TETANUS IMMUNIZATION AMONG PREGNANT WOMEN: COVERAGE RATE AND RATE OF PROTECTION AT TIME OF DELIVERY
Even though attempts have been effectively applied to eradicate the neonatal tetanus through widespread childhood vaccination and improved conditions at delivery, it remains major cause of infant mortality and continues a problem of public health in developing countries including Yemen. The aims of this study were to determine the tetanus immunization status, the association between the risk factors and failure of protection in pregnant women at time of delivery. This cross-sectional study included 476 women seeking care for delivery at Al Thawra Modern General Hospital and Al Sabain Hospital, women age ranged from 16-49 years old. Immunization information and factors affecting it were obtained through a standard questionnaire. Serum samples were collected and level of IgG antibody against Clostridium tetani was measured by ELISA technique. Protected women were defined as those with serum antibody levels > or = 0.6 IU/ml. The total vaccine covering rate of tetanus was 87%, and maternal vaccine rate was 33.6%, the protective rate at time of delivery was 68.5%. There were significant association between unvaccinated (OR=18.6), older ages (OR=1.7), rural residency (OR=34) and malaria infection during pregnancy (OR=2.9); with protection failure in pregnant women at time of delivery. It can be concluded that the total vaccine coverage rate and antenatal tetanus vaccine rate were insufficient. In addition, the protective rate at time of delivery was low and large numbers of neonate are susceptible to neonatal tetanus and death. Vaccinating every pregnant woman with at least one dose of TT would be an affordable and effective way to protect against neonatal tetanus, and would be a step toward eliminating the deaths that continue to occur due to this preventable disease in Yemen.