Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

The role of timely initiation of antenatal care on protective dose tetanus toxoid immunization: the case of northern Ethiopia post natal mothers

Authors: Muhabaw Shumye Mihret, Miteku Andualem Limenih, Temesgen Worku Gudayu

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Login to get access

Abstract

Background

Globally, tetanus toxoid protective dose immunization of the mothers is one of the strategies of maternal and neonatal tetanus prevention. Ethiopia has planned the national tetanus protection at birth coverage to reach 86% by the year 2015. However, there is still low coverage with less identified associated factors. Therefore; the purpose of this study was to assess tetanus toxoid protective dose immunization at last birth and associated factors among mothers who gave birth within one year prior to the study in Debretabor town, Northwest Ethiopia, 2016.

Methods

A community based cross sectional study was conducted from May 1 to June 10 / 2016. A total of 511 mothers were included in the study. Structured questionnaire and checklists were used to collect the data. Face to face interview with cross checking documented record were employed. A systematic random sampling technique was used. The data were entered in to Epinfo version 7.0 and then exported to SPSS version 20.0 for analysis. Both bivariate and multivariable logistic regression model were fitted and crude and Adjusted Odds ratio with 95% confidence interval were computed. Finally, statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value ≤0.05.

Result

The proportion of tetanus toxoid protective dose immunization among mothers was 56.2% (95% CI: 52–60%). In the multivariable analysis; formal education (AOR = 2.09; 95%CI: 1.12, 3.90), planned last pregnancy (AOR = 6.63; 95%CI: 2.36, 18.63), four or more antenatal care visits (AOR = 5.16; 95%CI: 2.93, 11.14), timely antenatal care visit (AOR = 4.29; 95%CI: 1.94, 9.49), and perceived good quality of service (AOR = 2.20; 95% CI: 1.26, 3.84) were positively associated with tetanus toxoid protective dose immunization.

