BMC Public Health. 2025 Oct 3;25(1):3319. doi: 10.1186/s12889-025-24687-9.
ABSTRACT
INTRODUCTION: Tetanus is a public health concern in East Africa, impacting pregnant women and infants since vaccination rates are below acceptable levels. Despite several studies examining tetanus toxoid vaccine coverage in East Africa, the total pooled vaccination coverage rate remains unknown, and the results of these studies are related to these variables. The purpose of this meta-analysis is to estimate the pooled tetanus toxoid vaccination coverage rates among pregnant women in East Africa and identify contributing variables.
METHODS: We searched PubMed, Scopus, Embase, and Google Scholar for studies published between March 10, 2015, and March 10, 2025. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) criteria. The study quality was assessed using a modified version of the Newcastle-Ottawa quality assessment tool. The data were retrieved separately by two authors using Microsoft Excel and analyzed with Stata version 17. A random effects model was used to calculate the pooled vaccination coverage and related covariates. Publication bias is assessed using funnel plots and Egger’s test, while heterogeneity is evaluated through Cochran’s Q test and the I² statistic, helping to ensure the reliability of meta-analytic findings. The PROSPERO registration number for this evaluation was CRD420251008125.
RESULT: The meta-analysis included 25 articles and 70,592 participants. Pregnant women in East Africa had at least two doses of tetanus toxoid vaccination, with a pooled estimate of 47% (95% CI: 41%-54%). The meta-analysis revealed that maternal education (OR = 0.63), media exposure (OR = 1.14), ANC service follow-up (OR = 1.06), place of delivery (OR = 1.17), wealth index (OR = 1.25), family planning use (OR = 0.55), number of ANC visits (OR = 3.12), place of residence (OR = 0.88), and need for indexed birth status (OR = 1.36) were significant predictors of tetanus toxoid vaccination coverage.
CONCLUSION: The findings indicate that receiving at least two doses of tetanus toxoid immunization coverage among pregnant women in East Africa was low. Furthermore, various factors were significantly associated.
PMID:41044529 | DOI:10.1186/s12889-025-24687-9
