Mahnoor Khattak, Laila Zia, Ayesha Rafiq Afridi, Ahmad Shiraz


Introduction: Maternal and neonatal tetanus is a disease of high mortality that is easily preventable through vaccination of pregnant women. In Pakistan due to poor tetanus immunization knowledge and practices, the disease is a prevalent cause of death amongst pregnant females and neonates.

Materials & Methods: This cross sectional study was carried out in two hospitals i.e. Hayatabad Medical Complex (HMC) and Rehman Medical Institute (RMI), Hayatabad, Peshawar from December 2015 to June 2016. Pregnant females (n=150) aged between 15-40 years were recruited for this study by convenience sampling and a structured questionnaire was used where the participants were interviewed after taking their consent. SPSS version 16.0 was used for data analysis.

Results: Majority of the pregnant females who participated in this study were aged between 15-25 years (47.2%) with no education of any sort (45.1%); 64.6% had knowledge of what tetanus vaccination was, while only 16.7% knew that it was for prevention of maternal and neonatal tetanus. In addition, 69.4% of the women cited the essentiality of tetanus vaccination for pregnant women, 56.9% of the women had been vaccinated against tetanus, majority of them (49.2%) having been given two doses. Only 41% had knowledge of what tetanus was, and a staggering 86.3% had no idea about the features of the disease itself. Though 32.8% women did not face any barriers to vaccination, 24.5% stated that their lack of knowledge of importance of tetanus vaccination caused a hindrance.

Conclusion: Practice of tetanus vaccination was high and attitude of the women was positive and encouraging but knowledge about tetanus vaccination was inadequate, with most of the females not knowing what tetanus was or why it was given.

Keywords: Tetanus; Immunization; Pregnancy; Vaccination; Tetanus Toxoid.

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Lambo JA, Nagulesapillai T. Neonatal tetanus elimination in Pakistan: Progress and challenges. Int J Infect Dis. 2012;16(12):e833-e842.

Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015 Jan 31;385(9966):430-40. Epub 2014 Sep 30.

UNICEF. WHO. UNFPA. Maternal and neonatal tetanus elimination by 2005: Strategies for achieving and maintaining elimination. [online][cited 10 May 2016]; Available from:

Demicheli V, Barale A, Rivetti A. Vaccines for women to prevent neonatal tetanus. Cochrane Database Syst Rev. 2013 May 31;(5):CD002959

Naeem M, Khan MZ, Abbas SH, Adil M, Khan A, Naz SM, et al. Coverage and factors associated with tetanus toxoid vaccination among married women of reproductive age: a cross sectional study in Peshawar. J Ayub Med Coll Abbottabad. 2010 Jul-Sep;22(3):136-40.

UNICEF. Maternal and Neonatal Tetanus Elimination Initiative Pampers UNICEF 2010 campaign launch. 2010.

WHO EMRO | Expanded Programme on Immunization | Programmes | Pakistan [Internet]. [cited 2016 Feb 16]. Available from:

Breu F, Guggenbichler S, Wollmann J. World Health Statistics 2013. [Internet]. Vasa. 2013. 168 p. Available from:

Celikel A, Ustunsoz A, Guvenc G. Determination of vaccination status of pregnant women during pregnancy and the affecting factors. J Clin Nurs. 2014;23(15-16):2142-50.

Beel ER, Rench MA, Montesinos DP, Mayes B, Healy CM. Knowledge and attitudes of postpartum women toward immunization during pregnancy and the peripartum period. Hum Vaccines Immunother. 2013;9(9):1926-31.

Kharbanda EO, Vazquez-Benitez G, Lipkind HS, Klein NP, Cheetham TC, Naleway AL, et al. Maternal Tdap vaccination: Coverage and acute safety outcomes in the vaccine safety datalink, 2007-2013. Vaccine. 2016;34(7):968-73.

Vaccine uptake in Canadian adults: Results from the 2014 adult National Immunization Coverage Survey (aNICS). 2016 Feb 24 [cited 2016 May 31]; Available from:

MacDougall DM, Halperin BA, MacKinnon-Cameron D, Li L, McNeil SA, Langley JM, et al. The challenge of vaccinating adults: attitudes and beliefs of the Canadian public and healthcare providers. BMJ Open. 2015;5(9):e009062 Available from:

Faraj FA. By: Fadwa Abdelrhman Faraj Supervised by: Dr. Ahmed Eltigani Elmardi. 2003. Available from:

Tanjida S, Sm AH, Sudhira B, Nahid S. Status of knowledge and practice about complete tetanus toxoid immunization of unmarried female students of a public university in Dhaka. Bangladesh Journal of Medical Sciences. 2009;8(4):102-9.


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