Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON, K1N 6N5, Canada.
The George Institute for Global Health, The University of Oxford, Oxford, UK.
BMC Public Health. 2020 Jun 5;20(1):855. doi: 10.1186/s12889-020-08985-y.
Immunization of women during pregnancy to protect them and their infants against tetanus, pertussis and influenza is recommended by the World health Organization (WHO). However, there is limited information about the coverage rate and associated factors in low-income countries. The aim of this study was to measure the prevalence and predictors of taking tetanus toxoid among pregnant women in Sierra Leone.
This study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Sierra Leone in 2017. In total 8722 women aged between 15 and 49 years were included in this study. Outcome variable was taking of Tetanus Toxoid vaccination during the last pregnancy. Data were analyzed using cross-tabulation and logistic regression methods.
The overall prevalence of receiving TT immunization during women's last pregnancy was 96.3% and that of taking at least two doses was 82.12%. In the regression analysis, women from Mende ethnicity had a 0.48 fold lower chance of being immunized (OR = 0.480, 95% CI = 0.385,0.59768) than those from the other ethnicity. In addition, women who attended at least four ANC visits had higher odds of receiving TT vaccine (OR = 1.919, 95% CI = 1.639,2.245) compared to those who attended less ANC visits. Stratified by areas, this association was observed in both urban (OR = 2.661, 95% CI = 1.924,3.679) and rural areas (OR = 1.716, 95% CI = 1.430,2.059). Attending at least four ANC visits showed a positive association with receiving at least two doses TT (OR = 2.434, 95% CI = 1.711,3.464) in both urban (OR = 2.815, 95% CI = 1.413,5.610) and rural areas (OR = 2.216, 95% CI = 1.463,3.356) as well.
Higher number of ANC visits, mass media exposure and higher wealth quintile increased the odds of receiving TT immunization. In addition, minimum two doses which were identified to reduce neonatal mortality. Therefore, immunization campaigns targeting improved utilization of healthcare and immunization services by women of childbearing age in Sierra Leone are strongly recommended.
世界卫生组织（WHO）建议在妇女怀孕期间接种疫苗，以保护她们及其婴儿免受破伤风、百日咳和流感的侵害。然而，在低收入国家，关于覆盖率和相关因素的信息有限。本研究旨在衡量塞拉利昂孕妇接种破伤风类毒素的流行率和预测因素。
本研究基于 2017 年在塞拉利昂进行的第五轮多指标类集调查（MICS 5）。共纳入 8722 名年龄在 15 至 49 岁之间的妇女。因变量是在最近一次妊娠期间接种破伤风类毒素疫苗。数据采用交叉表和逻辑回归方法进行分析。
在最近一次妊娠中，妇女接受 TT 免疫接种的总体流行率为 96.3%，接受至少两剂 TT 免疫接种的比例为 82.12%。在回归分析中，与其他种族的女性相比，门德族裔的女性接种疫苗的几率低 0.48 倍（OR=0.480，95%CI=0.385，0.59768）。此外，至少接受 4 次 ANC 就诊的妇女接受 TT 疫苗的几率更高（OR=1.919，95%CI=1.639，2.245），而接受 ANC 就诊次数较少的妇女则较低。按地区分层，这种关联在城市（OR=2.661，95%CI=1.924，3.679）和农村地区（OR=1.716，95%CI=1.430，2.059）均存在。在城市（OR=2.815，95%CI=1.413，5.610）和农村地区（OR=2.216，95%CI=1.463，3.356），至少接受 4 次 ANC 就诊与接受至少两剂 TT 也呈正相关（OR=2.434，95%CI=1.711，3.464）。
ANC 就诊次数增加、接触大众媒体和较高的财富五分位数都会增加接种 TT 免疫的几率。此外，已确定最低两剂可降低新生儿死亡率。因此，强烈建议在塞拉利昂开展针对育龄妇女改善利用医疗保健和免疫服务的免疫接种运动。