Conclusion

In this study, protective dose tetanus toxoid immunization is lower than the national target. Strengthening information education communication regarding tetanus and its prevention and encouraging timely initiation of and complete attendance of antenatal care is recommended.
Appendix
Available only for authorised users
Literature
1.
Minisitry of Health: Ethiopia national Expanded Programme on Immunization. 2010.
2.
Federal Republic of Ethiopia Minstry of Health: HMIS / M&E Indicator Definitions HMIS / M&E Redesign: Technical Standards: Area 1 version 1.0. 2007.
3.
World Health Organization: Tetanus vaccine. Weekly epidemiological record 2006.
4.
Thwaites CL, Farrar JJ. Preventing and treating tetanus -The challenge continues in the face of neglect and lack of research. Biomed J. 2003;326(7381):117–8.
5.
World Health Organization. Protection at birth (PAB) against tetanus. In: Global Health Observatory data; 2015.
6.
7.
Blencowe H, Lawn J, Vandelaer J, Roper M, Cousens S. Tetanus toxoid immunization to reduce mortality from neonatal tetanus. Int J Epidemol. 2010;27:102–9.
8.
Demicheli V, Barale A, Rivetti A. Vaccines for women for preventing neonatal tetanus. Cochrane Collaboration. Cochrane Database Syst Rev. 2015:1.
9.
Thwaites CL, Loan HT. Eradication of tetanus. Oxford J British Med Bulletin. 2015;116(1):69–77.
10.
11.
World Health Organization. Maternal and neonatal tetanus (MNT) elimination-the initiative and challenges. Immun Vaccin Biol. 2015;21:1–2.
12.
Central Statistical A. Ethiopian demographic and health survey key indicators report. Rockville: The DHS Program, ICF; 2016.
13.
Ethiopia Central Statistical Agency. Ethiopia Demographic and Health Survey 2011. Calverton: ICF International; 2012.
14.
15.
16.
World Health Organization. neonatal tetanus. Immun Vaccin Biol. 2015;512:1–4.
17.
Khan R, Vandelaer J, Yakubu A, Raza AA, Zulu F. Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all. J Women's Health. 2015;171–180:7.
18.
The Federal Democratic Republic of Ethiopia Ministry of Health: Health Sector Transformation Plan. 2015.
19.
Kidane T, Yigzaw A, Sahilemariam Y, Bulto T, Mengistu H, Belay T, Bisrat F, Benti D, Mbakuliyemo N, Olusegum B. National EPI coverage survey report in Ethiopia, 2006. Ethiop J Health Dev. 2008;22:1–5.
20.
WHO and UNICEF: Estimates of immunization coverage 2014.
21.
Federal Democratic Republic of Ethiopia Ministry of Health: Health Sector Development Programme IV 2014.
22.
Ethiopia Central Statistical Agency. Tetanus Toxoid Vaccination; 2005. p. 115–7.
23.
Federal Democratic Republic of Ethiopia Population Census Commission. Summary and statistical report of the 2007 population and housing census :population size by age and sex. In: United Nations Population Fund; 2008.
24.
Adugna E. factors influencing tetanus toxoid immunization and protection at birth coverage among child breang age women of Ambo town and its surrounding area. Ethiopia: Oromia regional state; 2011.
25.
World Health Organization: Protection at birth against neonatal tetanus(PAB) data by WHO Region 2015.
26.
Sule SS, Nkem-Uchendu C, Onajole AT, Ogunowo BE. Awareness, perception and coverage of tetanus immunisation in women of child bearing age in an urban district of Lagos, Nigeria. Niger Postgraduate Med J. 2014;21(2):107–14.
27.
Nwokeukwu HI, Ukegbu AU, UE-U KCN, Nwankwo N, Osunkwo D, Ajuogu E. Tetanus Toxoid Immunization Coverage in Federal Medical Centre, Umuahia, Abia State,South East Zone, Nigeria. International journal of tropical disease & health. 2014;4(12):1268–77.CrossRef
28.
Maral I, Baykan Z, Aksakal FN, Kayikcioglu F, Bumin MA. Tetanus immunization in pregnant women: evaluation of maternal tetanus vaccination status and factors affecting rate of vaccination coverage. Public Health. 2011;115(5):359–64.
29.
Orimadegun AE. Akinlolu a Adepoju, Olusegun O Akinyinka: prevalence and socio-demographic factors associated with non-protective immunity against tetanus among high school adolescents girls in Nigeria. Ital J Pediatr. 2014;40(29):1–8.
30.
Diamenu SK, Bosnu G, Abotsi F, Tweneboa PO, Okoh-Owusu M, Amoh P, Yakubu A, Khan R. Introducing protection at birth (Pab) method of monitoring tetanus-diphtheria (td) vaccination coverage of mothers in Ghana. International Journal of Vaccines and Immunization. 2015;1:1.
31.
Hasnain S, Sheikh NH. Causes of low tetanus toxoid vacccinatiuon coverage in pregnant women in Lahore District,Pakistan. East Mediterr Health J. 2007;13(5):1142–52.CrossRefPubMed
32.
Hashmi FK, Islam M, Khan TA, Tipu MK. Vaccination coverage of mothers during pregnancy with tetanus toxoid and infants after Birth. Pakistan J Pharmacy. 2011;24(2):1–3.
33.
Hager Awad Saeed Sultan: Assessment of tetanus toxoid coverage and protection at birth against neonatal tetanus in Khartoum state, Sudan. 2009.
34.
Rahman M. Determinants of the utilization of the tetanus toxoid (TT) vaccination coverage in Bangladesh: evidence from a Bangladesh demographic health survey 2010. Internet J Health. 2010;8(2):3–5.
35.
Guthmann JP, Fonteneau L, Antona D, Lévy-Bruhl D. Factors associated with tetanus vaccination coverage in adults in France and with knowledge of vaccination status. Medecine et maladies infectieuses. 2010;40(10):560–7.CrossRefPubMed
36.
Walle F, Kassa M. Coverage and factors associated with tetanus toxoid vaccination among private college students, Bahirdar, Ethiopia. J Vaccine. 2013;4:106.
37.
Rahman M. Tetanus toxoid vaccination coverage and differential between urban and rural areas of Bangladesh. East African journal of public health. 2009;6(1):26–31.PubMed
38.
Zelalem TH, Chertok IRA, Teweldeberhan AK. Determinants of utilization of sufficient tetanus toxoid immunization during pregnancy: evidence from the Kenya demographic and health survey, 2008–2009. J Community Health. 2013;38:492–9.CrossRef
39.
Naeem M, Khan MZ-U-I, Abbas SH, Adil M, Khan A, Naz SM, Khan MU. coverage and factors associated with tetanus toxoid vaccination among married women of reproductive age: a cross sectional study in Peshawar. J Ayub Med College. 2010;22(3):1.
40.
Anokye M, John A, Mensah, Frank O, Frimpong, Emelia O, Aboagye, Acheampong N. Immunization coverage of pregnant women with tetanus toxoid vaccine in Dormaa East District-Brong Adaro region, Ghana. Mathematical Theory and Modeling. 2014;4:6.
41.
Beel ER, Rench MA, Montesinos DP, Mayes B, Mary Healy C. Knowledge and attitudes of postpartum women toward immunization during pregnancy and the peripartum period. Human vaccines & immunotherapeutics. 2013;9(9):1926–31.CrossRef
Metadata
Title
The role of timely initiation of antenatal care on protective dose tetanus toxoid immunization: the case of northern Ethiopia post natal mothers
Authors
Muhabaw Shumye Mihret
Miteku Andualem Limenih
Temesgen Worku Gudayu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1878-y

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue

Research article

Prevalence and risk factors of gestational diabetes mellitus: findings from a universal screening feasibility program in Lima, Peru

Study protocol

Oxidative stress and endothelial function in normal pregnancy versus pre-eclampsia, a combined longitudinal and case control study

Research article

Obstetric and perinatal outcomes of singleton pregnancies conceived via assisted reproductive technology complicated by gestational diabetes mellitus: a prospective cohort study

Research article

Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia

Research article

A retrospective study of gestational weight gain in relation to the Institute of Medicine’s recommendations by maternal body mass index in rural Pennsylvania from 2006 to 2015

Research article

Not now but later – a qualitative study of non-exercising pregnant women’s views and experiences of exercise