Tetanus immunisation status among women of child-bearing age in three provinces in Turkey

Abstract number: p1096

Esen  B., Kurtoglu  D., Coplu  N., Gozalan  A., Miyamura  K., Ishida   S., Akin  L.

Objective: 

The goal of the study was to assess tetanus immune status among childbearing aged women in relation to the tetanus vaccine doses in three selected provinces in Turkey.

Method: 

A total of 2094 subjects were randomly selected from 26 health centres' areas in Diyarbakir, Antalya and Samsun between February 2000 and October 2001. There were no statistically significant differences between provinces by age group, gender and residence (P > 0.05). Of these, 404 15–49 years old women were selected for analyses about tetanus immunity among childbearing aged women. Tetanus antibody titres were determined by using in-house ELISA and particle agglutination tests and antibody titres >=0.1 IU/ml was accepted as protective level. Statistical analyses were done with qui-square test, Student's t-test, one-way ANOVA, and logistic regression analysis using SPSS 10.0 for windows and the special software prepared using Visual Basic 6.0 and Access.

Results: 

The women were divided into three age groups, 15–19, 20–39 and 40–49. Among 20–39 years-old women (n = 205), tetanus antibody level was higher in women with 1–3 children than those without children, demonstrating the effectiveness of the pregnant vaccination. The age specific fertility rate in Turkey is typically cumulated among the ages less than 40 years old, and the median age of first marriage in Turkey is 19.5. Based on these data women aged 20–39 years old are accepted as childbearing aged for analysis. The protective antibody level among 20–39-year-old was 74.7%, and the subjects who received more than two single-type tetanus vaccine doses were 58.8%. Among the provinces studied, Antalya had the highest immunity (P = 0.024). The percentages of the protective antibody level among women 20–39-year-ages were 86.6% in Antalya, 54.8% in Diyarbakir and 78.7% in Samsun. There was an inverse association between the percentage of the immunity level and age (P = 0.002).

Conclusion: 

Although pregnant vaccination seemed to be effective, the tetanus immunity among women of childbearing age was not enough. There is a need to reinforce the pregnant vaccination through intensive antenatal care services and encouraging pregnant women to receive these services.