regarding the situation.
 Mediscope Vol. 8, No. 1: January 2021, Page 40-44

Increasing Frequency of Antenatal Care Visits May Improve Tetanus Toxoid Vaccination Coverage in Pregnant Women in Pakistan

ABSTRACT Objective Maternal and neonatal tetanus (MNT) elimination in low-income countries is a major aim of public health endeavors, due to poor vaccination status, lack of antenatal care, and unhygienic birth practices. The objective of this study, thus, was to assess the present state and factors associated with maternal tetanus toxoid (TT) vaccination in Pakistan. Methods Overall, 80 pregnant women (26 ± 4 y) during their last trimester were recruited from the district hospital Khanewal, Pakistan. The prevalence of vaccination was ascertained through clinical interviews and examination of health records from each participant. A questionnaire-based interview was conducted to assess the education level, antenatal visits, and sociodemographic variables related to vaccination coverage. A generalized linear model was used for statistical analyses. Results Seventy-nine percent of pregnant women were vaccinated with two doses of TT vaccine, while 16% of women were unvaccinated. Overall, 66% of pregnant women received two or more antenatal visits. Two and more than two antenatal visits during pregnancy were associated with significantly increased odds ratios for sufficient TT vaccination (OR = 1.60, CI [95%] 1.34–1.92 and OR = 1.61, CI [95%] 1.32–1.97, respectively) as compared to no or only one antenatal visit. Conclusion Regular antenatal care can improve vaccination coverage during pregnancy. Hence, reducing barriers for visiting antenatal care facilities could be key to reach the goal for MNT elimination.

Factors Contributing to Low Tetanus Toxoid Vaccination Coverage among Young Adult Women in Khairpur District, Sindh

Background: Tetanus remains endemic in poor and developing countries since last decades as compared to rich and advanced countries. Low Tetanus Toxoid (TT) vaccination coverage has led to Tetanus related high morbidity and mortality amongst women and children in developing countries like Pakistan. Therefore, this study aims to assess the coverage of TT vaccination, knowledge about importance of TT vaccination and barriers to get full coverage among young women. Methodology: A cross-sectional study was conducted in district Khairpur among the female students of one Public Sector University. Total of 384 unmarried female students of more than 17 years of age were enrolled in the study. Information on vaccination status and different associated factors was collected through a questionnaire. We used logistic regression analysis to assess factors associated with vaccination status. Results: The mean age of study participants were 20.9 years with 2.15 standard deviation. Total of 311 (81%) respondents had heard about TT vaccination and among 160 (41.7%) major source of information was health care provider. Most of the respondents 303 (78.9%) were considering Tetanus as a health problem. Furthermore, 141 (36.7%) respondents knew that completion of 5 doses of TT vaccination can protect them from Tetanus disease. About 53 % young women were vaccinated for TT including 11% fully vaccinated and 42% partially vaccinated. In multivariable model, those who were aware of Tetanus diseases were more likely to be vaccinated than those who had not heard about Tetanus disease (odds ratio 2.76: 95% confidence interval; 1.19-6.43). Conclusion: We have found significant relationship of knowledge of Tetanus disease and vaccination coverage in the young adult women of Khairpur district. Study suggests the enhanced focus of government and other stakeholders on women’s health education which can increase the uptake of vaccination among young women.

Tetanus Toxoid Vaccination coverage and Reason for non-vaccination among females of reproductive age group

Tetanus Toxoid Vaccination coverage and Reason for non-vaccination among females of reproductive age group

Role of Health Education in Raising Tetanus Toxoid Vaccination Coverage among Pregnant Women and Mothers with Newborns in Khartoum North-Sudan, 2019

