Seroepidemiological surveillance of antitetanus antibodies in Pakistani childbearing women: A population based survey

Maternal and Neonatal Tetanus is a severe, often fatal ailment characterized by sweeping augmented strictness and convulsive spasms of skeletal muscles. Vaccination is the most steadfast method of forbearance against this disease and has inculcated to lessen mortalities. The present study was carried out with a view to assess the serum levels of tetanus antitoxins in randomly selected rural and urban women to find out the effect of age, number of pregnancy, parity and number of injections at the time of delivery. The study was cross-sectional in design and hospital-based. The gold standard mouse neutralization assay was employed despite being costly and cumbersome. Antibody titre of each sample was determined by seroneutralization method. 1504 women, randomly selected from various hospitals of age 15 to 40 years, 1064 (0.000) were vaccinated, which are significant while 440 were unvaccinated women and taken as control. The 65% (p = 0.000) women had antibody titre higher than protective level which is significant, 28% equal to protective level and 6.7% below protective level. Average antibody titre of 3rd trimester was higher than 2nd trimester (p = 0.000) which is significant. Immunization awareness and practice was higher in 30 years in women (63%) of both rural and urban areas but practice was comparatively higher in urban (74%) than rural area (67%). These finding shows that tetanus vaccination in our population is generally effective and cannot be protected by herd immunity, as tetanus is not communicable disease. Key words: Antitetanus antibodies, seroneutralization, childbearing age, Pakistan. INTRODUCTION Tetanus caused by Clostridium tetani , is a vaccine-preventable, global infectious disease with significant morbidity and mortality. The global status of serological immunity against tetanus varies between countries as a result of different national vaccination policies and methods, and the criteria used for determination of serum levels of tetanus antitoxin. Protective immunity was noted