Date of Conferral
2020
Degree
Ph.D.
School
Public Health
Advisor
Patrick B. Williams
Abstract
Although tetanus is not a contagious disease, it can be deadly for people who are exposed and do
not have protective immunity against tetanus, which can be acquired only through vaccination.
Most studies on adult tetanus protective immunity are from high-income countries; limited
studies occur in Africa, and none has been reported from the Democratic Republic of the Congo
(DRC). This study sought to determine protective immunity against tetanus among adults in
DRC in relation to their age, sex, place of residence, and for women, antenatal care. The primary
purpose of this observational cross-sectional study using a nested serosurvey within the
Demographic Health Survey was to assess protective immunity against tetanus among adults in
DRC from November 2013 to February 2014. The secondary purpose was to identify
characteristics of populations at greatest risk of tetanus infection. The health belief model was
the theoretical foundation for this study, and multivariate logistic regression for complex samples
was used to analyze data from 8,602 participants. Women in the DRC were 10 times as likely to
be protected against tetanus, but both sexes ages 15–19 had lower immunity as teens, with 75%
not protected against tetanus. As women were targeted for antenatal care during pregnancy,
immunity against tetanus increased in women over age 20. This evidence will allow the Ministry
of Health to make informed policy decisions regarding adolescent and adult immunization. There
is potential for positive social change by influencing immunization policy, providing equity in
preventive health services in DRC and preventing death from a disease that has an efficacious
vaccine.
Recommended Citation
Gerber, Sue K., "Tetanus Immunity Among Adults in the Democratic Republic of the Congo" (2020). Walden Dissertations and Doctoral Studies. 8715.
https://scholarworks.waldenu.edu/dissertations/8715
