Maternal and Neonatal Tetanus Elimination: Where are We Now?

Dhir, Shashi Kant; Dewan, Pooja; Gupta, Piyush

doi:10.2147/rrtm.s201989

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…For example, lower levels of ANC visits among pregnant women have also been shown to be associated with incomplete vaccination among their children in early childhood [27]. Findings from our study support equity-oriented interventions and policies targeted towards pregnant women both within and outside of routine healthcare, such as additional education for healthcare providers on the importance of screening for, providing, and recording TTCV doses during ANC visits, or supplemental immunization activities (SIAs) focused on geographic areas at greatest disadvantage [21,28].…”

Section: Discussionsupporting

confidence: 67%

Comparison of Wealth-Related Inequality in Tetanus Vaccination Coverage before and during Pregnancy: A Cross-Sectional Analysis of 72 Low- and Middle-Income Countries

Johns,

Blumenberg,

Kirkby

et al. 2024

Vaccines

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Immunization of pregnant women against tetanus is a key strategy for reducing tetanus morbidity and mortality while also achieving the goal of maternal and neonatal tetanus elimination. Despite substantial progress in improving newborn protection from tetanus at birth through maternal immunization, umbilical cord practices and sterilized and safe deliveries, inequitable gaps in protection remain. Notably, an infant’s tetanus protection at birth is comprised of immunization received by the mother during and before the pregnancy (e.g., through childhood vaccination, booster doses, mass vaccination campaigns, or during prior pregnancies). In this work, we examine wealth-related inequalities in maternal tetanus toxoid containing vaccination coverage before pregnancy, during pregnancy, and at birth for 72 low- and middle-income countries with a recent Demographic and Health Survey or Multiple Indicator Cluster Survey (between 2013 and 2022). We summarize coverage levels and absolute and relative inequalities at each time point; compare the relative contributions of inequalities before and during pregnancy to inequalities at birth; and examine associations between inequalities and coverage levels. We present the findings for countries individually and on aggregate, by World Bank country income grouping, as well as by maternal and neonatal tetanus elimination status, finding that most of the inequality in tetanus immunization coverage at birth is introduced during pregnancy. Inequalities in coverage during pregnancy are most pronounced in low- and lower-middle-income countries, and even more so in countries which have not achieved maternal and neonatal tetanus elimination. These findings suggest that pregnancy is a key time of opportunity for equity-oriented interventions to improve maternal tetanus immunization coverage.

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Section: Discussionsupporting

confidence: 67%

Comparison of Wealth-Related Inequality in Tetanus Vaccination Coverage before and during Pregnancy: A Cross-Sectional Analysis of 72 Low- and Middle-Income Countries

Johns,

Blumenberg,

Kirkby

et al. 2024

Vaccines

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“…These findings provide further evidence of differences in tetanus immunization strategies across country income groupings. This includes substantial supplementary immunization activities (SIAs) or campaigns in countries with the highest burden of maternal and neonatal tetanus, which are largely low-and lower-middle-income countries, and relatively few such activities in upper-middle-income settings [44]. Additionally, as MNTE has been achieved in all upper-middle-income countries analyzed, the disease is often no longer considered a priority public health issue, and immunization may be considered less necessary as there is near universal access to clean birth environments and adequate umbilical cord management practices [43].…”

Section: Discussionmentioning

confidence: 99%

Inequalities in Immunization against Maternal and Neonatal Tetanus: A Cross-Sectional Analysis of Protection at Birth Coverage Using Household Health Survey Data from 76 Countries

