PMID- 23152814
OWN - NLM
STAT- MEDLINE
DCOM- 20130501
LR  - 20220409
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 11
DP  - 2012
TI  - Maternal tetanus toxoid vaccination and neonatal mortality in rural north India.
PG  - e48891
LID - 10.1371/journal.pone.0048891 [doi]
LID - e48891
AB  - OBJECTIVES: Preventable neonatal mortality due to tetanus infection remains 
      common. We aimed to examine antenatal vaccination impact in a context of 
      continuing high neonatal mortality in rural northern India. METHODS AND FINDINGS: 
      Using the third round of the Indian National Family Health Survey (NFHS) 2005-06, 
      mortality of most recent singleton births was analysed in discrete-time logistic 
      model with maternal tetanus vaccination, together with antenatal care utilisation 
      and supplementation with iron and folic acid. 59% of mothers reported receiving 
      antenatal care, 48% reported receiving iron and folic acid supplementation and 
      68% reported receiving two or more doses of tetanus toxoid (TT) vaccination. The 
      odds of all-cause neonatal death were reduced following one or more antenatal 
      dose of TT with odds ratios (OR) of 0.46 (95% CI 0.26 to 0.78) after one dose and 
      0.45 (95% CI 0.31 to 0.66) after two or more doses. Reported utilisation of 
      antenatal care and iron-folic acid supplementation did not influence neonatal 
      mortality. In the statistical model, 16% (95% CI 5% to 27%) of neonatal deaths 
      could be attributed to a lack of at least two doses of TT vaccination during 
      pregnancy, representing an estimated 78,632 neonatal deaths in absolute terms. 
      CONCLUSIONS: Substantial gains in newborn survival could be achieved in rural 
      North India through increased coverage of antenatal TT vaccination. The apparent 
      substantial protective effect of a single antenatal dose of TT requires further 
      study. It may reflect greater population vaccination coverage and indicates that 
      health programming should prioritise universal antenatal coverage with at least 
      one dose.
FAU - Singh, Abhishek
AU  - Singh A
AD  - Global Health & Social Care Unit, School of Health Sciences & Social Work, 
      University of Portsmouth, Portsmouth, United Kingdom. abhi_iips@yahoo.co.in
FAU - Pallikadavath, Saseendran
AU  - Pallikadavath S
FAU - Ogollah, Reuben
AU  - Ogollah R
FAU - Stones, William
AU  - Stones W
LA  - eng
PT  - Journal Article
DEP - 20121109
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Tetanus Toxoid)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Female
MH  - Health Surveys/statistics & numerical data
MH  - Humans
MH  - India/epidemiology
MH  - *Infant Mortality
MH  - Infant, Newborn
MH  - Maternal Health Services/statistics & numerical data
MH  - Pregnancy
MH  - *Rural Population
MH  - Tetanus/epidemiology/*mortality
MH  - Tetanus Toxoid/*immunology
MH  - Young Adult
PMC - PMC3494717
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2012/11/16 06:00
MHDA- 2013/05/02 06:00
PMCR- 2012/11/09
CRDT- 2012/11/16 06:00
PHST- 2012/06/06 00:00 [received]
PHST- 2012/10/03 00:00 [accepted]
PHST- 2012/11/16 06:00 [entrez]
PHST- 2012/11/16 06:00 [pubmed]
PHST- 2013/05/02 06:00 [medline]
PHST- 2012/11/09 00:00 [pmc-release]
AID - PONE-D-12-16955 [pii]
AID - 10.1371/journal.pone.0048891 [doi]
PST - ppublish
SO  - PLoS One. 2012;7(11):e48891. doi: 10.1371/journal.pone.0048891. Epub 2012 Nov 9.