Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep;18(5):232-241.
doi: 10.1177/1757177416689722. Epub 2017 Feb 1.

Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan

Yasir Shafiq  1 , Asif Raza Khowaja  1 , Mohammad Tahir Yousafzai  1 , Syed Asad Ali  1 , Anita Zaidi  1 , Ali Faisal Saleem  1
Affiliations

Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan

Yasir Shafiq et al. J Infect Prev. 2017 Sep.

Abstract

Backgound: A higher incidence of neonatal tetanus implies failure of the vaccination program in Pakistan.

Objectives: The objective of this study was to assess knowledge, attitudes and practices related to tetanus toxoid (TT) vaccine in women of childbearing age.

Methods: We performed a cross-sectional survey in peri-urban Karachi, Pakistan, among women of childbearing age, stratified into three mutually exclusive groups as: married pregnant; married non-pregnant; and unmarried. Descriptive and inferential analyses were performed to estimate vaccine coverage and knowledge attributes.

Results: A total of 450 women participated, of which the largest proportion were married and non-pregnant (n = 185/450, 41%). Over 50% of women (n = 258/450) had not received TT vaccine. Most unmarried women (n = 139, 97%) were unvaccinated. Non-vaccination predictors included: women aged <25 years without any formal education (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.4), lack of knowledge about free vaccination (adjusted OR, 4.0; 95% CI, 1.64-10.20), poor knowledge of tetanus disease/vaccination (adjusted OR, 4.6; 95%, 2.2-9.6), living with extended family (adjusted OR, 2.0; 95% CI, 1.04-3.96); family non-supporting vaccination (adjusted OR, 5.7; 95% CI, 2.3-13.9); and husband/other family member deciding upon issues related to women's health (adjusted OR, 2.9; 95% CI, 1.3-6.6).

Conclusion: Low coverage of TT vaccine is largely influenced by poor knowledge, family structure and family decision-making in the local communities of Pakistan.

Keywords: Maternal and neonatal tetanus; tetanus immunisation; women of childbearing age.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study setting and Vaccination coverage. (a) Site description, showing four peri-urban sites located in Bin Qasim town of metropolitan city Karachi, Pakistan. (b) TT vaccination coverage at study sites.
Figure 2.
Figure 2.
Recruitment process. Flow diagram of the study.
Figure 3.
Figure 3.
Graphical presentation of KAP survey related to tetanus disease and TT vaccination (%).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Afridi NK, Hatcher J, Mahmud S, Nanan D. (2005) Coverage and factors associated with tetanus toxoid vaccination status among females of reproductive age in Peshawar. Journal of the College of Physicians and Surgeons – Pakistan: JCPSP 15: 391–395. - PubMed
    1. Ahmed V, Ahmed S. (2014) Poverty and Social Impact Analysis of Expanded Program on Immunization in Pakistan. Islamabad: Sustainable Development Policy Institute.
    1. Amin R, De Oliveira TJCR, Da Cunha M, Brown TW, Favin M, Cappelier K. (2013) Factors limiting immunization coverage in urban Dili, Timor-Leste. Global Health: Science and Practice 1: 417–427. - PMC - PubMed
    1. Antai D. (2012) Gender inequities, relationship power, and childhood immunization uptake in Nigeria: a population-based cross-sectional study. International Journal of Infectious Diseases 16: e136–e145. - PubMed
    1. Barau I, Zubairu M, Mwanza MN, Seaman VY. (2014) Improving polio vaccination coverage in Nigeria through the use of geographic information system technology. Journal of Infectious Diseases 210: S102–S110. - PubMed

LinkOut - more resources