Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus
OBJECTIVE: A Multiple-Indicator Cluster Survey (MICS) was conducted at mid-decade in more than 60 developing countries to measure progress towards the year 2000 World Summit for Children goals. These goals included the protection of at least 90% of children against neonatal tetanus through the immun...
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The World Health Organization
2002-01-01
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| Series: | Bulletin of the World Health Organization |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000900004 |
| _version_ | 1797288829303914496 |
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| author | Deming Michael S. Roungou Jean-Baptiste Kristiansen Max Heron Iver Yango Alphonse Guenengafo Alexis Ndamobissi Robert |
| author_facet | Deming Michael S. Roungou Jean-Baptiste Kristiansen Max Heron Iver Yango Alphonse Guenengafo Alexis Ndamobissi Robert |
| author_sort | Deming Michael S. |
| collection | DOAJ |
| description | OBJECTIVE: A Multiple-Indicator Cluster Survey (MICS) was conducted at mid-decade in more than 60 developing countries to measure progress towards the year 2000 World Summit for Children goals. These goals included the protection of at least 90% of children against neonatal tetanus through the immunization of their mothers, as measured by tetanus toxoid (TT) coverage. In the Central African Republic (CAR), serological testing was added to the MICS to understand better the relationship between survey estimates of TT coverage and the prevalence of serological protection. METHODS: In the CAR MICS, mothers of children younger than one year of age gave verbal histories of the TT vaccinations they had received, using the MICS TT questionnaire. A subsample of mothers was tested for tetanus antitoxin, using a double-antigen enzyme-linked immunoadsorbent assay (ELISA). Seropositivity was defined as a titre of > or = 0.01 IU/ml, and TT coverage was defined as the proportion of mothers protected at delivery, according to their history of TT vaccinations. FINDINGS: Among the 222 mothers in the subsample, weighted TT coverage was 74.4% (95% Confidence Interval (CI); 67.0% - 81.7%) and tetanus antitoxin seroprevalence was 88.7% (95% CI; 83.2% - 94.2%). The weighted median antitoxin titre was 0.35 IU/ml. CONCLUSIONS: Tetanus toxoid coverage in the CAR was lower than the prevalence of serological protection against neonatal tetanus. If this relationship holds for other countries, TT coverage estimates from the MICS may underestimate the extent to which the year 2000 goal for protecting children against neonatal tetanus was reached. We also showed that a high level of serological protection had been achieved in a country facing major public health challenges and resource constraints. |
| first_indexed | 2024-03-07T18:55:07Z |
| format | Article |
| id | doaj.art-383c2b7ced474e21b301dc103db12fcb |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:55:07Z |
| publishDate | 2002-01-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-383c2b7ced474e21b301dc103db12fcb2024-03-02T00:24:04ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862002-01-01809696703Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanusDeming Michael S.Roungou Jean-BaptisteKristiansen MaxHeron IverYango AlphonseGuenengafo AlexisNdamobissi RobertOBJECTIVE: A Multiple-Indicator Cluster Survey (MICS) was conducted at mid-decade in more than 60 developing countries to measure progress towards the year 2000 World Summit for Children goals. These goals included the protection of at least 90% of children against neonatal tetanus through the immunization of their mothers, as measured by tetanus toxoid (TT) coverage. In the Central African Republic (CAR), serological testing was added to the MICS to understand better the relationship between survey estimates of TT coverage and the prevalence of serological protection. METHODS: In the CAR MICS, mothers of children younger than one year of age gave verbal histories of the TT vaccinations they had received, using the MICS TT questionnaire. A subsample of mothers was tested for tetanus antitoxin, using a double-antigen enzyme-linked immunoadsorbent assay (ELISA). Seropositivity was defined as a titre of > or = 0.01 IU/ml, and TT coverage was defined as the proportion of mothers protected at delivery, according to their history of TT vaccinations. FINDINGS: Among the 222 mothers in the subsample, weighted TT coverage was 74.4% (95% Confidence Interval (CI); 67.0% - 81.7%) and tetanus antitoxin seroprevalence was 88.7% (95% CI; 83.2% - 94.2%). The weighted median antitoxin titre was 0.35 IU/ml. CONCLUSIONS: Tetanus toxoid coverage in the CAR was lower than the prevalence of serological protection against neonatal tetanus. If this relationship holds for other countries, TT coverage estimates from the MICS may underestimate the extent to which the year 2000 goal for protecting children against neonatal tetanus was reached. We also showed that a high level of serological protection had been achieved in a country facing major public health challenges and resource constraints.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000900004Tetanus toxoid/administration and dosageTetanus antitoxinTetanus/prevention and controlInfant, NewbornImmunization scheduleImmunization programs/utilizationSeroepidemiologic studiesCluster analysisCentral African Republic |
| spellingShingle | Deming Michael S. Roungou Jean-Baptiste Kristiansen Max Heron Iver Yango Alphonse Guenengafo Alexis Ndamobissi Robert Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus Bulletin of the World Health Organization Tetanus toxoid/administration and dosage Tetanus antitoxin Tetanus/prevention and control Infant, Newborn Immunization schedule Immunization programs/utilization Seroepidemiologic studies Cluster analysis Central African Republic |
| title | Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus |
| title_full | Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus |
| title_fullStr | Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus |
| title_full_unstemmed | Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus |
| title_short | Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus |
| title_sort | tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus |
| topic | Tetanus toxoid/administration and dosage Tetanus antitoxin Tetanus/prevention and control Infant, Newborn Immunization schedule Immunization programs/utilization Seroepidemiologic studies Cluster analysis Central African Republic |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000900004 |
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