Predictors of Tetanus Vaccine Uptake among Pregnant Women in Sudan: A Hospital-Based Cross-Sectional Study

Tetanus toxoid (TT) vaccination during pregnancy has been proven as an effective preven-tive measure to reduce the incidence of maternal and neonatal morbidity and mortality worldwide. This study aimed to assess the determinants of TT vaccine uptake among pregnant women in two public maternity specialized hospitals in Sudan. A hospi-tal-based cross-sectional study was conducted in two public hospitals, Omdurman Ma-ternity and AL-Saudi hospitals in Omdurman, Khartoum State in Sudan, from February to April 2020. Logistic regression analysis was carried out to identify factors associated with receiving three or more doses of TT vaccine among pregnant women (protected against tetanus), presented as Odds ratios, with p-values <0.05 considered significant (at 95% confidence interval). The study recruited 350 pregnant women, with 313 participants in-cluded in the analysis. This study found that only 40% of the pregnant women received 3 doses or more (protected) of TT vaccine during their current pregnancy. Pregnant women who attended Al Saudi hospital were less likely to be protected against Tetanus (received ≥ 3 doses) compared to those who attended Omdurman hospital [OR= 0.49 (95%C.I 0.29-0.82), p-value <0.05]. Furthermore, the number of children at home was a significant predictor of mothers’ immunization status as those with five children or more were ten times more to be protected against tetanus [OR= 10.54 (95% C.I 4.30-25.86), p-value <0.05]. We conclude that this low rate of TT vaccine uptake found in this study among pregnant women increases the number of newborn babies susceptible to contracting neonatal tetanus. This study provides useful information that can inform the will increase in the probabilities of morbidities and mortalities that result from maternal and neonatal tetanus. The findings of this study should be considered in development of communication strategies targeting and prioritizing at-risk groups to increase TT vaccine uptake among pregnant women in Sudan.