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东非农村地区妇女破伤风免疫预防的流行状况和相关风险因素:来自十个东非国家的人口与健康调查的证据。

Prevalence and risk factors associated with rural women's protected against tetanus in East Africa: Evidence from demographic and health surveys of ten East African countries.

机构信息

Department of Statistics, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

PLoS One. 2022 Mar 24;17(3):e0265906. doi: 10.1371/journal.pone.0265906. eCollection 2022.

Abstract

BACKGROUND

Tetanus is a deadly bacterial infection caused by Clostridium tetani wound contamination characterized muscular spasms and autonomic nervous system dysfunction. Maternal and neonatal tetanus occurs under improper hygiene practices during childbirth. Globally, an estimated 3.3 million newborn deaths occur every year, and about 9,000 babies die every day in the first 28 days of life. This study sought to identify risk factors associated with the immunization of rural women against tetanus in rural areas in ten East African countries.

METHOD

The data used in this study were taken from the Demographic and Health Survey (DHS) of ten East African countries (Ethiopia, Burundi, Comoros, Zimbabwe, Kenya, Malawi, Ruanda, Tanzania, Uganda and, Zambia). Multivariable binary logistic regression is used to determine the risk factors associated with tetanus-protected women in east Africa.

RESULTS

The weighted total samples of 73735 rural women were included in the analysis. The combined prevalence of tetanus immunization among protected rural women in ten East African countries was 50.4%. Those women with age of 24-34 (AOR = 0.778; 95%CI: 0.702-0.861), higher educational level (AOR = 4.010; 95%CI: 2.10-5.670), rich women (AOR = 3.097;95%CI: 2.680-3.583), mass media coverage (AOR = 1.143; 95%CI: 1.030-1.269), having above three antenatal care follow up (AOR = 1.550; 95% CI: 1.424-1.687), big problem of distance to health facility (AOR = 0.676; CI: 0.482-0.978) and place of delivery health facility (AOR = 1.103; 95% CI: 1.005-1.210) had a significant effect on women's protected from tetanus.

CONCLUSION

The coverage of tetanus immunization in East Africa was very low. Public health programs target rural mothers who are uneducated, poor households, longer distances from health facilities, mothers who have the problem of media exposure, and mothers who have not used maternal health care services to promote TT immunization.

摘要

背景

破伤风是一种由梭状芽孢杆菌属的破伤风梭菌引起的致命细菌性感染,其特征为肌肉痉挛和自主神经系统功能障碍。孕产妇和新生儿破伤风是由于分娩期间卫生条件不当导致的。全球每年估计有 330 万新生儿死亡,每天约有 9000 名婴儿在生命的头 28 天内死亡。本研究旨在确定与东非十个国家农村地区农村妇女破伤风免疫相关的风险因素。

方法

本研究使用的数据来自东非十个国家(埃塞俄比亚、布隆迪、科摩罗、津巴布韦、肯尼亚、马拉维、卢旺达、坦桑尼亚、乌干达和赞比亚)的人口与健康调查(DHS)。多变量二项逻辑回归用于确定与东非地区破伤风免疫保护妇女相关的风险因素。

结果

纳入分析的农村妇女加权总样本量为 73735 人。东非十个国家中保护农村妇女的破伤风免疫综合患病率为 50.4%。24-34 岁年龄组(AOR=0.778;95%CI:0.702-0.861)、较高教育程度(AOR=4.010;95%CI:2.10-5.670)、富裕妇女(AOR=3.097;95%CI:2.680-3.583)、大众媒体覆盖率(AOR=1.143;95%CI:1.030-1.269)、有三次以上产前保健随访(AOR=1.550;95%CI:1.424-1.687)、距离卫生设施大问题(AOR=0.676;CI:0.482-0.978)和分娩地点为卫生设施(AOR=1.103;95%CI:1.005-1.210)的妇女对破伤风的保护作用有显著影响。

结论

东非地区破伤风免疫接种覆盖率非常低。公共卫生项目的目标是针对未受过教育、贫困家庭、距离卫生设施较远、媒体曝光问题较多、未使用孕产妇保健服务的农村母亲,以促进 TT 免疫接种。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bca/8947264/87276d4de879/pone.0265906.g001.jpg

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