Factors associated with births protected against neonatal tetanus in Africa: Evidences from Demographic and health surveys of five African countries (original) (raw)

Determinants of births protected against neonatal tetanus in Ethiopia: A multilevel analysis using EDHS 2016 data

PLOS ONE, 2020

BackgroundEven though there is low coverage of maternal health services such as antenatal care and skilled birth attendant delivery as well as poor sanitary practice during delivery in Ethiopia, the proportion of births protected by the tetanus vaccine is low. Thus, this study aimed to investigate the determinants of births protected against neonatal tetanus in Ethiopia.ObjectiveTo assess the determinants of births protected against neonatal tetanus in Ethiopia.MethodThe study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A weighted sample of 7590 women who gave birth within five years preceding the survey was used for analysis. We conducted a multilevel analysis, due to the hierarchical nature of the data. Variables with p-value <0.05 in the multivariable analysis were declared to be significantly associated with having births protected against neonatal tetanus.ResultIn this study, mothers with primary education [adjusted odds rat...

Factors Associated With Protection of Last Live Birth Against Neonatal Tetanus Among Mother Age 15-49 in Ethiopia: A Multilevel Analysis Using EDHS 2016

Background: Neonatal tetanus is still the major public health problem in about 25 countries, mainly in Africa. Ethiopia has the highest neonatal tetanus mortality and morbidity rates in the world due to low TT immunization coverage coupled with the high amount of deliveries taking place at home. In Ethiopia, only 49% of the pregnant mothers received TT2+ in 2016. Objective: The objective of this study is to identify individual and community level factors associated with protections of last live birth against neonatal tetanus among mothers 15-49 years age in Ethiopia, evidence from Ethiopia Demographic and Health Survey 2016. Methods: The data for this study was obtained from Ethiopia Demographic and Health Survey of 2016. Population based cross-sectional study was conducted. The data were analyzed using Stata version 14. Variables that were significant in the bivariate multilevel logistic regression analysis were entered to the final model. Variables with p-value of less than 0.05 i...

Proportion of Births Protected Against Neonatal Tetanus and Its Associated Factors Among Mothers Who Gave Birth Within the Past 6 Months in Gozamn District, Northwest Ethiopia, 2022

Introduction: An estimated 3.3 million newborn deaths occur each year around the world, with 9,000 babies dying every day in their first 28 days. Neonatal tetanus is tetanus that occurs within the first 28 days of life, and maternal immunization can reduce neonatal tetanus by 94%. However, not enough mothers were vaccinated to protect against neonatal tetanus globally, and only 49% of mothers in Ethiopia were protected. The proportion of mothers who were protected from neonatal tetanus was not determined yet in the study area. Because neonatal tetanus is such a serious disorder with such a high fatality rate and there is a need for more recent evidence on it, more research on birth protection against neonatal tetanus is needed. Objective To assess the proportion of births protected against neonatal tetanus and its associated factors among mothers who gave birth within the past 6 months in Gozamn district, Northwest Ethiopia, 2022. Method A community-based cross-sectional study was c...

Predictors of Neonatal Tetanus Mortality in Katsina State, Northwestern Nigeria

Health Services Research and Managerial Epidemiology, 2017

Background: The mortality rate of neonatal tetanus (NNT) remains high in Nigeria. The study was guided by Mosley and Chen's model for the elements of child survival in developing countries. The goal of the study was to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and cord care with neonatal mortality as the outcome variable. Methods: The study is a retrospective record review using data from 332 NNT records and analyzed using a logistic regression model. Findings: Neonates whose mothers had 1 dose of tetanus toxoid vaccine were found to be 4% less prone to NNT mortality compared to neonates whose mothers did not have any dose of tetanus toxoid vaccine during pregnancy (P < .05, odds ratio ¼ 4.12, 95% confidence interval ¼ 1.04-16.29. Frequency of antenatal visits, place of delivery, and cord care were all not significant predictors of NNT mortality. Conclusion: The study shows that there is association between NNT risk factors and neonatal mortality, hence the need to further strengthen the NNT surveillance system for early detection of potential risk factors. This would help develop specific public health interventions aimed at improving the outcome of NNT. Implications: The identification and analysis of NNT mortality risk factors and promoting tetanus toxoid vaccination among pregnant women are effective strategies toward attaining NNT elimination goals in Nigeria.