et al. 2023

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Substantial progress in maternal and neonatal tetanus elimination has been made in the past 40 years, with dramatic reductions in neonatal tetanus incidence and mortality. However, twelve countries have still not achieved maternal and neonatal tetanus elimination, and many countries that have achieved elimination do not meet key sustainability thresholds to ensure long-lasting elimination. As maternal and neonatal tetanus is a vaccine-preventable disease (with coverage of the infant conferred by maternal immunization during and prior to pregnancy), maternal tetanus immunization coverage is a key metric for monitoring progress towards, equity in, and sustainability of tetanus elimination. In this study, we examine inequalities in tetanus protection at birth, a measure of maternal immunization coverage, across 76 countries and four dimensions of inequality via disaggregated data and summary measures of inequality. We find that substantial inequalities in coverage exist for wealth (with lower coverage among poorer wealth quintiles), maternal age (with lower coverage among younger mothers), maternal education (with lower coverage among less educated mothers), and place of residence (with lower coverage in rural areas). Inequalities existed for all dimensions across low- and lower-middle-income countries, and across maternal education and place of residence across upper-middle-income countries. Though global coverage changed little over the time period 2001–2020, this obscured substantial heterogeneity across countries. Notably, several countries had substantial increases in coverage accompanied by decreases in inequality, highlighting the need for equity considerations in maternal and neonatal tetanus elimination and sustainability efforts.

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“…Clostidium tetani merupakan bakteri Gram-positif yang berbentuk batang dan merupakan bakteri pembawa spora yang bersifat anaerob obligat (Megighian, Pirazzini, Fabris, Rossetto, & Montecucco, 2021). Bakteri ini dapat masuk kedalam tubuh manusia dan menyebabkan infeksi, tanpa melihat usia dan berdampak kepada kematian ibu (maternal) dan bayi (neonatal) (Dhir, Dewan, & Gupta, 2021).…”

Section: Pendahuluanunclassified

Penyuluhan Imunisasi Tetanus Toksoid Untuk Calon Pengantin Dan Wanita Usia Subur Di Fasilitas Kesehatan Tingkat Pertama

Kusumaratna,

Tan,

Suci

2023

juara. j. wahana. abdimas. sejahtera.

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Tetanus is a serious disease caused by spores of the bacterium Clostridium tetani. Tetanus infection has no boundaries as people of all ages can be infected and it is still a public health problem today, especially for pregnant women and newborns. Neonatal tetanus (TN) is the tetanus infection in infants aged 3 – 28 days after birth and maternal tetanus (MT) is the infection that occurs during pregnancy and up to 6 weeks after delivery. Tetanus infection generally occurs if the delivery is not carried out in health facilities with adequate equipment and is known as one of the most common causes of death during childbirth. The aim of this Community Service activity was to provide counseling about the importance of Tetanus Toxoid (TT) T immunization for prospective brides and WUS who came to the mother and children out-patient clinic at the Primary Health Care. Cadres those bearing an important role in expanding health information for the community were also involved in this program. This Community Service activity held counseling for the prospective bride and fertile-aged women, while the cadres were given refreshing additional knowledge about TT immunization. The results of this activity were increasing the cadres’ knowledge about TT immunization, and those prospective-bride and fertile-aged women were also encouraged to carry out active TT immunization at the Primary Health Care. There is also a need for cross-sector collaboration with the Religious Affairs office in the application of evidence of TT immunization for prospective-bride as a mandatory requirement that could be implemented properly.

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Maternal and Neonatal Tetanus Elimination: Where are We Now?

Cited by 5 publications

References 21 publications

Comparison of Wealth-Related Inequality in Tetanus Vaccination Coverage before and during Pregnancy: A Cross-Sectional Analysis of 72 Low- and Middle-Income Countries

Comparison of Wealth-Related Inequality in Tetanus Vaccination Coverage before and during Pregnancy: A Cross-Sectional Analysis of 72 Low- and Middle-Income Countries

Inequalities in Immunization against Maternal and Neonatal Tetanus: A Cross-Sectional Analysis of Protection at Birth Coverage Using Household Health Survey Data from 76 Countries

Penyuluhan Imunisasi Tetanus Toksoid Untuk Calon Pengantin Dan Wanita Usia Subur Di Fasilitas Kesehatan Tingkat Pertama

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