Differentials in prevalence and correlates on uptake of tetanus toxoid and intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy: A community-based cross-sectional study in The Gambia

Objectives: The study examined the differentials in prevalence and correlates on the uptake of tetanus toxoid and intermittent preventive treatment of malaria among pregnant women in The Gambia. Methods: The 2018 data from The Gambia Multiple Indicators Cluster Survey were analyzed. Data from 6143 women of reproductive age who have given birth were extracted for the analysis. Percentages and Chi-square tests were used. In addition, a multivariable logistic regression model was used to calculate the adjusted odds ratios (with a corresponding 95% confidence interval). The level of significance was set at p < 0.05. Results: The prevalence of tetanus toxoid uptake among women in The Gambia was 88.2%, while that of the adequate tetanus toxoid doses was 34.8%. The prevalence of intermittent preventive treatment with sulfadoxine-pyrimethamine uptake among maternal women in The Gambia was 98.6%, while that of the adequate intermittent preventive treatment with sulfadoxine-pyrimethamine doses taken was 34.3%. The identified statistically significant covariates of tetanus toxoid immunization and intermittent preventive treatment with sulfadoxine-pyrimethamine uptake includes women’s age, local government areas, parity, use of radio, use of newspaper, and antenatal care visits. Conclusion: The current utilization rate for adequate intermittent preventive treatment with sulfadoxine-pyrimethamine and tetanus toxoid immunization during pregnancy in The Gambia is very low and even below universal levels. The country needs to strengthen more and effective mass media advocacy programs that would target both rural and urban populace, and motivate maternal women to ensure adequate vaccination against malaria and tetanus.

Knowledge about Care of Pregnant Mothers during the Covid-19 Pandemic

BACKGROUND: China reported a case of pneumonia known as severe acute respiratory syndrome coronavirus to the World Health Organization of unknown cause in Wuhan City. Regulation Number 6 of 2018 concerning Health Quarantine regulates the basic provisions of the PSBB. Health services at the primary care are very limited, one of which is the care of pregnant women which is an activity that monitors and supports the health of normal pregnant women and detects normal pregnancies. AIM: The purpose of this study was to describe the knowledge of pregnant women about the care of pregnant women during the COVID-19 pandemic at the Jayengan primary health care. METHODS: This study uses a crosssectional design, the sample selection using purposive sampling with a sample of 40 respondents. Data collection was carried out using questionnaires made by researchers and filled out by respondents. Then, the data that have been collected is processed using software. RESULTS: The results showed that the value of the sub-variable understanding of pregnant women with an average value of 100, the sub-variable time of visit to pregnant women had an average value of 72.5, the sub-variable of breast care for pregnant women had an average value of 79.16, sub-variable nutrition variables in pregnant women have an average of 75.63, the tetanus toxoid immunization sub-variable for pregnant women got an average value of 76.66, the pregnancy check-up sub-variable got an average value of 97.5, and the care of pregnant women who were confirmed to have COVID-19 got an average score of 55.93. CONCLUSION: The conclusion shows that the average knowledge level of respondents is sufficient.

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

Background. Tetanus is a bacterial disease caused by the Clostridium tetani, which is a highly fatal, noncommunicable, and toxin-mediated disease. Globally, maternal and neonatal tetanus is a public health problem due to low maternal tetanus toxoid immunization. Ethiopia has the highest neonatal mortality and morbidity related to tetanus due to low tetanus toxoid immunization and the high number of home deliveries. The main objective of this systematic review and meta-analysis was to estimate the pooled coverage of at least two doses of tetanus toxoid immunization, and the pooled effect sizes of associated factors in Ethiopia. Methods. Primary studies for this review were searched from the PubMed/MEDLINE online, ScienceDirect, Hinari, Google, and Google Scholar databases. Primary articles published from 2010 up to August 30, 2020, were included in this meta-analysis. Data were extracted in Microsoft Excel format and exported to STATA Version 14.0. A random-effects meta-analysis model was used to estimate the pooled coverage of two or more tetanus toxoid immunizations and its associated factors. Heterogeneity was evaluated by the I 2 test. Egger’s weighted regression test was used to assess publication bias. Results. We retrieved 212 records; of these, 199 articles were excluded for reasons. Finally, 14 studies were included in this meta-analysis. The pooled estimate of receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia was 52.2% (95% CI: 42.47-61.93, I 2 = 98.4 % ). Antenatal care ( OR = 7.8 (95% CI: 3.2, 19.2), I 2 = 96.3 % ), media exposure ( OR = 8.3 (95% CI: 2.1, 33.3), I 2 = 98.1 % ), distance from the health facility ( OR = 2.64 (95% CI: 1.1, 6.6), I 2 = 94.1 % ), educational status of women ( OR = 4.7 (95% CI: 2.07, 9.56), I 2 = 94.2 % ), and educational status of husbands ( OR = 2.995 (95% CI: 1.194, 7.512), I 2 = 92.5 % ) were factors significantly associated with receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia. Conclusions. The coverage of tetanus toxoid immunization among childbearing women was low in Ethiopia. Strengthening maternal health service utilization (antinatal care and institutional delivery) to the nearest health facility even in health posts and empowering education for both women and their husbands is recommended to increase tetanus toxoid immunization coverage in Ethiopia.

