Background: Tetanus toxoid (TT) immunization coverage is low in Tigray as in many other parts of Ethiopia. Protection at birth (PAB) coverage has never been assessed in Tigray.
Objective: To identify factors influencing TT immunization and PAB coverage.
Methods: A community based cross-sectional immunization coverage survey was conducted in Tselemti district, Ethiopia in July 2001. Two hundred-twenty households with 0-23 months old children in 7 rural villages and 4 urban
centres were selected using a stratified multistage cluster sampling technique. Trained nurses assessed the immunization status of 140 rural and 80 urban mothers by reviewing of vaccination cards and mother’s history.
Results: TT 3+coverage (mothers vaccinated with three or more doses of TT) was 75.5% by card plus history, 82.1% for rural and 63.8% for urban areas (p=0.002). Percent of children PAB from tetanus was 61.8% by card plus history, 71.4% for rural and 45.0% for urban areas (p<0.001), 58.6% for illiterate and 79.4% for literate mothers (p=0.022). Multi-variate logistic regression analysis demonstrated maternal immunization awareness score (MIAS), and residence to be predictors of TT 3 immunization status, and MIAS, residence and maternal education to be the predictors of PAB.
Conclusion: Community mobilization and raising mothers' awareness along with the expansion of antenatal care services might be important strategies to increase TT immunization coverage and protect newborns in urban as well as
in rural areas.