Knowledge and Behaviour Towards Tetanus Toxoid Immunisation in South-South, Nigeria: Findings from Antenatal Clinic Attendees


  • Otobong A. Asuquo
  • Emmanuel C Inyangetoh



Tetanus toxoid, Immunisation, Practice, Attitude, Nigeria


Tetanus infection has remained a major health problem in the third world countries despite the availability and accessibility of effective antibodies as vaccines. The knowledge of women about the diseases may affect their behavior with regards to prevention of the disease. This was a descriptive cross sectional study to assess the knowledge and behavior towards tetanus toxoid immunization by 252 antenatal clinic attendees in two health facilities Uyo metropolis. The majority of respondents had heard about Tetanus infection 247(98.1%) and tetanus toxoid (97.2%), with Health workers being the main source of information 213 (85.9%). Most, 228(90.5%) knew it is for prevention, while only 80 (31.7%) were aware 5 doses confer lifetime immunity.  Most of the women 236 (93.7%) had received at least a dose of TT; 123(52.1%) had up to 5 doses, while 184(78%) claimed they had completed the immunisation schedule. The commonest reason some had not received any was its not being offered to them (31.3%). There was a global positive attitude towards TT immunisation. The level of education but not age of respondents was statistically associated with being immunized (P=0.001).The study showed a fairly good awareness of tetanus infection and immunisation with   misconceptions and a good disposition unmatched by practice. There is therefore the need for proper health education especially on the number of doses, intervals/ schedules, the protection offered, as well as need for the evaluation of the content of health enlightenment information provided by health personnel to mothers attending ANCs

Author Biography




Khan R, Vandelaer J, Yakubu A, Raza A A, and Zulu F, "Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all. A review.," International journal of women`s health, vol. 7, no. 1, pp. 171-180, 2015.

Roper M H, Vandelaer J, and Gasse F, "Maternal and neonatal tetanus," Lancet , vol. 370, pp. 1947-1959, 2007.

Blum FC, Chen C, Kroken A R, and Barbieri J T, "Tetaus toxin and botulinum toxin A utilize Unique mechanisms to enter neurons of the central nervous system," Infect. Immune, vol. 80, pp. 1662-1669, 2012.

Hassel B, "Tetanus: Pathophysiology, treatment, and the possibility of using Botulinum toxin against Tetanus induced rigidity and spasms," Toxins, vol. 5, pp. 5:73-83, 2013.. [Online].;doi:10.3390/toxins5010073

William Atkinson MJ H. (2016, March) Docshare. [Online].

Bleck T P, Clostridium tetani(Tetanus): In Principles and Practice of infectious diseases, 6th ed., Mandell L G, Bennett E J, and Dolin R, Eds. Amsterdam, The Netherlands: Elsevier, 2005.

Kyu H H et al., "Mortality from tetanus between 1990 and 2015: findings from the Global Burden of Disease study 2015," BMC Public Health, vol. 17, no. 1, p. 179, 2017. [Online].

WHO. (2015, May) Maternal and Neonatal Tetanus(MNT) elimination. The initiative and challenges. [Online].

Darmstadt G L et al., "Evidence-based, cost-effective interventions: how many newborn babies can we save?," Lancet, vol. 365, pp. 977–988, 2005.

World Health Organization. (2014, May) Second and subsequent doses of tetanus toxoid: reported estimates of TT2+ coverage. [Online].

National Population Commission (NPC) [Nigeria] and ICF International, "Nigeria Demographic and Health Survey 2013," in NPC and ICF International, Abuja, Nigeria, and Rockville, Maryland, USA, 2014.

Jalal-Eddeen Abubakar Saleh and Khaled Abdelrahim, "Towards Elimination of Maternal and Neonatal Tetanus in the Developing Countries: A Look at the Theory of Planned Behaviour," European Journal of Preventive Medicine, vol. 3, no. 4, pp. 110-116, 2015.

Nigeria Galleria. Prominent Towns in Akwa-Ibom. [Online].

