Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda
Background Neonatal mortality due to tetanus persists in Uganda despite the mandatory vaccination of pregnant mothers. Maternal antibodies wane within a year. Uganda’s maternal vaccination guidelines do not specify the timing or frequency of tetanus shots, contributing to suboptimal transfer of teta...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/7/1/e001334.full |
| _version_ | 1797368390693683200 |
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| author | Milton W Musaba David Mukunya Musa Sekikubo Moses Musooko Nicholas Mugagga Bernard Ssentalo Bagaya Mary Nantongo Fahad Muwanda Annette Olivia Nakimuli |
| author_facet | Milton W Musaba David Mukunya Musa Sekikubo Moses Musooko Nicholas Mugagga Bernard Ssentalo Bagaya Mary Nantongo Fahad Muwanda Annette Olivia Nakimuli |
| author_sort | Milton W Musaba |
| collection | DOAJ |
| description | Background Neonatal mortality due to tetanus persists in Uganda despite the mandatory vaccination of pregnant mothers. Maternal antibodies wane within a year. Uganda’s maternal vaccination guidelines do not specify the timing or frequency of tetanus shots, contributing to suboptimal transfer of tetanus antibodies to neonates. We aimed to determine the prevalence and factors associated with protective tetanus antibodies among newborns at Kawempe National Referral Hospital.Methods We conducted a cross-sectional study among 293 mother-newborn pairs. At delivery, neonatal cord and maternal venous blood were collected and titred for antitetanus antibodies using a quantitative ELISA kit. The primary outcome of the study was the proportion of newborn babies with tetanus antibodies ≥0.1 IU/mL. Associated factors were determined using generalised linear models for the Poisson family with a log link and robust variance estimation.Results A total of 258/293 (88.1%) newborns had protective antibody titres. Factors associated with adequate protective antibodies in the newborn included: high (≥0.1 IU/mL) maternal antibody titres, first antenatal visit ≥12 weeks of gestation and receiving a tetanus toxoid (TT) shot ≥28 weeks of gestation. However, number of doses received before current pregnancy was not associated with adequate protective antibody titres.Conclusion There is a high prevalence of adequate protective levels of antibodies among TT-vaccinated mothers. Maternal titres and a third trimester TT dose correlate with adequate levels of protective anti-TT antibodies among newborns. A third trimester TT dose is recommended. |
| first_indexed | 2024-03-08T17:31:47Z |
| format | Article |
| id | doaj.art-7127e2f83b5d4c1d85ee37e59ba20bed |
| institution | Directory Open Access Journal |
| issn | 2399-9772 |
| language | English |
| last_indexed | 2024-03-08T17:31:47Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj.art-7127e2f83b5d4c1d85ee37e59ba20bed2024-01-02T14:55:08ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722023-12-017110.1136/bmjpo-2021-001334Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from UgandaMilton W Musaba0David Mukunya1Musa Sekikubo2Moses Musooko3Nicholas Mugagga4Bernard Ssentalo Bagaya5Mary Nantongo6Fahad Muwanda7Annette Olivia Nakimuli86 Department of Obstetrics and Gynaecology, Busitema University, Mbale, Uganda4 Community and Public Health, Busitema University, Mbale, Uganda7 Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda1 Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda1 Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda2 Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda2 Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda2 Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda1 Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, UgandaBackground Neonatal mortality due to tetanus persists in Uganda despite the mandatory vaccination of pregnant mothers. Maternal antibodies wane within a year. Uganda’s maternal vaccination guidelines do not specify the timing or frequency of tetanus shots, contributing to suboptimal transfer of tetanus antibodies to neonates. We aimed to determine the prevalence and factors associated with protective tetanus antibodies among newborns at Kawempe National Referral Hospital.Methods We conducted a cross-sectional study among 293 mother-newborn pairs. At delivery, neonatal cord and maternal venous blood were collected and titred for antitetanus antibodies using a quantitative ELISA kit. The primary outcome of the study was the proportion of newborn babies with tetanus antibodies ≥0.1 IU/mL. Associated factors were determined using generalised linear models for the Poisson family with a log link and robust variance estimation.Results A total of 258/293 (88.1%) newborns had protective antibody titres. Factors associated with adequate protective antibodies in the newborn included: high (≥0.1 IU/mL) maternal antibody titres, first antenatal visit ≥12 weeks of gestation and receiving a tetanus toxoid (TT) shot ≥28 weeks of gestation. However, number of doses received before current pregnancy was not associated with adequate protective antibody titres.Conclusion There is a high prevalence of adequate protective levels of antibodies among TT-vaccinated mothers. Maternal titres and a third trimester TT dose correlate with adequate levels of protective anti-TT antibodies among newborns. A third trimester TT dose is recommended.https://bmjpaedsopen.bmj.com/content/7/1/e001334.full |
| spellingShingle | Milton W Musaba David Mukunya Musa Sekikubo Moses Musooko Nicholas Mugagga Bernard Ssentalo Bagaya Mary Nantongo Fahad Muwanda Annette Olivia Nakimuli Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda BMJ Paediatrics Open |
| title | Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda |
| title_full | Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda |
| title_fullStr | Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda |
| title_full_unstemmed | Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda |
| title_short | Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda |
| title_sort | antitetanus toxoid antibodies in mothers and neonates a single centre study from uganda |
| url | https://bmjpaedsopen.bmj.com/content/7/1/e001334.full |
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