ArticleHealth science reports2026
Knowledge, Attitudes, and Self-Reported Tetanus-Toxoid-Containing Vaccine Uptake Among Women Aged 15-44 Years in Ifakara Town, Tanzania: A Community-Based Cross-Sectional Study.
Article in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Tetanus-toxoid-containing vaccines protect mothers and newborns, but cumulative uptake may decline at higher dose thresholds. We assessed knowledge, attitudes, self-reported tetanus-toxoid-containing vaccine uptake, and factors associated with receipt of at least three doses among women aged 15-44 years in Ifakara Town, Tanzania. Methods: A community-based analytical cross-sectional study included 383 women aged 15-44 years; electronic records were submitted between September 14, 2025, and January 6, 2026. Participants were selected through multistage sampling and completed an interviewer-administered questionnaire. The primary outcome was self-reported receipt of at least three tetanus-toxoid-containing vaccine doses. Participant-level data were reanalyzed using multivariable logistic regression. The parity-adjusted complete-case model included 382 women; Firth bias-reduced regression assessed sparse-data sensitivity. Results: Almost all participants had heard of tetanus vaccination (97.7%) and reported ever receiving it (97.4%). Self-reported uptake was 80.7% for at least two doses, 66.6% for at least three doses, 38.4% for at least four doses, and 24.5% for five doses. Good knowledge was reported for 66.1%, and 74.4% had a positive attitude score. In the parity-adjusted model, the odds of reporting at least three doses were higher for ages 26-35 years (aOR 2.89, 95% CI 1.34-6.20) and 36-44 years (aOR 5.89, 95% CI 1.66-20.96), healthcare-provider information (aOR 2.06, 95% CI 1.07-3.97), and parous status (aOR 15.94, 95% CI 6.84-37.14). Education, knowledge, and reported access barriers were not independently associated after parity adjustment. Conclusion: Initial contact with tetanus vaccination services was high, but self-reported uptake declined at higher dose thresholds. Age and parity probably reflect cumulative opportunities for vaccination, rather than causal effects. Dose-history review, provider-led counseling, and access support may improve cumulative uptake.
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