TY - JOUR
T1 - Seroprevalence of anti-tetanus antibodies in mothers and cord blood and associated factors in health-care settings in Lao People's Democratic Republic
AU - Ounnavong, Phoumsavath
AU - Chanthavilay, Phetsavanh
AU - Khampanisong, Phonepaseuth
AU - Reinharz, Daniel
AU - Muller, Claude P.
AU - Black, Antony P.
N1 - Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2020/1/29
Y1 - 2020/1/29
N2 - Background: Maternal neonatal tetanus (MNT) was eliminated from Lao People's Democratic Republic (PDR) in 2014. WHO recommends 80% coverage of 2 or more tetanus vaccinations (TT2+) in pregnancy to maintain MNT control. Vaccination coverage in Lao PDR varies among regions although the reasons are not clear. Methods: 185 pregnant women giving birth in three district hospitals in Savannakhet province, Lao PDR were recruited. A questionnaire was administered to determine factors associated with seroprotection and blood was taken from mother and cord blood to be tested for anti-tetanus antibodies by ELISA. Results: 77% of mothers and 79% of newborns had sufficiently protective antibody titres (>0.5 IU/ml) against tetanus. Only 70% of the mothers received one dose of TT vaccination during antenatal care (ANC) consultation and 45% received the recommended two injections. Although most of the vaccination took place during ANC 1 and 2, many were missed at these time-points. Anti-tetanus seroprotection in the mothers was associated with maternal age, number of ANC visits, number of TT vaccinations during and before pregnancy and gestational age. Conclusion: Seroprevalence of anti-tetanus antibodies in mothers and newborns was intermediate but TT2+ coverage was low in healthcare settings in Lao PDR. TT2+ coverage during ANC is likely to be significantly lower in settings with less robust ANC practices. Missed opportunities to vaccinate in ANC 1 and 2 suggest a need to promote vaccine awareness and vaccination at first ANC visit. A booster dose of TT containing vaccine should be considered for children aged between 4 and 7 years old.
AB - Background: Maternal neonatal tetanus (MNT) was eliminated from Lao People's Democratic Republic (PDR) in 2014. WHO recommends 80% coverage of 2 or more tetanus vaccinations (TT2+) in pregnancy to maintain MNT control. Vaccination coverage in Lao PDR varies among regions although the reasons are not clear. Methods: 185 pregnant women giving birth in three district hospitals in Savannakhet province, Lao PDR were recruited. A questionnaire was administered to determine factors associated with seroprotection and blood was taken from mother and cord blood to be tested for anti-tetanus antibodies by ELISA. Results: 77% of mothers and 79% of newborns had sufficiently protective antibody titres (>0.5 IU/ml) against tetanus. Only 70% of the mothers received one dose of TT vaccination during antenatal care (ANC) consultation and 45% received the recommended two injections. Although most of the vaccination took place during ANC 1 and 2, many were missed at these time-points. Anti-tetanus seroprotection in the mothers was associated with maternal age, number of ANC visits, number of TT vaccinations during and before pregnancy and gestational age. Conclusion: Seroprevalence of anti-tetanus antibodies in mothers and newborns was intermediate but TT2+ coverage was low in healthcare settings in Lao PDR. TT2+ coverage during ANC is likely to be significantly lower in settings with less robust ANC practices. Missed opportunities to vaccinate in ANC 1 and 2 suggest a need to promote vaccine awareness and vaccination at first ANC visit. A booster dose of TT containing vaccine should be considered for children aged between 4 and 7 years old.
KW - Anti-tetanus antibodies
KW - Laos
KW - Maternal and neonatal tetanus
KW - Seroprevalence
KW - Vaccine
UR - http://www.scopus.com/inward/record.url?scp=85075474454&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2019.11.007
DO - 10.1016/j.vaccine.2019.11.007
M3 - Article
C2 - 31735506
AN - SCOPUS:85075474454
SN - 0264-410X
VL - 38
SP - 1234
EP - 1240
JO - Vaccine
JF - Vaccine
IS - 5
ER -