Assessment of tetanus Immunization among healthcare workers in Mogadishu, Somalia

Figures & data

Table 1. Sociodemographic parameters, numbers, percentages.

Parameters		N	%
Gender	Male Female	121 297	28.9 71.1
Age	<25 25–35 36–40 >40	301 114 2 1	72 27.3 0.5 0.2
Profession	Doctor Nurse Nursing student Laborant Paramedics	65 148 178 12 15	15.6 35.4 42.6 2.9 3.6
Educational status	School level University level Bachelor’s degree Master’s degree Specialist	5 264 124 20 5	1.2 63.2 29.7 4.8 1.2
Monthly Income status	<$250 $250–500 >$500	196 88 134	46.9 21.1 32.1
Work experience	None 1–4 years 5–10 years >10 years	241 111 58 8	57.7 26.6 13.9 1.9
Region of residence	Village Town City center	92 72 254	22 17.2 60.8

Table 2. Knowledge of tetanus and vaccine.

Questions	Responses	N	%
1. Tetanus enters the body through cuts or wounds.	Yes No Do not know	317 29 72	75.8 6.9 17.2
2. Tetanus can cause serious health problems, such as the inability to open the mouth, difficulty swallowing and breathing, or death.	Yes No Do not know	289 48 81	69.1 11.5 19.4
3. Tetanus is a bacterial infection.	Yes No Do not know	318 44 56	76.1 10.5 13.4
4. Vaccine prevents tetanus.	Yes No Do not know	323 24 71	77.3 5.7 17
5. Tetanus vaccine can be given at any age, including pregnancy.	Yes No Do not know	255 81 82	61 19.4 19.6
6. Five doses of *DtaP are recommended during childhood.	Yes No Do not know	211 60 147	50.5 14.4 35.2
7. A booster dose of the tetanus vaccine is usually recommended every 10 years.	Yes No Do not know	187 82 149	44.7 19.6 35.6
8. A booster dose is given every five years in case of a large or dirty wound or burn.	Yes No Do not know	208 60 150	49.8 14.4 35.9
9. Tetanus vaccine can be given at the same time as other vaccines.	Yes No Do not know	205 101 112	49 24.2 26.8
10. Tetanus vaccine may cause an allergic reaction or an epileptic seizure.	Yes No Do not know	195 88 135	46.7 21.1 32.3
11. In clean and minor injuries, if the immunization status is unknown or < 3 doses, vaccine + TIG is recommended.	Yes No Do not know	209 52 157	50 12.4 37.6
12. If immunization status is unknown or < 3 doses in dirty injuries, vaccine +**TIG is recommended.	Yes No Do not know	191 58 169	45.7 13.9 40.4

(*): Diphtheria Tetanoz acellular Pertussis; (**): Tetanus immunoglobulin.

Table 3. Tetanus vaccine status of healthcare workers.

Questions	Responses	N	%
1. Frequency of clean or dirty injuries?	At least once a day At least once a week At least once a month At least once a year	161 82 95 80	38.5 19.6 22.7 19.1
2. Did you receive a tetanus vaccine in childhood?	Yes No Do not know	220 132 66	52.6 31.6 15.8
3. Have you ever had a booster dose of the tetanus vaccine?	Yes No Do not know	163 174 81	39 41.6 19.4
4. The number of vaccine doses?	I never did One dose Two doses Three doses > Three doses I don’t know	102 54 36 69 45 112	24.4 12.9 8.6 16.5 10.8 26.8
5. Vaccine was free or paid?	Paid myself Free Do not know	97 177 144	23.2 42.3 34.4
6. Availability of the tetanus vaccine at the workplace or educational institution?	Yes No Do not know	241 90 87	57.7 21.5 20.8
7. Reasons for not being vaccinated?	Expensive Afraid of the side effects of the vaccine The vaccine is not easily available Not necessary Lack of time Because of religious and cultural values Unanswered	50 87 67 46 33 23 112	12 20.8 16 11 7.9 5.5 26.8
8. Is tetanus vaccination mandatory in your institution or education unit?	Yes No Do not know	161 177 80	38.5 42.3 19.1
9. Is vaccination training given in the health institution or education unit you work for?	Yes No Do not know	215 146 57	51.4 34.9 13.6

Table 4. Comparison of sociodemographic characteristics and level of knowledge about tetanus and vaccine (χ²).

