Tetanus Toxoid Vaccination Uptake and Associated Factors among Mothers Who Gave Birth in the Last 12 Months in Errer District, Somali Regional State, Eastern Ethiopia

Abstract

Background. Maternal tetanus is defined as tetanus acquired during pregnancy or within 6 weeks after the end of conception. As tetanus is a vaccine-preventable disease, immunization of pregnant mothers with a TT (tetanus toxoid) dose is one of the most effective ways to protect against the disease. Some studies showed that 94% of neonatal mortality reduction could be achieved through immunization of pregnant and childbearing-age mothers with at least two doses of TT vaccination. Objective. To assess the uptake of tetanus toxoid vaccine and associated factors among mothers who gave birth in the last 12 months in Errer district, Somali Regional State, Eastern Ethiopia, 2017. Methods and Materials. A community-based cross-sectional study design was implemented to study 440 mothers who gave birth in the last 12 months. Participants were selected using the strata and systematic sampling technique after conducting a preliminary survey. Data were collected through a face-to-face interviewer-administered questionnaire. The collected data was entered into EpiData version 3.02 and then exported to Statistical Package for the Social Sciences (SPSS) version 20. Bivariate and multivariate logistic regressions were carried out to see the association between variables at p<0.05 and 95% confidence interval. Finally, the information was presented by using frequencies, summary measures, and tables. Result. The overall tetanus vaccination uptake (≥TT2) doses was found to be 51.8%, 95% CI (47.7%, 56.4%). The total number of mothers who complete the five TT doses was 31 (14.8%). Urban residence [AOR=6.1, 95% CI: (2.33, 10.43)], multiparity [AOR=2.3, 95% CI: (1.7, 6.4)], and traveling less than 30 minutes from the home to a health facility [AOR=4.6, 95% CI: (1.34, 6.72)] were some the factors that were significantly associated with tetanus toxoid vaccination uptake. Conclusion and Recommendation. Although TT immunization is a scientifically proven mechanism to protect against maternal and neonatal tetanus, only half of the district mothers received ≥TT2 doses. Besides, our study revealed that the low vaccine uptake is attributed to long distance travel to reach a health facility, maternal illiteracy, and pastoralist lifestyle of mothers in the district. Thus, the regional stakeholders are required to scale up efforts on mother’s awareness creation towards the importance of the vaccine through health education and to arrange outreach TT vaccination campaigns in distant pastoralist communities within the region.

Sociodemographic and health‐related determinants of seasonal influenza vaccination in pregnancy: A systematic review and meta‐analysis of the evidence since 2000

“…Frequent visits to a physician have been shown to be associated with increased receipt of SIV and may explain the association found between receipt of prenatal care and increased SIV uptake 72 . Whereas we found an association between nulliparity and increased SIV uptake, Gebremedhin et al 73 found multiparity to be associated with increased uptake of tetanus toxoid vaccine in Eastern Ethiopia. However, our findings may be explained by the higher risk of adverse birth outcomes among nulliparous compared with multiparous women, 74 which may inform increased preventive care by a healthcare provider in many of the developed countries.…”

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

“…In this review, primary studies with a total of 13,731 study participants were included. The studies were conducted from 2010 to 2020 and were retrieved from ve regions of the country: 4 from the southern region, 3 from Amahara, 3 from Oromia, 1 from Tigray, 1 from Somalia, and another study was based on EDHS data [34][35][36][37][38][39][40][41][42][43][44][45][46]. All of these studies included in this review were community-based cross-sectional studies with sample sizes ranging from 239 to 7193 participants as reported from studies done in Bahir Dar and studies from EDHS data respectively [34,39].…”

“…Distance from home to health facility was identi ed as a factor associated with two or more tetanus toxoid immunization among three primary studies with a total of 1933 study participants [38,43,44]. Women who walked less than 1 hour to reach health facilities were 2.6 times more likely to take tetanus toxoid immunization than mothers who walked greater than or equal to 1 hour to reach the health facility [OR = 2.635 (95% CI; 1.1, 6.6)] (Figure 8).…”

“…The educational status of the mothers was signi cantly associated with tetanus toxoid immunization coverage among ve primary studies included in our analysis [37,38,40,42,43]. A total of 2884 mothers were included in the analysis to examine the association of the educational status of the mothers and tetanus toxoid immunization.…”

“…Three primary studies reported that the husband's educational status was associated with receiving two or more dose of tetanus toxoid immunization with a total sample of 1957 mothers [37,38,40]. Accordingly, women whose husbands had no formal education were 81.6% less likely to receive two or more tetanus toxoid immunization as compared to women having educated husbands [OR = 0.184 (95% CI; 0.104, 0.323)] ( Figure 10).…”