Incidence and Risk Factors for Neonatal Tetanus in Admissions to Kilifi County Hospital, Kenya

PloS one, 2015

Neonatal Tetanus (NT) is a preventable cause of mortality and neurological sequelae that occurs at higher incidence in resource-poor countries, presumably because of low maternal immunisation rates and unhygienic cord care practices. We aimed to determine changes in the incidence of NT, characterize and investigate the associated risk factors and mortality in a prospective cohort study including all admissions over a 15-year period at a County hospital on the Kenyan coast, a region with relatively high historical NT rates within Kenya. We assessed all neonatal admissions to Kilifi County Hospital in Kenya (1999-2013) and identified cases of NT (standard clinical case definition) admitted during this time. Poisson regression was used to examine change in incidence of NT using accurate denominator data from an area of active demographic surveillance. Logistic regression was used to investigate the risk factors for NT and factors associated with mortality in NT amongst neonatal admissi...

Risk factors for neonatal tetanus—Busoga region, Uganda, 2002–2003

Global Epidemiology

Vol. 55/Supplement MMWR 25 Risk Factors for Neonatal Tetanus— Busoga Region, Uganda, 2002–2003 Sheba N. Gitta, 1 F. Wabwire-Mangen, 1 D. Kitimbo, 2 G. Pariyo1 1Makerere University Institute of Public Health, Kampala, Uganda 2District Directorate of Health Services ...

Prevalence and risk factors associated with rural women’s protected against tetanus in East Africa: Evidence from demographic and health surveys of ten East African countries

PLOS ONE, 2022

Background Tetanus is a deadly bacterial infection caused by Clostridium tetani wound contamination characterized muscular spasms and autonomic nervous system dysfunction. Maternal and neonatal tetanus occurs under improper hygiene practices during childbirth. Globally, an estimated 3.3 million newborn deaths occur every year, and about 9,000 babies die every day in the first 28 days of life. This study sought to identify risk factors associated with the immunization of rural women against tetanus in rural areas in ten East African countries. Method The data used in this study were taken from the Demographic and Health Survey (DHS) of ten East African countries (Ethiopia, Burundi, Comoros, Zimbabwe, Kenya, Malawi, Ruanda, Tanzania, Uganda and, Zambia). Multivariable binary logistic regression is used to determine the risk factors associated with tetanus-protected women in east Africa. Results The weighted total samples of 73735 rural women were included in the analysis. The combined...

Non-protective immunity against tetanus in primiparous women and newborns at birth in rural and urban settings in Ibadan, Nigeria

Pan African Medical Journal, 2017

Introduction: Nigeria remains among the few countries that are yet to achieve eradication of neonatal tetanus in the world despite the availability of an effective vaccine. This study investigated immunity against tetanus in primiparous mothers and neonates at birth, and identified associated factors. Methods: this cross-sectional study involved consecutive selection of 244 primiparous mother-neonate pairs (119 from rural areas, 125 from urban areas, 137 male neonates and 107 female neonates) delivered at primary healthcare facilities in Ibadan, Nigeria. Socio-demographic characteristics, obstetric history, immunisation and birthweight were obtained from mothers by interview. A validated immunochromatographic rapid diagnostic test kit was used to test for immunity against tetanus. Positive and negative results were interpreted as protective immunity against tetanus (PIaT) and non-protective immunity against tetanus (NPIaT), respectively. Data were analysed using descriptive statistics, Chi-square and logistic regression at p = 0.05. Results: the mean age of mothers was 27.9±3.4 years (range: 20-33) and median birthweight was 2700g (range: 1760-3300). Of the 244 mothers, 198 (81.1%) received at least two doses of tetanus toxoid injection during pregnancy and prevalence of NPIaT and PIaT was 28.7% and 71.3%, respectively. The prevalence of PIaT was significantly higher among mothers in urban areas (n= 96; 80.7%) than rural (n=78; 62.4%), p<0.001.The prevalence of NPIaT among neonates was 36.5% (n= 89). Predictors of NPIaT among neonates were residence in rural LGA (OR = 2.22; 95% CI = 1.23-3.99) and maternal tetanus immunisation <2 doses (OR = 11.68; 95% CI = 4.05-21.75). Conclusion: lack of protective immunity against tetanus among neonates of primiparous women in Ibadan is prevalent and a more conscientious enforcement of routine tetanus prevention practices is needed.

Evaluation of Active and Passive Neonatal Tetanus Surveillance Systems in Katsina State, Nigeria

2016

Evaluation of Active and Passive Neonatal Tetanus Surveillance Systems in Katsina State, Nigeria by Shafique Sani Nass MPH, Usman Danfodio University, 2011 MBBS, Bayero University, 2005 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2016 Abstract The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen’s model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and...