Antitetanus toxoid antibodies in mothers and neonates: a single-centre study from Uganda.
epidemiology
health services research
microbiology
neonatology
Journal
BMJ paediatrics open
ISSN: 2399-9772
Titre abrégé: BMJ Paediatr Open
Pays: England
ID NLM: 101715309
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
02
03
2022
accepted:
22
06
2022
medline:
4
8
2023
pubmed:
3
8
2023
entrez:
2
8
2023
Statut:
ppublish
Résumé
Neonatal mortality due to tetanus persists in Uganda despite the mandatory vaccination of pregnant mothers. Maternal antibodies wane within a year. Uganda's maternal vaccination guidelines do not specify the timing or frequency of tetanus shots, contributing to suboptimal transfer of tetanus antibodies to neonates. We aimed to determine the prevalence and factors associated with protective tetanus antibodies among newborns at Kawempe National Referral Hospital. We conducted a cross-sectional study among 293 mother-newborn pairs. At delivery, neonatal cord and maternal venous blood were collected and titred for antitetanus antibodies using a quantitative ELISA kit. The primary outcome of the study was the proportion of newborn babies with tetanus antibodies ≥0.1 IU/mL. Associated factors were determined using generalised linear models for the Poisson family with a log link and robust variance estimation. A total of 258/293 (88.1%) newborns had protective antibody titres. Factors associated with adequate protective antibodies in the newborn included: high (≥0.1 IU/mL) maternal antibody titres, first antenatal visit ≥12 weeks of gestation and receiving a tetanus toxoid (TT) shot ≥28 weeks of gestation. However, number of doses received before current pregnancy was not associated with adequate protective antibody titres. There is a high prevalence of adequate protective levels of antibodies among TT-vaccinated mothers. Maternal titres and a third trimester TT dose correlate with adequate levels of protective anti-TT antibodies among newborns. A third trimester TT dose is recommended.
Sections du résumé
BACKGROUND
Neonatal mortality due to tetanus persists in Uganda despite the mandatory vaccination of pregnant mothers. Maternal antibodies wane within a year. Uganda's maternal vaccination guidelines do not specify the timing or frequency of tetanus shots, contributing to suboptimal transfer of tetanus antibodies to neonates. We aimed to determine the prevalence and factors associated with protective tetanus antibodies among newborns at Kawempe National Referral Hospital.
METHODS
We conducted a cross-sectional study among 293 mother-newborn pairs. At delivery, neonatal cord and maternal venous blood were collected and titred for antitetanus antibodies using a quantitative ELISA kit. The primary outcome of the study was the proportion of newborn babies with tetanus antibodies ≥0.1 IU/mL. Associated factors were determined using generalised linear models for the Poisson family with a log link and robust variance estimation.
RESULTS
A total of 258/293 (88.1%) newborns had protective antibody titres. Factors associated with adequate protective antibodies in the newborn included: high (≥0.1 IU/mL) maternal antibody titres, first antenatal visit ≥12 weeks of gestation and receiving a tetanus toxoid (TT) shot ≥28 weeks of gestation. However, number of doses received before current pregnancy was not associated with adequate protective antibody titres.
CONCLUSION
There is a high prevalence of adequate protective levels of antibodies among TT-vaccinated mothers. Maternal titres and a third trimester TT dose correlate with adequate levels of protective anti-TT antibodies among newborns. A third trimester TT dose is recommended.
Identifiants
pubmed: 37532465
pii: 10.1136/bmjpo-2021-001334
doi: 10.1136/bmjpo-2021-001334
pmc: PMC10401206
pii:
doi:
Substances chimiques
Tetanus Toxoid
0
Toxoids
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : FIC NIH HHS
ID : R25 TW011213
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: No, there are no competing interests.
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