Alex-Hart B A and Okon BA N, "Awareness and status of Tetanus Toxoid Vaccination among female undergraduate students in a Nigerian University," Int. J Trop. Dis Health, vol. 7, no. 1, pp. 6-15, 2015.

Charan J and Biswas T, "How to calculate sample size for different study designs in medical research?," Indian J Psychol Med, vol. 35, no. 2, pp. 121-6, 2013. [Online].

Qadir M et al., "Frequency of tetanus toxoid immunization among college and University female students of Karachi," J Ayub med coll Abbottabad, vol. 22, no. 1, pp. 147-9, 2010.

Chris-Otubor G O, Dangiwa D A, Lor L D, and Anukam N C, "Assessment of knowledge, Attitude and practices of mothers in Jos North Regarding immunization," IOSR Journal of Pharmacy, vol. 5, no. 6, pp. 34-45, June 2015.

Madubuike G, Asuquo E O, and Oriji V K, "Tetanus toxoid immunization, Drop - out Rates and determining factors among women in Niger- Delta community," Nigeria. International Journal of public Health Research, vol. 6, no. 2, pp. 20-25, 2018.

Basher M S, "Knowledge and practice about TT vaccination among undergraduate medical students," Mymensingh Med J, vol. 19, no. 4, pp. 520-523, 2010.

Sule S S, Nkem-Uchendu C, Onajole A T, and Ogunowo B E, "Awareness, Perception and coverage of TT immunization in women of child bearing age in an Urban district of Lagos, Nigeria," Niger Postgrad Med J, vol. 21, no. 2, pp. 107-24, 2014.

Seger H R and Abbas I M, "Assessment of Pregnant Women's Knowledge about Tetanus Toxoid Vaccination in Karbala City," Iraqi National Journal of Nursing specialties, vol. 27, no. 1, pp. 23-31, 2014.

UNICEF. (2018, October) MNT- Endemic Countries. [Online]. Http://

Bello A D and Aduroja P E, "Asseessment of tetanus toxoid vaccination and uptake among women of reproductive age in Kwara state, Nigeria," JOCAMR, vol. 4, no. 2, pp. 1-10, 2017. [Online]. in_Kwara_StateNigeria

Enuku C A and Orru O, "Awareness of tetanus toxoid vaccination by pregnant women attending antenatal clinic in central hospital, Benin City," Journal of science and practice of Pharmacy, vol. 3, no. 1, pp. 92-96, December 2016. [Online].

WHO. Immunization, vaccines and biologicals: vaccines and diseases - maternal and neonatal tetanus elimination (MNTE). [Online]. http://www.who.Int/immunization/diseases/MNTE_initiative/en/

Onale R, Mshelia H, William I, and Ogala N, "Prevalence and outcome of Neonatal Tetanus in Zaria, North West, Nigeria," J infest Dev Countries , vol. 5, no. 4, pp. 225-39, 2011.

Martin A, Mensah A, Frimpong F, Aboagye E, and Acheampong N, "Immunization Coverage of pregnant Woman With Tetanus Toxoid Vaccine in Dormant East District- Bring Adaro Region, Ghana," vol. 4, no. 6, pp. 47-55, 2014.

Madubuike G, Asuquo E O, and Oriji V, "Perception of tetanus toxoid immunization among women in a Niger Delta community, Nigeria," International Journal of tropical disease and Health, vol. 23, no. 3, pp. 1-8, June 2017.

Orimadegun A E, Adepoju A A, and Akinyinka O O, "Prevalence and socio-demographic factors associated with non-protective immunity against tetanus among high school adolescents girls in Nigeria," Ital J Pediatr, vol. 40, no. 1, p. 29, March 2014. [Online].

Shafiq Y et al., "Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan," J Infect Prev, vol. 18, no. 5, pp. 232-241, 2017.




How to Cite

Abah, M. G., Asuquo, O. A., & Inyangetoh, E. C. (2019). Knowledge and Behaviour Towards Tetanus Toxoid Immunisation in South-South, Nigeria: Findings from Antenatal Clinic Attendees. Asian Journal of Applied Sciences, 7(5).