Perinatal mortality and its association with antenatal care visit, maternal tetanus toxoid immunization and partograph utilization in Ethiopia: a meta-analysis

Despite remarkable progress in the reduction of under-five mortality; perinatal mortality is the major public health problem in Africa. In Ethiopia, the study findings on perinatal mortality and its predictors were inconsistent. Therefore, this systematic review and meta-analysis estimated the pooled perinatal mortality, and its association with antenatal care visit, maternal tetanus toxoid immunization, and partograph monitoring. International databases like PubMed, SCOPUS, Google Scholar and Science Direct were systematically searched. I squared statistics was used to determine the levels of heterogeneity across studies and the pooled estimate was computed using a random-effect model. The meta-analysis showed that a pooled prevalence of perinatal mortality in Ethiopia was 6.00% (95% CI 5.00%, 7.00%). The highest proportion of perinatal mortality was a stillbirth, 5.00% (95% CI 4.00%, 7.00%). Women who had antenatal care visit [OR = 0.20 (95% CI 0.12, 0.34)], maternal tetanus toxoid immunization [OR = 0.43 (95% CI 0.24, 0.77)] and partograph monitoring [POR = 0.22 (95% CI 0.06, 0.76)] reduced the risk of perinatal mortality. Whereas, previous history of perinatal mortality [POR = 7.95 (95% CI 5.59, 11.30)] and abortion history (POR = 2.02 (95% CI 1.18, 3.46)) significantly increased the risk of perinatal mortality. Therefore, antenatal care visit, maternal tetanus toxoid vaccination uptake, and partograph utilization should be an area of improvements to reduce perinatal mortality.

Individual and community-level determinants of poor tetanus toxoid immunization among pregnant women in Ethiopia using data from 2016 Ethiopian demographic and health survey; multilevel analysis

Background Tetanus is a vaccine-preventable disease that can occur in all populations, with neonates and pregnant women being at the most risk. Ethiopia has the highest maternal and neonatal tetanus morbidity and mortality rates. Besides, only 49% of mothers get vaccinated with adequate tetanus toxoid in Ethiopia which is below the world health organization recommendation. To date, there is limited evidence on the individual and community level determinants of poor tetanus toxoid (TT) immunization. Therefore, this study aimed to assess individual and community-level factors associated with poor TT immunization coverage in Ethiopia. Method Secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey. A total of 7043 pregnant women were included in the current study. A multilevel logistic regression model was used to identify individual and community level determinants of poor tetanus toxoid immunization. Finally, the adjusted odds ratio with a 95% confidence interval was reported. Results In the multilevel logistic regression model adjustment, having no Antenatal care visit (AOR = 5.64; 95% CI:2.48,7.30) and having one to three antenatal care visit (AOR = 1.50; 95% CI: 1.19–1.82); poor wealth index (AOR = 1.26; 95% CI: 1.03, 1.54); not being exposed to media (AOR = 1.29; 95% CI: 1.10, 1.51); maternal unemployment (AOR = 1.15; 95% CI: 1.10, 1.31); rural residence (AOR = 1.13; 95% CI: 1.08, 1.72); and high community illiteracy (AOR = 1.28; 95% CI: 1.03, 1.58) were associated with higher odds of poor tetanus toxoid immunization. Whereas, iron uptake during pregnancy (AOR = 0.59; 95% CI: 0.51, 0.68), was associated with lower odds of poor tetanus toxoid immunization. Conclusion In this study tetanus toxoid (TT) vaccine utilization was affected by both community and individual-level factors. Therefore, focusing on antenatal care services especially encouraging pregnant women to have at least four visits, consulting women to be exposed to media, improving community literacy and maternal employment will help to minimize TT underutilization.

