ArticleArchives of public health = Archives belges de sante publique2021
Individual and community-level determinants of poor tetanus toxoid immunization among pregnant women in Ethiopia using data from 2016 Ethiopian demographic and health survey; multilevel analysis.
Article in Archives of public health = Archives belges de sante publique, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Tetanus toxoid vaccination coverage and associated factors among pregnant women in East Africa: systematic review and meta-analysis.BMC public health · 2025Pooled it
- Facilitators and barriers to maternal immunization and strategies to improve uptake in low-income and lower-middle income countries: A systematic review.Human vaccines & immunotherapeutics · 2024Pooled it
- Adequate tetanus toxoid immunization and its correlates among married women with a recent live birth in Afghanistan: Insights from a national survey.Human vaccines & immunotherapeutics · 2026Article
- Determinants of tetanus-unprotected births in Tanzania: a multilevel analysis using the 2022 Tanzania Demographic and Health Survey data.Maternal health, neonatology and perinatology · 2026Article
- Residential differentials in prevalence and factors associated with tetanus toxoid uptake among women of reproductive age in Nigeria: a Multiple Indicator Cluster Survey analysis (MICS 2021).BMC public health · 2026Article
- Tetanus Toxoid Vaccine Uptake and Associated Factors Among Reproductive Age Women in Mogadishu, Somalia: A Cross-Sectional Study.IJID regions · 2026Article
- Tetanus toxoid immunization coverage and its determinants among pregnant women in Somalia: A cross-sectional analysis of the 2020 Demographic and Health Survey.Human vaccines & immunotherapeutics · 2025Article
- Determinants of tetanus immunization among pregnant women where tetanus has not been eliminated: a multilevel analysis of 6 countries.Frontiers in global women's health · 2025Article
- Number of tetanus toxoid injections before birth and associated factors among pregnant women in low and middle income countries: Negative binomial poisson regression.Human vaccines & immunotherapeutics · 2024Review
- Hotspot areas of tetanus-unprotected births and its associated factors in Ethiopia: Spatial analysis of EDHS data.Human vaccines & immunotherapeutics · 2024Article
- Prevalence and factors associated with rural mothers' protection against tetanus: a cross-national analysis in 33 sub-Saharan African countries.International health · 2024Article
- Uptake of protective tetanus toxoid vaccine doses and maternal associated factors during pregnancy in armed conflict zone, hospital-based cross-sectional study.Frontiers in reproductive health · 2024Article
- Neonatal Tetanus Case Series: A Tale of Survival and Tragedy at St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.Pediatric health, medicine and therapeutics · 2024Article
- Contents of antenatal care services in Afghanistan: findings from the national health survey 2018.BMC public health · 2023Article
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- Article
- Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis.Frontiers in global women's health · 2023Article
- Maternal Tetanus Toxoid Vaccination in Benin: Evidence from the Demographic and Health Survey.Vaccines · 2022Article
- Factors Associated with the Uptake of Antenatal Tetanus Toxoids Containing Vaccine by First-Time Mothers in Nigeria: Findings from the 2018 Nigerian Demographic Health Survey.Journal of pregnancy · 2022Article
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Abstract
backgroundTetanus is a vaccine-preventable disease that can occur in all populations, with neonates and pregnant women being at the most risk. Ethiopia has the highest maternal and neonatal tetanus morbidity and mortality rates. Besides, only 49% of mothers get vaccinated with adequate tetanus toxoid in Ethiopia which is below the world health organization recommendation. To date, there is limited evidence on the individual and community level determinants of poor tetanus toxoid (TT) immunization. Therefore, this study aimed to assess individual and community-level factors associated with poor TT immunization coverage in Ethiopia.
methodSecondary data analysis was conducted using the 2016 Ethiopian demographic and health survey. A total of 7043 pregnant women were included in the current study. A multilevel logistic regression model was used to identify individual and community level determinants of poor tetanus toxoid immunization. Finally, the adjusted odds ratio with a 95% confidence interval was reported.
resultsIn the multilevel logistic regression model adjustment, having no Antenatal care visit (AOR = 5.64; 95% CI:2.48,7.30) and having one to three antenatal care visit (AOR = 1.50; 95% CI: 1.19-1.82); poor wealth index (AOR = 1.26; 95% CI: 1.03, 1.54); not being exposed to media (AOR = 1.29; 95% CI: 1.10, 1.51); maternal unemployment (AOR = 1.15; 95% CI: 1.10, 1.31); rural residence (AOR = 1.13; 95% CI: 1.08, 1.72); and high community illiteracy (AOR = 1.28; 95% CI: 1.03, 1.58) were associated with higher odds of poor tetanus toxoid immunization. Whereas, iron uptake during pregnancy (AOR = 0.59; 95% CI: 0.51, 0.68), was associated with lower odds of poor tetanus toxoid immunization.
conclusionIn this study tetanus toxoid (TT) vaccine utilization was affected by both community and individual-level factors. Therefore, focusing on antenatal care services especially encouraging pregnant women to have at least four visits, consulting women to be exposed to media, improving community literacy and maternal employment will help to minimize TT underutilization.
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