Study finds few Yemeni women immunized, also spelling trouble for their unborn babiesDeadly tetanus could disappear with simple vaccine [Archives:2007/1024/Health]

February 12 2007

Jamal Al-Najjar
[email protected]

Although tetanus is one of the world's most common fatal diseases, the majority of Yemeni women don't receive the tetanus vaccine, according to a recent graduate research study by Sana'a University's Faculty of Medicine.

The study found that 99 percent of the estimated 1,300 girls studied know about tetanus, 96 percent know a vaccine is available and 86 percent know about methods of transmission. However, only 39 percent of girls were vaccinated, which may have deadly consequences in the future for these girls and their babies.

The study concentrated on female immunization because immunizing the mother can protect both her and her baby from the deadly disease. According to UNICEF, 500,000 infants worldwide die every year because their mothers aren't immunized.

Tetanus is transmitted to babies by using unsterile instruments that carry the tetanus bacteria when cutting the umbilical cord following delivery. Unimmunized mothers also can be subject to the disease if post-delivery, post-abortion or post-surgical wounds are exposed to the infectious bacteria.

[Tetanus] can be eliminated through effectively vaccinating infants and women of childbearing age (15-45 years old), as well as promoting safe and clean delivery practices,” the research stated.

The high number of unimmunized girls in Yemen raises many questions about the role the Ministry of Public Health and international organizations play in eliminating the problem.

The study investigated why Yemeni girls don't get the vaccine. Some said they refrained from vaccination because they feared the pain from the needle, while others said the vaccination campaigns didn't come to their schools.

Ahmed Al-B'adani, supervisor of the immunization program in Sana'a, said there are no regular vaccination campaigns against tetanus. “We only did vaccination activities at some schools in Sana'a, such as Al-Tahrir and Al-Saba'een districts in 2004, in addition to five vaccination rounds that covered most of the areas far from Sana'a city in 2006,” he noted.

One reason for the lack of immunization campaigns against tetanus is absence of financial support, said a source from the National Program for Extended Immunization Center, who declined to give his name.

“With the cooperation of [the World Health Organization], we aim to eliminate tetanus in 2007. Approximately 4.9 million women are targeted, but we need about $10 million to cover immunizations nationwide. Campaigns will be launched in intervals according to the vaccination schedule,” he explained.

“Due to traditions, some women don't want to go to immunization centers where only men work, so we need female staff at those centers, especially in the rural areas,” he added.

The same source disclosed that there are no specific statistics regarding the mortality rate due to tetanus in Yemen.

The researchers recommended the Ministry of Health exert more effort, particularly concerning regular vaccination campaigns in schools. They also stressed that the Ministry of Education should shed light on the disease and its protection factors, including the vaccination schedule in schools, so that all students are aware.

It seems that the risk of tetanus is much higher in remote areas.

“We conducted our research on educated groups represented by female students in Sana'a; however, the number of unimmunized girls was high. What about the immunization practices of illiterate women, especially those living in rural areas?” said Mohammed Al-Alie, a member of the research group.

A vaccine schedule must be followed in order for immunization to be most effective. Women need five doses. The first dose begins as early as possible in pregnancy, then again four weeks later, then after six months or during the subsequent pregnancy. The fourth dose follows a year after the third dose or during the subsequent pregnancy, and the last dose is a year after the fourth dose or the next pregnancy.

According the national program of extended immunization in Yemen, children should have three doses. The first dose begins a month and a half after birth, followed by the second dose at two and a half months and the last dose at three and a half months.

All of those involved in this field stress that without public cooperation, the efforts of both the Ministry of Health and international organizations aren't enough to eliminate the disease. The entire society must contribute effectively to the elimination process by adhering to the vaccination schedule, as well as following clean delivery practices during childbirth.