Faktor Yang Berhubungan Dengan Pemberian Imunisasi Tetanus Toxoid Pada Ibu Hamil

ABSTRACT: FACTORS RELATED TO GIVING TETANUS TOXOID IMMUNIZATION IN PREGNANT WOMEN Background: Tetanus toxoid immunization in pregnant women is one of the recommended things before labor takes place in order to reduce the risk of death of a newborn fetus. In addition to reducing the risk of fetal death. Apart from reducing the risk of fetal death, this vaccine is also useful for preventing tetanus in babies. The spread of neonatal tetanus cases that occurred in eight districts/cities (47%) in South Sumatra found that out of 11 reported cases 82% had never received TT immunization.Purpose: the purpose of this research was to find out the factors associated with tetanus toxoid immunization.Method: This research is in the form of a literature review. Search literature reviews through publications in three databases using the keywords (“associated factors” OR “related factors”) AND (tetanus toxoid immunization OR tetanus toxoid immunization). From the search results, the researchers got articles through Google Scholar, Garuda Portal, Mendeley, and 474 articles using Science Direct that match these keywords. From the search results obtained, screening was carried out based on duplication, conformity with the title and inclusion criteria, and study selection criteria. So that there are 2 articles that meet the criteria (n = 2).Result: From 2 literature that has met the inclusion and exclusion criteria, these two articles are a cross-sectional study, the study was conducted in Indonesia, using Indonesian. These two articles have different results regarding knowledge, attitudes, and family support.Conclusion: Factors related to tetanus toxoid immunization are knowledge, attitude, and family support. Keywords: related factors, tetanus toxoid immunization INTISARI : FAKTOR YANG BERHUBUNGAN DENGAN PEMBERIAN IMUNISASI TETANUS TOXOID PADA IBU HAMIL Latar belakang : Imunisasi tetanus toksoid pada ibu hamil merupakan salah satu hal yang dianjurkan sebelum persalinan berlangsung guna menurunkan risiko kematian janin yang baru saja dilahirkan. Selain menurunkan risiko kematian janin. Selain menurunkan risiko kematian janin, vaksin ini juga berguna untuk mencegah tetanus pada bayi. Penyebaran kasus tetanus neonatorum yang terjadi di delapan kabupaten/kota (47%) di Sumatera Selatan didapatkan bahwa dari 11 kasus yang terlaporkan 82% tidak pernah mendapat imunisasi TT.Tujuan : diketahuinya faktor-faktor yang berhubungan dengan pemberian imunisasi tetanus toksoid.Metode Penelitian : Penelitian ini berbentuk literature review. Pencarian literature review melalui publikasi di tiga database dengan menggunakan kata kunci (“associated factors” OR “faktor yang berhubungan”) AND (imunisasi tetanus toxoid OR tetanus toxoid immunization). Dari hasil pencarian tersebut peneliti mendapatkan artikel melalui google scholar, portal garuda, Mendeley, dan 474 artikel menggunakan Science Direct yang sesuai dengan kata kunci tersebut. Dari hasil pencarian yang didapat selanjutnya dilakukan skrining berdasarkan duplikasi, kesesuaian dengan judul dan kriteria inklusi dan kriteria seleksi studi. Sehingga diperoleh 2 artikel yang memenuhi kriteria (n = 2).Hasil : Dari 2 literatur yang telah memenuhi kriteria inklusi dan eksklusi, kedua artikel ini berupa cross-sectional study, penelitian dilakukan di Indonesia, menggunakan bahasa Indonesia. Kedua artikel ini memiliki hasil ulasan yang berbeda mengenai pengetahuan, sikap dan dukungan keluarga.Kesimpulan : Faktor-faktor yang berhubungan dengan pemberian imunisasi tetanus toxoid yaitu pengetahuan, sikap dan dukungan keluarga. Kata Kunci: Faktor Berhubungan, Imunisasi Tetanus Toxoid

