Antenatal visits are positively associated with uptake of tetanus toxoid and intermittent preventive treatment in pregnancy in Ivory Coast

Abstract

BackgroundMalaria and tetanus infections among pregnant women represent two major public health problems in sub-Saharan Africa. Optimum use of Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (IPTp-SP) and immunization against tetanus among pregnant women during antenatal care (ANC) visits are recommended strategies to prevent these issues. Despite these recommendations, many women in Africa remain deprived of these cost-effective and life-saving interventions. In this study, we aimed to examine the prevalence of women using these two services, and the association between women’s uptake of IPTp-SP and tetanus toxoid (TT) with antenatal care use in Ivory Coast.MethodsThis study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Ivory Coast in 2016. Participants were 9583 women aged between 15 and 49 years. Outcomes were TT and Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). Data analysis was conducted using bivariate and multiple logistic regression.ResultsIn this study, the prevalence of taking TT immunization and IPTp-SP drugs was 81.97 and 17.83% respectively. Of the participants who took these drugs at all, the prevalence of taking adequate doses of TT immunization was 78.75% and that of IPTp-SP was 35.46%. In the multivariable analysis model, higher age groups, 25–29 years (OR = 2.028, 95%CI = 1.120–3.669) were found to be positively associated with uptake of adequate doses of IPTp-SP drugs. Women who attended at least four ANC visits had higher odds of taking IPTp-SP drugs (OR = 1.656, 95%CI = 1.194–2.299) and TT immunization (OR = 2.347, 95%CI = 1.384–3.981), and also had higher odds of receiving adequate doses of IPTp-SP drugs (OR = 3.291, 95%CI = 2.157–5.020) and that of TT immunization (OR = 1.968, 95%CI = 1.398–2.771). The odds of taking IPTp-SP drugs were significantly higher among women with primary (OR = 2.504, 95%CI = 1.020–6.146) and secondary/higher education (OR = 3.298, 95%CI = 1.343–8.097) compared to those with no education. Also, women with higher parity had lower odds of taking TT immunization (OR = 0.218, 95%CI = 0.055–0.858) compared to those with lower parity. Findings from this study also revealed that the odds of taking adequate doses of IPTp-SP drugs were significantly lower among participants from Mandé du Nord ethnicity (OR = 0.378,95%CI = 0.145–0.983) compared to those from other ethnicities.ConclusionIn this study, uptake of IPTp-SP drugs was much lower than TT immunization. High number of ANC visits were found to be significantly associated with taking IPTp-SP drugs and TT immunization and also with that of taking them in adequate doses. Vaccination promotion is necessary to protect pregnant women and reduce adverse health outcomes among the newborn in Ivory Coast.

Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone

“…In the current study, we also provided evidence household wealth quintile had no effect on receiving adequate doses of TT immunization when compared to those with the poorest wealth quintile. This finding is contrary to previous studies done in Ivory Coast and in Pakistan [26,32,34,35]. We perceive that women from wealthy households have the financial means to seek healthcare services than those from poor households.…”

Predictors for Uptake of Tetanus Toxoid Vaccination During Pregnancy Among Women of Reproductive Age in Tanzania; An Analysis of Data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicators Survey

“…In this study, parity was found less likely to promote TT vaccine uptake, which is congruent to ndings from Nigeria, were parity had no any statistical association with TT vaccine uptake (21). However, the ndings is contrary to what was reported by Yaya and colleagues (10) in their study from Ivory Coast, were parity increased the odds of TT vaccine uptake. It is further claimed that parity of the woman promotes maternal healthcare utilization (29).…”

“…After adjusted for confounders, predictors of uptake of tetanus vaccination were early antenatal booking (AOR = 1.174 at 95% CI = 1.033-1.335, p = 0.014), age group of women [ to 34 years (AOR = 1.433 at 95% CI = 1.155-1.778, p = 0.001), more than 34 years (AOR = 1.379 at 95% CI = 1.065-1.786, p = 0.015)], wealth index [ rich (AOR = 1.261 at 95% CI = 1.083-1.468, p = 0.003)], parity [para 2-4 (AOR = 0.401 at 95% CI = 0.343-0.468, p < 0.001), para 5 and above (AOR = 0.217 at 95% CI = 0.178-0.265, p < 0.001)], level of education [ primary level, (AOR = 0.864 at 95% CI = 0.754-0.99, p = 0.035)] zones [Unguja Zanzibar Island (AOR = 0.434 at 95% CI = 0.309-0.609, p < 0.001), Pemba (Pemba Island) (AOR = 0.34 at 95% CI = 0.226-0.512, p < 0.001)] and adequate ANC visits (AOR = 0.649 at 95% CI = 0.582-0.723, p < 0.001) Table 3 Antenatal care service utilization have been recognized important approach to improve uptake of TT vaccine among women of reproductive age (10,13). Our study showed that early ANC booking determines the uptake of TT vaccine.…”

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

“…Most of our findings are, however, consistent with the literature on uptake of other prenatal vaccines (eg tetanus toxoid and hepatitis B), even though the literature is mainly from Africa and Asia. Compared with no antenatal visit, Iqbal et al, 69 Yaya et al 70 and Roosihermiatie et al 71 all found that antenatal visits were associated with significantly increased tetanus toxoid vaccination among pregnant women in Pakistan, Ivory Coast and Indonesia, respectively. 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.…”