Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone

Abstract

Background: Immunization of women during pregnancy to protect them and their infants against tetanus, pertussis and influenza is recommended by the World health Organization (WHO). However, there is limited information about the coverage rate and associated factors in low-income countries. The aim of this study was to measure the prevalence and predictors of taking tetanus toxoid among pregnant women in Sierra Leone. Methods: This study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Sierra Leone in 2017. In total 8722 women aged between 15 and 49 years were included in this study. Outcome variable was taking of Tetanus Toxoid vaccination during the last pregnancy. Data were analyzed using cross-tabulation and logistic regression methods. Results: The overall prevalence of receiving TT immunization during women's last pregnancy was 96.3% and that of taking at least two doses was 82.12%. In the regression analysis, women from Mende ethnicity had a 0.48 fold lower chance of being immunized (OR = 0.480, 95% CI = 0.385,0.59768) than those from the other ethnicity. In addition, women who attended at least four ANC visits had higher odds of receiving TT vaccine (OR = 1.919, 95% CI = 1.639, 2.245) compared to those who attended less ANC visits. Stratified by areas, this association was observed in both urban (OR = 2.661, 95% CI = 1.924,3.679) and rural areas (OR = 1.716, 95% CI = 1.430,2.059). Attending at least four ANC visits showed a positive association with receiving at least two doses TT (OR = 2.434, 95% CI = 1.711,3.464) in both urban (OR = 2.815, 95% CI = 1.413,5.610) and rural areas (OR = 2.216, 95% CI = 1.463,3.356) as well. Conclusion: Higher number of ANC visits, mass media exposure and higher wealth quintile increased the odds of receiving TT immunization. In addition, minimum two doses which were identified to reduce neonatal mortality. Therefore, immunization campaigns targeting improved utilization of healthcare and immunization services by women of childbearing age in Sierra Leone are strongly recommended.

Tetanus toxoid immunization Coverage and associated factors in Ethiopia: A systematic review and meta-analysis.

“…This nding was consistent with a report from studies conducted in Kenya 52.0% and Pakistan 55.6% [18,47]. It was low compared to studies conducted in different developing countries such as Ghana 71% [48], India 68% [16], and Sierra Leone 82.1% [49]. The possible explanation for this difference might be due to geographical differences, sociocultural variation and maternal and child health service utilization.…”

Factors associated with births protected against neonatal tetanus in Africa: Evidences from Demographic and health surveys of five African countries

“…In this study, those women with ANC follow up had higher chance of having births protected from tetanus compared to mothers with no ANC follow up. Similarly, evidence from Sierra Leone, Ethiopia, and Kenya strengthened our findings [ 10 , 11 , 15 , 16 ]. The possible reason is that women with ANC follow up usually have an increased awareness about the importance of taking TT immunization, one of the ANC service packages, and mothers who had ANC follow up are more likely to get vaccinated and immunized against tetanus which in turn results in births protected against neonatal tetanus [ 31 ].…”

“…According to the finding of different studies, antenatal care [10][11][12][13][14][15][16][17], women education [11,14,[16][17][18], income [12,13,15,18], distance to a health facility [11,12,14,19], residence [14,18,19], parity [19], husband education [12,14,18], maternal age at last birth [18], women's employment status [15] and media exposure [11,17] are significantly associated with births protected against neonatal tetanus.…”

Tetanus Toxoid Vaccination Coverage and Associated Factors among Childbearing Women in Ethiopia: A Systematic Review and Meta-Analysis

“…This finding was consistent with a report of studies conducted in Kenya (52.0%) and Pakistan (55.6%) [ 18 , 48 ]. It was low compared to studies conducted in other developing countries such as Ghana 71% [ 49 ], India 68% [ 16 ], and Sierra Leone 82.1% [ 50 ]. The possible explanation for this difference could be due to geographical differences, sociocultural variation, and maternal health service utilization between the countries.…”