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

Background: Tetanus is a bacterial disease caused by the bacterium Clostridium tetanus which is a highly fatal, non-communicable, and toxin-mediated disease. Globally, both maternal and neonatal tetanus is a public health problem due to low maternal tetanus toxoid vaccination. The main strategies for the prevention of maternal and neonatal tetanus at birth were vaccination of the mothers with a protective dose of tetanus toxoid and clean delivery. Ethiopia has the highest neonatal mortality and morbidity related to tetanus in the world due to low tetanus toxoid immunization coverage and a higher number of home-deliveries. The main aim of this systematic review and meta-analysis was to estimate the pooled tetanus toxoid immunization coverage and associated factors in Ethiopia. Methods: The primary studies for this review were searched from PubMed/MEDLINE online, Science Direct, and Hinari databases. We retrieved 212 records; of these, 199 articles were excluded due to different reasons, and 13 studies were included in the systematic review and this meta-analysis. The data were extracted in Microsoft Excel format and exported to STATA Version 14.0 statistical software for analysis. Heterogeneity was evaluated by the I2 test. A random-effect meta-analysis model was used to estimate the pooled coverage of two or more tetanus toxoid immunization and its associated factors. Egger’s weighted regression and Begg’s rank correlation test were used to assess publication bias at a 5% significance level. Result: The pooled estimate of at least two dose of tetanus toxoid immunization coverage was 52.6% (95% CI 41.4%–63.8%). Ante-natal care (ANC) visits [OR = 7.8 (95% CI; 3.2, 19.2)], media exposure [OR = 8.3 (95% CI; 2.1. 33.3), distance from the health facility [OR = 2.635 (95% CI; 1.1, 6.6)], educational status of mothers [OR = 0.225 (95% CI; 0.105, 0.483) and husband educational status [OR = 0.184 (95% CI; 0.104, 0.323)] were significantly associated factors for tetanus toxoid immunization coverage in Ethiopia.Conclusion: The tetanus toxoid immunization coverage among childbearing women was low in Ethiopia. Strengthening maternal health service utilization (ANC, institutional delivery) to the nearest health facility including in health posts and empowering education is recommended to increase tetanus toxoid immunization coverage. Additionally, awareness creation on the advantage of taking tetanus toxoid immunization should be emphasized.

Tetanus Toxoid Immunization Status and Associated Factors among Mothers in Hawzen, Eastern Zone of Tigray, Ethiopia, 2019

Background: Neonatal tetanus remains a significant avertable cause of morbidity and mortality in neonates. Adequate vaccination strategies, including at least two doses of tetanus toxoid for reproductive age women, can decrease neonatal mortality. In Ethiopia, a few numbers of neonates were protected at birth through this proactive intervention. Therefore, this study aimed to determine factors associated with the low coverage of tetanus toxoid immunization. Objective: This study aimed to determine the status of Tetanus Toxoid immunization coverage and factors associated with it. Methods: Community-based cross-sectional study design was implemented among 515 mothers in Hawzen, Eastern zone of Tigray. The data were entered into Epi data manager version 3.5.1 and exported to Statistical Package for Social Science version 20 software for analysis. Bivariate and multivariate logistic regression was used to identify factors significantly associated with tetanus toxoid immunization coverage. Results: Two hundred and seven (40.2%) mothers were protected against tetanus at last birth. Mothers whose age was less than 20 years [AOR 0.19(0.10, 0.32), had no future plan for fertility [AOR 0.30(0.17, 0.53)], mothers attended once for antenatal care visits [AOR 0.38(0.18, 0.82)] and who got information from media [AOR 4.49(1.82, 11.07] were independent predictors of tetanus toxoid immunization status of mothers. Conclusion: More than half of the mothers were not protected against tetanus at the time of last birth. This study found the age of mothers, future fertility plans, numbers of antenatal care visits and mothers who got information from media; these were significant factors associated with the likelihood of tetanus toxoid immunization of mothers.