The role of timely initiation of antenatal care on protective dose tetanus toxoid immunization: the case of northern Ethiopia post natal mothers

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Abstract

Background

Globally, tetanus toxoid protective dose immunization of the mothers is one of the strategies of maternal and neonatal tetanus prevention. Ethiopia has planned the national tetanus protection at birth coverage to reach 86% by the year 2015. However, there is still low coverage with less identified associated factors. Therefore; the purpose of this study was to assess tetanus toxoid protective dose immunization at last birth and associated factors among mothers who gave birth within one year prior to the study in Debretabor town, Northwest Ethiopia, 2016 .

Methods

A community based cross sectional study was conducted from May 1 to June 10 / 2016. A total of 511 mothers were included in the study. Structured questionnaire and checklists were used to collect the data. Face to face interview with cross checking documented record were employed. A systematic random sampling technique was used. The data were entered in to Epinfo version 7.0 and then exported to SPSS version 20.0 for analysis. Both bivariate and multivariable logistic regression model were fitted and crude and Adjusted Odds ratio with 95% confidence interval were computed. Finally, statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value ≤0.05.

Result

The proportion of tetanus toxoid protective dose immunization among mothers was 56.2% (95% CI: 52–60%). In the multivariable analysis; formal education (AOR = 2.09; 95%CI: 1.12, 3.90), planned last pregnancy (AOR = 6.63; 95%CI: 2.36, 18.63), four or more antenatal care visits (AOR = 5.16; 95%CI: 2.93, 11.14), timely antenatal care visit (AOR = 4.29; 95%CI: 1.94, 9.49), and perceived good quality of service (AOR = 2.20; 95% CI: 1.26, 3.84) were positively associated with tetanus toxoid protective dose immunization.

Conclusion

In this study, protective dose tetanus toxoid immunization is lower than the national target. Strengthening information education communication regarding tetanus and its prevention and encouraging timely initiation of and complete attendance of antenatal care is recommended.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-1878-y) contains supplementary material, which is available to authorized users.

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Most cited references 15

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Nutritional management and follow up of infants and children with food allergy: Italian Society of Pediatric Nutrition/Italian Society of Pediatric Allergy and Immunology Task Force Position Statement

Marcello Giovannini, Enza D’Auria, Carlo Caffarelli … (2014)

Although the guidelines on the diagnosis and treatment of food allergy recognize the role of nutrition, there is few literature on the practical issues concerning the nutritional management of children with food allergies. This Consensus Position Statement focuses on the nutritional management and follow-up of infants and children with food allergy. It provides practical advices for the management of children on exclusion diet and it represents an evidence-based consensus on nutritional intervention and follow-up of infants and children with food allergy. Children with food allergies have poor growth compared to non-affected subjects directly proportional to the quantity of foods excluded and the duration of the diet. Nutritional intervention, if properly planned and properly monitored, has proven to be an effective mean to substantiate a recovery in growth. Nutritional intervention depends on the subject’s nutritional status at the time of the diagnosis. The assessment of the nutritional status of children with food allergies should follow a diagnostic pathway that involves a series of successive steps, beginning from the collection of a detailed diet-history. It is essential that children following an exclusion diet are followed up regularly. The periodic re-evaluation of the child is needed to assess the nutritional needs, changing with the age, and the compliance to the diet. The follow- up plan should be established on the basis of the age of the child and following the growth pattern.

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Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all

Rownak Khan, Jos Vandelaer, Ahmadu Yakubu … (2015)

A total of 35 of the 59 countries that had not eliminated maternal and neonatal tetanus (MNT) as a public health problem in 1999 have since achieved the MNT-elimination goal. Neonatal tetanus deaths have decreased globally from 200,000 in 2000 to 49,000 in 2013. This is the result of increased immunization coverage with tetanus toxoid-containing vaccines among pregnant women, improved access to skilled birth attendance during delivery, and targeted campaigns with these vaccines for women of reproductive age in high-risk areas. In the process, inequities have been reduced, private–public partnerships fostered, and innovations triggered. However, lack of funding, poor accessibility to some areas, suboptimal surveillance, and a perceived low priority for the disease are among the main obstacles. To ensure MNT elimination is sustained, countries must build and maintain strong routine programs that reach people with vaccination and with clean deliveries. This should also be an opportunity to shift programs into preventing tetanus among all people. Regular assessments, and where needed appropriate action, are key to prevent increases in MNT incidence over time, especially in areas that are at higher risk. The main objective of the paper is to provide a detailed update on the progress toward MNT elimination between 1999 and 2014. It elaborates on the challenges and opportunities, and discusses how MNT elimination can be sustained and to shift the program to protect wider populations against tetanus.

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Determinants of utilization of sufficient tetanus toxoid immunization during pregnancy: evidence from the Kenya Demographic and Health Survey, 2008-2009.

Zelalem Haile, Ilana Chertok, Asli K Teweldeberhan (2013)

Although the effectiveness of tetanus toxoid (TT) immunization during pregnancy in preventing maternal and neonatal tetanus is well established, in many developing countries, TT immunization programs are underutilized. The objective of this study was to examine factors associated with sufficient TT immunization among postpartum women in Kenya. Population based secondary data analysis was conducted using de-identified data from the 2008-2009 Kenyan Demographic and Health Survey (KDHS) for 1,370 female participants who had a live birth during or within 12 months of the cross-sectional survey. Chi-square test and independent sample t test were conducted to assess bivariate associations and a multivariable logistic regression analysis was conducted to examine associations before and after adjustment for demographic, socioeconomic, cultural, and access to care factors. The main factors contributing to having been sufficiently immunized against tetanus were lower birth order, higher household wealth index, women's employment, making joint health-related decisions with a partner, and higher number of antenatal care visits. Implications for health care providers and other professionals involved in development of strategies and interventions aimed at improving immunization rates are discussed.

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Author and article information

Contributors

Muhabaw Shumye Mihret: muhabawshumye@gmail.com

Miteku Andualem Limenih: mitekuandualem2017@gmail.com

Temesgen Worku Gudayu: teme.worku@gmail.com

Journal

Journal ID (nlm-ta): BMC Pregnancy Childbirth

Journal ID (iso-abbrev): BMC Pregnancy Childbirth

Title: BMC Pregnancy and Childbirth

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2393

Publication date (Electronic): 15 June 2018

Publication date PMC-release: 15 June 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 235

Affiliations

ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Midwifery, College of Medicine and Health Sciences, , University of Gondar, ; Po. Box 196, Gondar, Ethiopia

Article

Publisher ID: 1878

DOI: 10.1186/s12884-018-1878-y

PMC ID: 6003212

PubMed ID: 29907139

SO-VID: 4e29f7aa-b42c-4c35-a231-610afe5e2fc6

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 2 January 2018

Date accepted : 31 May 2018

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: debretabor,immunization,protective dose,tetanus toxoid

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: debretabor, immunization, protective dose, tetanus toxoid

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The role of timely initiation of antenatal care on protective dose tetanus toxoid immunization: the case of northern Ethiopia post natal mothers

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Most cited references 15

Nutritional management and follow up of infants and children with food allergy: Italian Society of Pediatric Nutrition/Italian Society of Pediatric Allergy and Immunology Task Force Position Statement

Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all

Determinants of utilization of sufficient tetanus toxoid immunization during pregnancy: evidence from the Kenya Demographic and Health Survey, 2008-2009.

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