the importance of tetanus toxoid vaccine for pregnant women attending ante natal Care at Yusuf Dantsoho memorial hospital, Tudun wada Kaduna.

CHAPTER ONE 1.0 INTRODUCTION 1.1 BACKGROUND OF THE STUDY Tetanus is an acute infectious disease caused by toxigenic strains of the bacterium Clostridium tetani (C. tetani). The spores of C. tetani are present in the environment irrespective of geographical location; they enter the body through contaminated skin wounds or tissue injuries including puncture wounds. The disease may occur at any age and case-fatality rates are high even where intensive care is available. The majority of reported tetanus cases are birth-associated, occurring in low income countries among insufficiently vaccinated mothers and their newborn infants, following unhygienic deliveries and abortions and poor postnatal hygiene and cord care practices. The disease remains an important public health problem in many parts of the world where immunization programmes are suboptimal, particularly in the least developed districts of low income countries. Tetanus is a life-threatening disease caused by the spore-forming, obligate anaerobic bacterium Clostridium tetani. This bacterium is abundant worldwide, mainly found in soil and the gastrointestinal tracts of humans and other animals. The Disease is caused by the introduction of bacteria through a skin break, most commonly from a contaminated wound, or poor perinatal hygiene and improper cord care in the neonate, with most cases being birth related. Under anaerobic conditions, dormant C. tetani spores germinate into bacilli. Bacilli produce the endotoxin tetanospasmin, which prevents the presynaptic release of neurotransmitters that inhibit muscle contraction, leading to uncontrolled muscle contraction and clinical spasms. The incidence of tetanus has dramatically decreased worldwide since the mid-20th century, largely due to the development and implementation of the tetanus toxoid vaccine. Nonetheless, tetanus remains a significant infection cause of mortality in the developing world, causing an estimated 56,000 deaths annually worldwide (2015 estimate), approximately 20,000 of the in neonates. The majority of tetanus cases occur in South Asia and sub-Saharan Africa. In the United States, incidence is 0.01 per 100,000, with approximately 10% of cases occurring in patients younger than 20 years. 1.2 STATEMENT OF RESEARCH PROBLEM Tetanus is acquired when the spores of the bacterium Clostridium Tetani infect a wound or the umbilical stump of a newborn baby. People of all ages can contact tetanus but the disease is particularly common and serious in newborn babies ("neonatal tetanus"). Neonatal tetanus can be prevented by immunizing women of childbearing age with tetanus toxoid, either during or outside of pregnancy. This protects the mother through a transfer of tetanus antibodies to the fetus - also her baby. 1.3 AIM The main aim of this research work is to evaluate the importance of tetanus toxoid vaccine for pregnant women attending ante natal Care at Yusuf Dantsoho memorial hospital, Tudun wada Kaduna. 1.4 OBJECTIVES OF THE STUDY i. To evaluate the effect of tetanus toxoid vaccination for pregnant women. ii. To achieve elimination of meternal and neonatal tetanus (MNT). iii. To ensure lifelong protection against tetanus. 1.5 RESEARCH QUESTION 1. When should you worry about tetanus? 2. How do they test you for tetanus? 3. What is the first symptoms of tetanus? 4. Its possible to contact tetanus from a scratch? 5. Can you die from complication of the disease? 6. What happens to the unborn child if he/she gets tetanus? 7. what causes it? 1.6 SIGNIFICANCE OF THE STUDY • The purpose of administering the vaccine to pregnant women is to protect them from tetanus and to protect their newborn infants against Neonatal Tetanus. • Tetanus vaccination produces protective antibody levels in more than 80% of recipients after two doses (1–3). 1.7 SCOPE AND LIMITATIONS OF THE STUDY The hospital is based in Kaduna State at the North East of center Tudun Wada Kaduna Local Government then under the chairmanship of Alhaji Yusuf Dantsoho. It was commissioned in March, 1975 through the effort of his Excellency Governor Abba Kyeri (Military Administration of Kaduna State) and his Hon. Commissioner of Health Alhaji Sani Zangon Daura the Hospital was named General Hospital Tudun Wada popularly known as (Asibitin Dutse). Due to very big mountain neighboring the hospital as the right side, the hospital has some of the faculties such as male/female ward. Theatre laboratories maternity and Administration section which are all well equipped and also partner with NOCACOPLE Maryam Foundation and Government Houses e.t.c The hospital was renamed in 1992 by his Excellency colonel Hamid Ali and Governor of Kaduna State as Yusuf Dantsoho Memorial Hospital Tudun Wada Kaduna after the death of the former Chairman of Kaduna Local Government due to regards and remembrance of his efforts in serving the Local Government during his life time in Kaduna State. 1.8 OPERATIONAL DEFINITION OF TERMS i. METERNAL HEALTH: refers to the health of women before and during pregnancy, at childbirth and during the postpartum period. ii. NEONATE: A newborn baby, specifically a baby in the first 4 weeks after birth. After a month, a baby is no longer considered a neonate. iii. TETANUS: is a serious illness contracted through exposure to the spores of the bacterium, Clostridium tetani, which is found in the soil, saliva, dust, and manure. The bacteria can enter the body through deep cuts, wounds or burns affecting the nervous system. iv. MORTALITY: Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. v. MORBIDITY: Refers to having a disease or a symptom of disease, or to the amount of disease within a population. vi. ANTIBODIES:A complex protein that is manufactured by lymphocytes to neutralize or destroy an antigen or foreign protein, many types of antibodies are protective, however inappropriate or excessive formation of antibodies may lead to illness. vii. ANAEROBIC: Means "with air" and refers to the body producing energy with the use of oxygen. viii. ANTE NATAL: Is the rountine health control of presumed healthy pregnant women without symptoms in order to diagnose, disease or complicating obstetric conditions without symptoms. ix. TRIMESTER: Another common term been mentioned throughout your pregnant is trimester period of three months. x. PREGNANCY: Is the term used to describe the period in which a fetus develops from conception to birth. xi. BACTERIA: are Prokaryotic microorganisms, that are tiny and cannot be seen with the naked eyes, some are good for the body, offering protection to certain parts of the body, (normal flora) others aiding digestion while others are pathogenic (disease causing). xii. TOXIN: is a poison produced by other organisms which can make us sick or kill us. In other words, a toxin is toxic. A toxin is both toxic and immunogenic. xiii. TOXOID: is no longer toxic but it is still as immunogenic as the toxin from which it was derived.