Prevalence and risk factors associated with rural women’s protected against tetanus in East Africa: Evidence from demographic and health surveys of ten East African countries

Abstract

Background Tetanus is a deadly bacterial infection caused by Clostridium tetani wound contamination characterized muscular spasms and autonomic nervous system dysfunction. Maternal and neonatal tetanus occurs under improper hygiene practices during childbirth. Globally, an estimated 3.3 million newborn deaths occur every year, and about 9,000 babies die every day in the first 28 days of life. This study sought to identify risk factors associated with the immunization of rural women against tetanus in rural areas in ten East African countries. Method The data used in this study were taken from the Demographic and Health Survey (DHS) of ten East African countries (Ethiopia, Burundi, Comoros, Zimbabwe, Kenya, Malawi, Ruanda, Tanzania, Uganda and, Zambia). Multivariable binary logistic regression is used to determine the risk factors associated with tetanus-protected women in east Africa. Results The weighted total samples of 73735 rural women were included in the analysis. The combined prevalence of tetanus immunization among protected rural women in ten East African countries was 50.4%. Those women with age of 24–34 (AOR = 0.778; 95%CI: 0.702–0.861), higher educational level (AOR = 4.010; 95%CI: 2.10–5.670), rich women (AOR = 3.097;95%CI: 2.680–3.583), mass media coverage (AOR = 1.143; 95%CI: 1.030–1.269), having above three antenatal care follow up (AOR = 1.550; 95% CI: 1.424–1.687), big problem of distance to health facility (AOR = 0.676; CI: 0.482–0.978) and place of delivery health facility (AOR = 1.103; 95% CI: 1.005–1.210) had a significant effect on women’s protected from tetanus. Conclusion The coverage of tetanus immunization in East Africa was very low. Public health programs target rural mothers who are uneducated, poor households, longer distances from health facilities, mothers who have the problem of media exposure, and mothers who have not used maternal health care services to promote TT immunization.

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

“…For instance, the oldest age category of women was less likely to have received TTV compared to the youngest age category that is 15–19 years. This finding may contrast with that of earlier studies such as Belay et al [ 21 ] and Yaya et al’s [ 13 ] finding that older women in East Africa and Sierra Leone were more likely to receive TTV due to their exposure to information on TT. It is possible that younger women may be experiencing their first births, which may lead to higher risk perceptions associated with their pregnancy.…”

“…Women with secondary, primary, or no formal education were found to be less likely to have been vaccinated against TT compared to their colleagues who have attained tertiary education. This finding is consistent with that of existing studies in Benin and elsewhere in SSA, suggesting that women with higher educational attainment tend to be more proactive in meeting their health care needs and that of their unborn babies and a such, are more likely to meet the recommended number of ANC visits [ 10 , 21 , 31 , 32 ]. It has been argued that higher educational attainment increases women’s self-awareness about their health care needs and they are more likely to take up preventive health behaviours that are intended to safeguard their health and that of their families.…”

“…During these ANC visits, expectant mothers receive health education on lifestyle and dietary choices, as well as information on preventive health care practices including the usefulness of TTV in protecting the mother and unborn child [ 28 , 29 ]. Given the health promotion activities at health care facilities targeted at expectant mothers, several studies have revealed similar findings where women with frequent ANC visits and delivering in recommended health care facilities were more likely to report receiving TTV relative to their counterparts who did not meet the total number of ANC visits or delivered at home [ 21 , 30 ].…”

Factors associated with utilization of quality antenatal care: a secondary data analysis of Rwandan Demographic Health Survey 2020

“…Although components such as having a blood sample taken, blood pressure measured, urine sample taken and receiving iron tablets/syrups were utilized by over 80% of the women (95.5%, 87.4%, 82.6% and 80.6% respectively), having at least two tetanus injections (33.6%) and receiving drugs for intestinal parasites (43%) were highly underutilized. A similar pattern of low tetanus toxoid vaccine among pregnant women has been registered in the East African region (50.4%) [ 35 ] and in The Gambia (34.8%) [ 36 ]. More efforts such as awareness and sensitization to women and increasing availability of immunization logistics and human resources are needed to ensure increased uptake.…”

Tetanus in Uganda: Clinical Outcomes of Adult Patients Hospitalized at a Tertiary Health Facility Between 2011 and 2020

“…This probably highlights missed opportunities for tetanus vaccination, and it calls for efforts to ensure universal access to tetanus vaccination. In a study by Islam et al [ 26 ], TT vaccination among women correlated with living conditions, whereas another study in East Africa found that less educated women, those who traveled long distances to health facilities, and those who had less access to health information from electronic media were more likely to miss tetanus vaccination [ 27 ].…”