SynthesisInternational journal of epidemiology2010
Tetanus toxoid immunization to reduce mortality from neonatal tetanus.
Synthesis in International journal of epidemiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
108 citing papers in PubMed, 11 syntheses or guidelines pooled it, 283 citations in OpenAlex.
- Expert consensus on vaccination as a primary prevention strategy for women of reproductive age, pregnant, or adulthoodRevista colombiana de obstetricia y ginecologia · 2025Guideline
- A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses.PharmacoEconomics · 2024Pooled it
- Tetanus Toxoid Vaccination Coverage and Associated Factors among Childbearing Women in Ethiopia: A Systematic Review and Meta-Analysis.BioMed research international · 2021Pooled it
- Guidance for the collection of case report form variables to assess safety in clinical trials of vaccines in pregnancy.Vaccine · 2016Guideline
- Neonatal death: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data.Vaccine · 2016Guideline
- Strategies for improving health care seeking for maternal and newborn illnesses in low- and middle-income countries: a systematic review and meta-analysis.Global health action · 2016Pooled it
- Vaccines for women for preventing neonatal tetanus.The Cochrane database of systematic reviews · 2015Pooled it
- Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: a systematic review and meta-analysis.The Lancet. Infectious diseases · 2014Pooled it
- Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010.Pediatric research · 2013Pooled it
- Interventions to reduce neonatal mortality from neonatal tetanus in low and middle income countries--a systematic review.BMC public health · 2013Pooled it
- Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect.BMC public health · 2011Pooled it
- Backfire effect of salient information on vaccine take-up experimental evidence from scared-straight intervention in rural northern Nigeria.Human vaccines & immunotherapeutics · 2021Trial
- Effect of cash incentives on tetanus toxoid vaccination among rural Nigerian women: a randomized controlled trial.Human vaccines & immunotherapeutics · 2020Trial
- Determinants of the Number of Tetanus-Toxoid Injections Before Birth Among Pregnant Women in Somalia: A Multilevel Analysis.Public health challenges · 2026Article
- Determinants of tetanus toxoid immunization among pregnant women in Somaliland: evidence from the 2020 nationwide survey using a zero-inflated negative binomial model.AJOG global reports · 2026Article
- Determinants of Tetanus Toxoid Vaccination Among Women of Reproductive Age in Somaliland: A Cross-Sectional Study.Health science reports · 2026Article
- Reducing parents' vaccination hesitancy: a new educational training model in Turkish sample.Frontiers in public health · 2026Article
- Thermostability of tetanus toxoid vaccine encapsulated in metal-organic frameworks.Drug delivery and translational research · 2025Article
- Safety and efficacy of maternal RSV vaccination: a systematic review and meta-analysis.Clinical and experimental vaccine research · 2025Review
- Disability status and socioeconomic related inequality in receiving quality antenatal care in nine low- and middle-income countries: A multilevel analysis.Reproductive health · 2025Article
48 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeonatal tetanus remains an important and preventable cause of neonatal mortality globally. Large reductions in neonatal tetanus deaths have been reported following major increases in the coverage of tetanus toxoid immunization, yet the level of evidence for the mortality effect of tetanus toxoid immunization is surprisingly weak with only two trials considered in a Cochrane review.
objectiveTo review the evidence for and estimate the effect on neonatal tetanus mortality of immunization with tetanus toxoid of pregnant women, or women of childbearing age.
methodsWe conducted a systematic review of multiple databases. Standardized abstraction forms were used. Individual study quality and the overall quality of evidence were assessed using an adaptation of the GRADE approach. Meta-analyses were performed.
resultsOnly one randomised controlled trial (RCT) and one well-controlled cohort study were identified, which met inclusion criteria for meta-analysis. Immunization of pregnant women or women of childbearing age with at least two doses of tetanus toxoid is estimated to reduce mortality from neonatal tetanus by 94% [95% confidence interval (CI) 80-98%]. Additionally, another RCT with a case definition based on day of death, 3 case-control studies and 1 before-and-after study gave consistent results. Based on the consistency of the mortality data, the very large effect size and that the data are all from low/middle-income countries, the overall quality of the evidence was judged to be moderate.
conclusionThis review uses a standard approach to provide a transparent estimate of the high impact of tetanus toxoid immunization on neonatal tetanus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.