Seroepidemiological surveillance of antitetanus antibodies in Pakistani childbearing women: A population based survey

Abstract

Maternal and Neonatal Tetanus is a severe, often fatal ailment characterized by sweeping augmented strictness and convulsive spasms of skeletal muscles. Vaccination is the most steadfast method of forbearance against this disease and has inculcated to lessen mortalities. The present study was carried out with a view to assess the serum levels of tetanus antitoxins in randomly selected rural and urban women to find out the effect of age, number of pregnancy, parity and number of injections at the time of delivery. The study was cross-sectional in design and hospital-based. The gold standard mouse neutralization assay was employed despite being costly and cumbersome. Antibody titre of each sample was determined by seroneutralization method. 1504 women, randomly selected from various hospitals of age 15 to 40 years, 1064 (0.000) were vaccinated, which are significant while 440 were unvaccinated women and taken as control. The 65% (p = 0.000) women had antibody titre higher than protective level which is significant, 28% equal to protective level and 6.7% below protective level. Average antibody titre of 3rd trimester was higher than 2nd trimester (p = 0.000) which is significant. Immunization awareness and practice was higher in < 30 (78%) than > 30 years in women (63%) of both rural and urban areas but practice was comparatively higher in urban (74%) than rural area (67%). These finding shows that tetanus vaccination in our population is generally effective and cannot be protected by herd immunity, as tetanus is not communicable disease.

A Comparative Approach on Shelf Life Stability of Tetanus Toxoid Vaccine Produced from Imported and Locally Formulated Bulk in Private Sector Facility of Pakistan

“…The determinants of the incidence of neonatal tetanus also relate to the cultural diversity of unhygienic childbirth practices and cord care [4,13] as well. The unskilled attendance with delivery, parent's illiteracy, lack of antenatal care, including low level or no immunization against tetanus, geographical location and climatic prevalence of spores of Clostridium tetani and rural settled populations [7] are some of the factors responsible for this deadly disease. Vaccine shelf-life must be best managed through determination of a minimum potency release requirement, which helps assure good potency throughout expiry.In our study, the testing of the vaccines has been done at the time of batch manufacturing, then six months before expiry, three months before expiry, at expiry month and has also extended its testing for another three months after its expiry for both RTF & Local Formulated bulk filled batches.…”

“…In Pakistan, 898 cases of Neonatal tetanus reported till july 2014 [6]. Vaccination is the most potent methodology against this illness and has gradual impact to subside mortalities [7]. Tetanus vaccine is given to neonates and a pregnant lady, as in mid 1970s it had been enclosed in WHO's expanded program of immunization [8].…”