Frequency rate of tetanus toxoid vaccination and associated factors among women attending well baby clinic at selected primary health care center in Cairo governorate

Abstract

Tetanus is an acute, often fatal, disease caused by an exotoxin produced by the bacterium Clostridium tetani. The disease is characterized by generalized rigidity and convulsive spasms of skeletal muscles. The muscle stiffness usually involves the jaw (lockjaw) and neck and then becomes generalized. The disease can affect any age group and case-fatality rates are high (10-80%) even where modern intensive care is available. There is no natural immunity against tetanus; protection can be provided by active immunization with tetanus toxoid (TT)-containing vaccine or administration of an anti-tetanus antibody. Although tetanus vaccine has been available for years, neonatal tetanus (NT) still remains one of the major but preventable causesof infant mortality in many developing countries. Thedisease has been virtually eliminated in the more industrializednations. The MNT Elimination Initiative aims to reduce MNT cases to such low levels that the disease is no longer a major public health problem through immunization of pregnant women as well as other women of reproductive age and promotion of more hygienic deliveries as well as cord care practices. MNT elimination is defined as less than one case of neonatal tetanus per 1000 live births in every district. In 2007 WHO declared that Egypt has achieved MNT elimination. This has been achieved through national and sub-national vaccination campaigns targeting women of childbearing age (15-49) with TT during the period 1995-2006. Maintaining elimination status in Egypt requires continued strengthening of routine TT immunization services that target pregnant women, routine immunization of children, clean delivery services in all districts and to identify the main reasons for low coverage. These points signify the importance of the current study which was carried out to measure frequency of TT vaccination among mothers at child bearing period and to highlight the different associated factors affecting TT vaccination rate because there were not enough recent studies as far as we know discussing this issue in Egypt. This study was a cross sectional study which included two hundred seventy seven mothers at childbearing period attended the well baby clinic at El-Darb El- Ahmar PHC center to vaccinate their infants or to follow up. Two days were randomly selected every week to fulfill the sample size. On these two days (10) females were chosen by simple random sample meeting the eligibility criteria in the period between 1 January 2015 and 1 April 2015. After taking a verbal consent from the mothers, an interview Arabic questionnaire was used to collect data about sociodemographic characteristics of the mother, obstetric history, details of last pregnancy and knowledge of the mother about (NT) disease and (TT) vaccine. All the suitable required statistical tests were performed and all the research ethical considerations were maintained all through the study period. The basic the sociodemographic characteristics of the studied mothers were as following: the age of the studied mothers ranged from (18) to (45) years with mean of (31.06± 6.22).The socioeconomic score range is from (1) to (10) with a mean of (4.556).The majorities of the studied mothers (77.3%) live inside the catchment area. Forty percent (40%) of the studied mothers completed secondary school or middle diploma.Most of the studied mothers were housewives (93.5%), while most of their husbands were skilled workers (32.9%). Most of the studied mothers (90.3%) have a near PHC center and they can go to it alone (97.8%).There were no plans of another pregnancy for most of them (60.6%). Forty three percent of the studied mothers got pregnant three or four times. There was no history of abortion in (72.2%) of the studied mothers. More than half of the studied mothers (58.5%) have one or two children. Most of the studied mothers (93.1%) received complete ANC (4 or more visits) during last pregnancy, when asked about the place of ANC, (63.6%) of them answered at a private clinic. Most of the studied mothers (91.1%) received health education during their ANC visits. The most important topics of HE were the importance of ANC visits (94%) and the danger signs during pregnancy (89.4%).