<p><em>Tetanus is an acute disease caused by the toxin of a bacterium called C</em><em>lostridium tetani which is often found in soil. It is a life-threatening bacterial disease, which causes severe mortality among maternal, neonatal, and young infant. It is so serious even it can waste pregnancy, harm her baby during pregnancy or after delivery. A quasi experimental community based study was conducted among pregnant women and mothers with newborns in Khartoum North Locality from 2015-2019 with the aim to assess the effectiveness of health education intervening in raising tetanus toxoid vaccination coverage among pregnant women and mothers with new born. 266 participants were selected by using a systematic random sampling technique. The intervention that continued for six months includes; health talks, home visits, video show, presentations with power points, focus groups discussion, exhibitions, distribution of printed materials, pamphlets, brochures and posters. The data was statistically analyzed by using the (SPSS) and significant t and </em><em>c</em><em>2 - tests. The result showed a significant increase in the participants’ knowledge after the intervention towards tetanus toxoid at P value 0.00, the mode of infection with tetanus at P value 0.00, vulnerable group to tetanus at p value is 0.00, the seriousness of the tetanus at P value 0.00, neonatal tetanus at P value 0.00. There was a significant positive modification of the participants’ attitudes towards the easiness to communicate with the health workers at P value 0.00. The result showed a significant change in the participants’ practices towards vaccination against tetanus toxic at P value 0.00 and significant change towards taking vaccine dose regularly at P value 0.00. The study recommended that Federal Ministry of Health has to conduct many health education interventions to raise the tetanus toxoid vaccination coverage. </em><em></em></p>

Knowledge about the importance of antenatal care among females of child bearing age living in a suburban community of Lahore.

Background and Objectives:During the past few decades, females had been making conscious decision to have antenatal checkup from skilled health care provider due to improved education which had played a vital role to enhance their awareness regarding the importance of this comprehensive health service. The objective was to find out the perception of females of child bearing age about the importance of antenatal care during their last pregnancy, living in a suburban community of Kot-Lakhodare Lahore.Methods:Females of reproductive age (15-49 years) living in Kot-Lakhodare were enrolled. Through a structured questionnaire, using convenient sampling technique, 1224 females of childbearing were interviewed through a cross sectional survey. The study was completed between January till August 2016. Question pertaining to their sociodemographic characteristics, perception about the importance of antenatal care services and comorbid conditions during the last pregnancy were asked. Data was analyzed by using SPSS version 21. The ethical approval both institutional and individual were duly taken.Results:Mean age was 32 ±7.8SD years with education up to primary. Three quarter of females were un- employed with monthly income less than rupees 25,000 / month. All females 869(73%) who had perception about importance of antenatal checkup during their last pregnancy had no history of anemia, hypertension, diabetes and abortion (p<0.05). These females coming for the antenatal checkup delivered uneventfully by normal vaginal route and preferred government and private hospital for delivery and were vaccinated against Tetanus Toxoid (p<0.05).Conclusion:The females of child bearing age during the last pregnancy had adequate knowledge about the importance of antenatal care which played an important role in prevention of comorbid conditions like anemia, hypertension, diabetes and risk of abortion. Moreover, they had the perception of importance of institutionalized deliveries, tetanus Toxoid vaccination coverage during pregnancy.

Study on tetanus toxoid vaccination coverage among female garment workers in two selected factory

This was a cross sectional descriptive study conducted to assess the coverage of tetanus vaccine immunization among the female garment workers using a semi-structured questionnaire employing purposive sampling technique with a sample size of 214 by face to face interview from March to June 2018. Most of the respondents (44%) belonged to the 25-30 years age group. Majority (68%) of them were illiterate and Only 15% of the respondents had education level of HSC or more. More than half of the respondents were unmarried. The mean monthly income was taka 2275. It was revealed that 160, (74.76%) of the respondents completed immunization schedule, 40, (18.70%) not completed while 14, (6.54%) were not immunized against EPI diseases. There is statistically significant association between education and immunization status (p=&lt;0.05). Prevention of tetanus specially depends on tetanus immunization and early diagnosis. Health education and positive public attitude will play significant role in prevention and control the tetanus. The study recommends for effective strategies to increase TT5 vaccination coverage countrywide especially among vulnerable women.

