Compliance with tetanus toxoid immunization schedule by women using the immunization services at the university of port harcourt teaching hospital: a lesson for child immunization service providers.

Background: Maternal and neonatal tetanus (MNT) are major contributors to morbidity and mortality amongst women and neonates in Nigeria, with neonatal tetanus accounting for 20% of all neonatal deaths. MNT are preventable through immunization and hygienic birth practices. WHO recommends two doses of tetanus toxoid (TT) for pregnant women and three doses for women of child bearing age in high risk areas. Aim: To determine TT coverage rates amongst women using the University of Port Harcourt Teaching Hospital immunization centre. Method: Data in the TT immunization registers of UPTH kept from January 2011 to January 2015 (a period of 5 years) were reviewed. Information obtained included year of registration, vaccination dates, and intervals between consecutive doses. Women were considered eligible for a dose of TT if interval between consecutive doses was at least 4weeks between TT1 and TT2, 6months between TT2 and TT3, and 1 year between TT3 and TT4, and TT4 and TT5 respectively and to have defaulted if they did not receive vaccines for which they were eligible well after the minimum interval. Vaccines were considered invalid if received before the minimum interval between doses. Data were entered using Microsoft Excel spread sheet and analyzed using SPSS version 20.0. Results: During the 5year period, the number of women registered ranged from 1158-1625. One thousand, one hundred and fifty eight (71.3%) women received TT2 at the right interval, whereas 308 (19%) defaulted and 15(1.2%) were not eligible.16 (1.6 %,) received invalid doses while 137 (8.4%) had TT2 but were defaulters. Default rates increased with consecutive doses. Only 53 (3.3%) received TT1 – TT5 at appropriate intervals, 1266 (77.9%) defaulted, while 293 (18%) were not eligible for TT2-TT5. Conclusion: Tetanus toxoid coverage rates are low in our environment. The 5 dose tetanus toxoid schedule remain key to preventing maternal and neonatal tetanus. Concerted efforts should be made by all stakeholders to improve TT coverage using this schedule.