Variables			Good Knowledge (≥%70),		Poor Knowledge (<%70),		p values
			N	%	N	%
Overall	Categories		123	29.4	295	69.6	-
Gender	Male		53	12.7	68	16.3	<.001
	Female		70	16.7	227	53.3
Age	<25		48	11.5	253	60.5
	25–35		75	17.9	39	8.5	<.001
	36–40		0	0	2	0.4
	>40		0	0	1	0.2
Profession	Doctor		40	9.5	25	6.5
	Nurse		54	12.9	94	20
	Nursing student		23	5.5	155	37	<.001
	Laborant		5	1.3	7	1.6
	Paramedics		1	0.2	14	3.2
Education	School level		0	0	5	1.3
	University level		37	8.8	227	54.2
	Bachelor’s Degree		70	16.8	54	12.1	<.001
	Master’s Degree		13	3.1	7	1.6
	Specialist		3	0.7	2	0.4
Income	<$250		32	7.7	164	39.2
	$250–500		28	6.6	60	14.3	<.001
	>$500		63	15.1	71	16.1
Region of Residence	Village		10	2.4	82	19.6
	Town		21	5	51	12.2	<.001
	City center		92	22	162	37.8
Experience	None		37	8.8	204	48.8
	1–4 years		48	11.5	63	13.6	<.001
	5–10 years		33	7.8	25	6.5
	>10 years		5	1.3	3	0.7

Table 5. Evaluation of none-vaccination according to sociodemographic characteristics (χ²).

Variables		Expensive	Afraid of Side Effects	Not Easily Available	Not Necessary	Lack of Time	Religious and Cultural Factors	Total (%)	p-value
Gender (%)	Male	17.4	25.6	24.4	14	14	4.7	100	.008
	Female	15.9	29.5	20.9	15.5	9.5	8.6	100
Age (%)	<25	17	29.8	20	16.2	8.9	8.1	100	<.001
	25–35	14.7	25	29.4	10.3	14.7	5.9	100
	36–40	0	0	0	50	50	0	100
	>40	0	0	0	0	100	0	100
Profession (%)	Doctor	10.6	40.4	17	8.5	19.1	4.3	100	<.001
	Nurse	22.5	28.4	16.7	14.7	9.8	7.8	100
	Nursing student	15	25	27.1	16.4	7.9	8.6	100
	Laborant	14.3	14.3	42.9	0	28.6	0	100
	Paramedic	0	30	10	40	10	10	100
Education (%)	School Level	20	40	20	0	20	0	100	<.001
	University	16.3	25.7	21.3	17.8	9.4	9.4	100
	Bachelor’s Degree	17.6	30.6	23.5	10.6	14.1	3.5	100
	Master’s Degree	0	63.6	27.3	0	0	9.1	100
	Specialist	33.3	0	0	33.3	33.3	0	100
Experience (%)	None	19.4	20.6	22.6	16.8	11.6	9	100	.001
	1–4 years	20.7	27.6	22.4	20.7	8.6	0	100
	5–10 years	8.6	41.9	20.4	8.6	10.8	9.7	100
	>10 years	17.5	27.9	23.5	15.3	8.7	7.1	100
Income (%)	<$250	14.1	28.2	20.5	15.4	12.8	9	100	<.001
	$250–500	15	35	20	12.5	12.5	5	100
	>$500	20	0	0	20	40.0	20	100
Region (%)	Village	27.1	21.4	21.4	10	11.4	8.6	100	.002
	Town	14.3	28.6	26.5	12.2	8.2	10.2	100
	City center	12.8	31	20.9	17.6	11.2	6.4	100

Figure 1. Factors affecting vaccination in Sub-Saharan Africa.