Factors related to the escapement of reproductive age women from tetanus toxoid vaccination at the Sub – Divisional Medicalized Health Center Nkwen, Bamenda

The purpose of this study was to find out the factors related to the escapement of reproductive age women from tetanus toxoid vaccination at the Sub – Divisional Medicalized Health Center Nkwen Bamenda. A cross – sectional hospital based study was conducted in which 100 reproductive aged women (15 – 40 years) were randomly selected to participate. Demographic and clinical data were collected from participants and health personnel using a well – structured pre – tested questionnaire. From the results obtained, most of the women were within the age range of 26 – 30 years (41.1%) and were graduates (40.0%) that were employed (36.7%). Most of the reproductive age women had not taken any dose of the vaccine (54.5%) reasons being that they did not know the time the vaccine was given (80.0%), they were not aware (71.1%) and that they were scared of the side effects (61.0%). From the point of view of the health professionals, misconception about the vaccine (90.0%), poor socio – economic status (90.0%) and lack of awareness (80.0%) were the major reasons of the low tetanus toxoid vaccination coverage. In conclusion, majority of the reproductive age women are not vaccinated and notably, lack of awareness, fear of side effects and not knowing the time the vaccine is given were the main reasons for their escapement.

Assessment of Pregnant Women's Knowledge about Tetanus Toxoid Vaccination in Karbala City

Objectives of the study: Assess pregnant women's knowledge about tetanus toxoid vaccination, to find out therelationship between pregnant women's knowledge and some variables which included: (age, level ofeducation, occupational status, socio-economic level, gravidity, parity, following visits of antenatal care,tetanus toxoid vaccination coverage).Methods and Materials: Descriptive analytic study conducted on multistage probabilistic sample of 130pregnant women during period from 30th January 2012 to the 24th April 2013 was carried out in the six primaryhealth care centers at Karbala city. The questionnaire was consisted of four parts which include of: sociodemographiccharacteristics, reproductive information, knowledge about tetanus toxoid vaccination, sources ofinformation regarding tetanus toxoid vaccine. Content validity and reliability of the questionnaire weredetermined through pilot study, descriptive and inferential statistics were used to analyze the data.Results: The results of the study showed that highest percentage (29.2%) of study sample were at age group(20-24) years, (31.5%) of them were not read and write, and (97.7%) of them were housewives. The highestpercentage (68.5%) of them were living in low socio-economic level, the highest percentage (50.8%) of studysample were had (2–4) pregnancies, and (40.8%) of them were had (2-4) deliveries, (72.3%) of them haveirregular visits to antenatal care, (76.2%) of them have partial vaccination coverage. Their knowledge wereadequate in some items ,and inadequate in other items, (72.3%) of them were not provided with informationabout tetanus toxoid vaccine about it, (61.11%) of women that provided with information answered ; doctorswere source of their information. There were statistical significant association between level of knowledge and(Level of education and Tetanus toxoid vaccination coverage) with probability value ≤ 0.05.Recommendations: The study recommended to enhance women's knowledge on tetanus by using the variousmass media to increase the coverage of tetanus toxoid. Encouraging the pregnant women to have regularantenatal care visits which consider the cause to contact with sources of tetanus toxoid and hence increase thechance of vaccination.

Tetanus Toxoid Vaccination Coverage Among Women of Reproductive Age: Experience From a Rural Community

