Prevalence and socio-demographic factors associated with non-protective immunity against tetanus among high school adolescents girls in Nigeria

Abstract

BackgroundThe low uptake of tetanus vaccine and its resultant high burden of tetanus in Nigeria suggest the need to improve routine and booster vaccination in children and adolescents. However, epidemiological evidence for vaccination in the adolescent age group needed for effective strategy and policy formulation is lacking. This study was carried out to determine the prevalence of protective immunity against tetanus and to identify risk factors for non-protective immunity among schooling adolescents.MethodsUsing a three-stage sampling technique, 851 female adolescents were randomly selected from secondary schools in Ibadan, Nigeria. A pre-tested questionnaire was used to obtain data on demographic and socio-economic characteristics and history of tetanus vaccination. An immuno-chromatographic rapid test kit, “Tetanos Quick Stick” was used to test specific anti-tetanus antibody protective level in venous blood samples. Descriptive statistics, Chi-square and logistic regression analyses were done with level of significance set at p = 0.05.ResultsMean age of participants was 14.3 ± 1.9 years. Seroprevalence of protective immunity against tetanus was 38.1% and it significantly decreased with increasing age. More adolescents in public (65.4%) than private (44.7%) schools had non-protective level of immunity. A significantly increasing trend in the risk of non-protective immunity was observed with decreasing level of mothers’ education. Also, the Odds of non-protective level of immunity was significantly higher in public than private schools (OR = 2.14; 95% CI =1.39, 3.20) but lower among adolescents who had history of recent tetanus toxoid injection than those who did not (OR = 0.11 95% CI = 0.09, 0.22). However, no significant association was found between protective immunity against tetanus and parents’ marital status as well as family size.ConclusionProtective immunity against tetanus among female adolescents was poor, more so in public schools and those who had not received vaccination a year prior to the study. Policy-makers need to consider the inclusion of immunization against tetanus in the school health programme.

Knowledge and Behaviour Towards Tetanus Toxoid Immunisation in South-South, Nigeria: Findings from Antenatal Clinic Attendees

“…This may be a function of their knowledge of the vaccine as found in this study and others [16,28]. While age and educational status were positive predictors for tetanus toxoid uptake in some studies, one study showed an inverse relationship between protective immunity for tetanus and increasing maternal age [29,30]. The differences in findings may be a function of the variation in the studied population characteristics and differences in study designs.…”

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

“…However, that none of the primiparous mothers who participated in this study could recollect being given tetanus toxoid injection 1-2 years prior to pregnancy calls for public health concern. Given the mean age of the mothers (27.9 years), it was unlikely that many of the mothers had had tetanus toxoid injection during adolescence as a previous study in the same Ibadan reported a very poor immunisation experiences among high school adolescent girls [ 7 ]. It was on the basis of these observations that the investigator counselled the participating mothers and advised the health worker at the primary health facilities to give tetanus toxoid injection to those who tested negative to the TQS test before they were discharged home after delivery.…”

“…Trained research assistants (nurses and community health officers) administered the questionnaire to mothers and examined neonates within 24 hours after delivery. The various items in the questionnaire were adapted from those used for three previous studies [ 7 – 9 ], this included socio-demographic characteristics, questions on knowledge and tetanus vaccination history. Knowledge about tetanus was assessed on a 10-point scale, comprising statements and questions (with possible answers as true, false, or I don't know).…”

“…After administration of the questionnaire, immunity against tetanus was determined for mothers and neonates using a rapid diagnostic: Tetanos Quick Stick (TQS) (Gamma, Angleur, Belgium). The TQS detected any level of anti-tetanus antibodies ≥0.1 IU/ml [ 7 ]. Neonates who tested negative to TQS on day 1 (that is NPIaT) were given human anti-tetanus serum (ATS) immunisation injection 500 IU (Vins Bioproducts Limited, India) once after a sensitivity test was carried out by injecting 0.1 ml serum in 1:10 dilution either subcutaneously and observing for half an hour for any reactions of local or general.…”

Assessing the Importance of Domestic Vaccine Manufacturing Centers: An Overview of Immunization Programs, Vaccine Manufacture, and Distribution

“…Finally, pertussis, also known as whopping cough, is caused by Bortedella pertussis , which can produce loss of weight, subconjunctival hemorrhages, and syncope ( 26 ). Currently these three diseases circulate in the population worldwide and the highest rates are observed in children from countries with low vaccination coverage, especially in developing countries ( 27 – 29 ). However, and despite high vaccination coverage, several outbreaks have recently been reported in industrialized countries ( 30 ).…”