The Open Public Health Journal

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Tetanus Toxoid Immunization Status and Associated Factors among Mothers in Hawzen, Eastern Zone of Tigray, Ethiopia, 2019

Meresa Berwo Mengesha1, *, Desta Abraha Weldegeorges1, Natnael Etsay Assefa1, Senait Gebreslasie Gebremeskel1, Hagos Degefa Hidru2, Hirut Teame2, Yared Hailesilassie3
1 Department of Midwifery, Adigrat University, College of Medicine and Health Sciences, Adigrat, Tigray, Ethiopia
2 Department of public Health, Adigrat University College of Medicine and Health Sciences, Adigrat, Tigray, Ethiopia
3 Department of Nursing, Adigrat University College of Medicine and Health Sciences, Adigrat, Tigray, Ethiopia



Neonatal tetanus remains a significant avertable cause of morbidity and mortality in neonates. Adequate vaccination strategies, including at least two doses of tetanus toxoid for reproductive age women, can decrease neonatal mortality. In Ethiopia, a few numbers of neonates were protected at birth through this proactive intervention. Therefore, this study aimed to determine factors associated with the low coverage of tetanus toxoid immunization.


This study aimed to determine the status of Tetanus Toxoid immunization coverage and factors associated with it.


Community-based cross-sectional study design was implemented among 515 mothers in Hawzen, Eastern zone of Tigray. The data were entered into Epi data manager version 3.5.1 and exported to Statistical Package for Social Science version 20 software for analysis. Bivariate and multivariate logistic regression was used to identify factors significantly associated with tetanus toxoid immunization coverage.


Two hundred and seven (40.2%) mothers were protected against tetanus at last birth. Mothers whose age was less than 20 years [AOR 0.19(0.10, 0.32), had no future plan for fertility [AOR 0.30(0.17, 0.53)], mothers attended once for antenatal care visits [AOR 0.38(0.18, 0.82)] and who got information from media [AOR 4.49(1.82, 11.07] were independent predictors of tetanus toxoid immunization status of mothers.


More than half of the mothers were not protected against tetanus at the time of last birth. This study found the age of mothers, future fertility plans, numbers of antenatal care visits and mothers who got information from media; these were significant factors associated with the likelihood of tetanus toxoid immunization of mothers.

Keywords: Tetanus Toxoid, Vaccination, Immunization, Mothers, Bivariate and multivariate analysis, Vaccination.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 13
First Page: 281
Last Page: 288
Publisher Id: TOPHJ-13-281
DOI: 10.2174/1874944502013010281

Article History:

Received Date: 28/2/2020
Revision Received Date: 1/5/2020
Acceptance Date: 13/5/2020
Electronic publication date: 21/06/2020
Collection year: 2020

© 2020 Mengesha et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Midwifery, Adigrat University, College of Medicine and Health Sciences, Adigrat, Tigray, Ethiopia; E-mail:

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