Tetanus Toxoid (TT) is a routine vaccination activity under Expanded Program on Immunization (EPI) in Bangladesh. The women of reproductive age (15-49 years) are the target population for five doses of TT vaccine to protect them from tetanus. The study was a cross-sectional study in context of a rural community. The study was conducted to assess TT vaccination coverage among the women of reproductive age in a rural community of Bangladesh. A total of 224 women of reproductive age were randomly included in the study following selection criteria. Data was collected by recall history and reviewing immunization card by using a semi-structured questionnaire and checklist respectively. Data was processed and analyzed considering both descriptive and inferential statistics. Mean age of the women was 27.22 ± 6.87 years and major part (30.4%) was illiterate. Most of the women were married (87.6%) and housewives (81.3%). Mean age at marriage was 17+2.37 years and mean age at first child birth was 18+2.24 years. On the basis of recall history and vaccination card, 83.5% women received first dose of TT (TT1), while 16.5% didn't receive any TT vaccine. Among the women received all five doses of TT, 'Crude Vaccination Rate" was 37.0% and ''Valid Vaccination Rate' was 33.0%. By card, these rates were 18.5% and 14.2% respectively. The invalid doses found 6.2% for TT2, 7.3% for TT3, 12.5% for TT4 and the lowest 10.8% for TT5 dose. The dropout rate was 5.3% for TT1-TT2, 14.7% for TT2-TT3, the highest 31.1% for TT3-TT4 and 20.2% for TT4-TT5 while 55.6% was for TT1-TT5. Vaccination coverage was significantly higher among the women aged 25-29 years (91.0%) and having HSC level education (92.3%) (x2 test, p&lt;0.05). An incredible segment of rural women didn't receive any dose of TT5 vaccine and dropout rate was significantly higher among poor and illiterate women. Painstaking interventions and strategies should be taken to increase TT5 vaccination coverage among the rural women to protect them from tetanus. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18780 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 37-41

Determinants Of The Utilization Of The Tetanus Toxoid (TT) Vaccination Coverage In Bangladesh: Evidence From A Bangladesh Demographic Health Survey 2004

Objectives: This paper employs statistical methods to determine the complete vaccination rate and to identify the factors that influence vaccination of mothers during pregnancy. The principal objective of this paper is to suggest various policy options on the basis of study findings in order to provide guidelines to fulfill the complete vaccination coverage in Bangladesh. Methods: This study analyzes data extracted from Bangladesh Demographic and Health Survey 2004 (BDHS) considering only the case of the mothers of last five years preceding the survey. To meets the objectives this study considers bivariate and multivariate analysis Results: The analysis showed that, although maximum respondents received two or more doses of TT injection a significant portion of women did not receive the TT injection yet (18.6 percent). The immunization coverage of two/more doses was higher among mothers whose husbands are highly educated and non-manual workers. This study elucidates that the rate of immunizing increases with the increase of mother's education. Receiving two/more doses of TT injection shows highest prevalence (58.3 percent) among mothers whose mobility status is unrestricted. The logistic analysis showed that receiving two or more doses of TT injection is almost 3 times higher among respondents using modern toilet facility. The model also shows that higher proportion of respondents belonging to upper category regarding household asset and quality index received two/more doses TT injection than their congruent parts. The other contributing factors for tetanus toxoid vaccination coverage were found to be mother's age at last birth, told about pregnancy complications, place of residences, mother's earning status, sources of drinking water. Conclusion: The results indicate several policy options: (1) improve the monitoring and supervision of vaccination activities especially in the rural area (2) mass media campaign to create awareness among both urban and rural women, their husbands and families about the importance of TT vaccination and the consequences of not being vaccinated (3) education for husband's and wife needs to be given very high priority (4)enable women to exercise their rights to control their concerning freedom of movement, own health acre and access to economic resources

Causes of low tetanus toxoid vaccination coverage in pregnant women in Lahore district, Pakistan

To assess the causes of low tetanus toxoid (TT) vaccination coverage in pregnant women a mixture of quantitative and qualitative methods were adopted at the community, primary health care delivery and management levels in Lahore district, Pakistan. Out of a random sample of 362 women who had delivered during the previous 3 months, 87% recalled receiving 2 doses of TT. The main reasons for non-vaccination were poor knowledge about the importance of TT (32% of women) or the place and time to get vaccinated (18%). According to the managers and primary health care medical officers, the main reasons for low coverage were lack of awareness about the importance of vaccination among the public and misconceptions about TT vaccination (e.g. that it was a contraceptive).