Investigator(s)
| Submitter |
Tshokey Tshokey JDWNRH, KGUMSB Tshokey Tshokey 
|
| Principal Investigator |
Tshokey Tshokey JDWNRH, KGUMSB Tshokey Tshokey
|
| Co-Investigator(s) |
Dhrupthob Sonam JDWNRH/KGUMSB Dhrupthob Sonam
|
| Co-Investigator(s) |
Sweta Giri KGUMSB/JDWNRH Sweta Giri
|
| Co-Investigator(s) |
Nar Bdr Rai ERRH/KGUMSB Nar Bdr Rai
|
| Co-Investigator(s) |
Tashi Dawa MoH Tashi Dawa
|
| Co-Investigator(s) |
Cheten Zangmo MoH Cheten Zangmo
|
| Co-Investigator(s) |
Ugyen Rinzin ERRH/KGUMSB Ugyen Rinzin
|
Title(s) and abstract
| Scientific title | Assessment of Knowledge, attitude and prescription practices of health workers on tetanus toxoid in Bhutan |
| Public title | KAP on tetanus vaccine |
| Background | Tetanus toxoid is one of the commonest vaccines used in the health facilities in Bhutan daily. In the Bhutanese health system, it is one of the few therapeutics that can be prescribed without restriction by several categories of clinical providers including medical doctors, dentists, nurses, clinical officers and health assistants without any restriction. It is prescribed for various indications including cut injuries, road traffic accidents, dog and other animal bites, human bites etc. Most prescriptions happen in the emergency units of the hospitals at odd hours. While the existing EPI guideline outlines tetanus toxoid administration as part of the routine immunization schedule, it does not specifically address its use in wound care or injury management. In the absence of a separate clinical guideline or protocol, tetanus toxoid is often over-prescribed and overused, with patients receiving the vaccine without adequate screening or risk assessment. This leads to unnecessary exposure to the toxoid and avoidable healthcare costs. |
| Objectives | This study will be carried out with the following objectives: • To assess the knowledge of Bhutanese health workers on the use of tetanus toxoid vaccine • To explore the attitude of health professionals towards TT vaccine use • To determine their clinical practices on tetanus toxoid • To enumerate the factors influencing TT prescription behaviors of health workers |
| Study Methods | This will be a cross-sectional descriptive survey conducted through a self-administered online questionnaire. |
| Expected outcomes and use of results | The findings from this study will be useful for creating awareness amongst the public and health workers in Bhutan. The study findings may prompt wide scale advocacy to public, development of guidelines and protocols and training of health workers in the country, if required. It may also prompt the development of guidelines and clinical practice recommendations for the widespread use of TT vaccine boosters leading to the overall adaptation of international best practices. It will also lead to change in policy and practice on administration of TT vaccine. In the long run, the findings will contribute to a reduction in unnecessary TT prescriptions, prevention of adverse events associated with overuse, and a decrease in TT vaccine costs for the government. Furthermore, the study may encourage improvements in vaccine data management systems, enabling better tracking and monitoring of vaccine usage, and enhancing overall vaccine delivery efficiency. These improvements will facilitate more adequate resource allocation, increase public trust in the immunization system, and ultimately contribute to stronger health system performance and sustainability. |
| Keywords | Bhutan, booster, KAP, tetanus toxoid, vaccination |
Research Details
| Student research | No |
| Start Date | 01-Sep-2025 |
| End Date | 31-Dec-2025 |
| Key Implementing Institution | Self |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Immunization/Vaccine Preventable Disease |
| Involves human subjects | Yes |
| Population-Based Survey | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |