85 research outputs found
Incidence and Predictors of Mortality among Severe Acute Malnourished Under Five Children Admitted to Dilla University Referal Hospital: A Retrospective Longitudinal Study
No full textBackground: Many developing countries continue to experience high mortality of children with severe acute malnutrition that receive treatment in inpatient set ups associated to either co-morbidity or due to poor adherence to the World Health Organization therapeutic guidelines for the management of severe acute malnutrition. Objective: To assess incidence and predictors of mortality among severe acute malnourished under five children admitted to Dilla university referral hospital from 2013 to 2015 Methods: A 36 month retrospective cohort study was conducted among 450 under five children admitted to stabilization centers in Dilla university referral hospital between 2013 and 2015. The data was collected from a randomly selected chart after getting ethical clearance from the Institutional review board of Arba Minch University by trained professionals. Data was entered and cleaned by Epi Info version 7 and analyzed by STATA version 11. Life table was used to estimate the cumulative incidence of death and Log rank tests to compare probability of hazard between variables. Bivariate and multivariate Cox proportional hazards model were used to identify predictors. Significance was considered at P-value < 0.05 in the multivariate analysis. Model was built by forward step wise procedure; compared by likely hood ratio test and Harrell’s concordance and fitness checked by cox-snell residual plot.Result: A total of 450 children were followed for 7389 person-day of observation; during the follow up period 56(12.4) died making overall incidence density rate of 7.57 (CI=5.83-9.84) per 1000 Person day. Survival at the end of 1st, 2nd and 3rd week was 95%, 88% and 84% respectively and overall mean survival time was 47(95%CI=45-48.6) day. Presence of Altered pulse rate [AHR =5.85, 95% CI= 2.55-13.4], altered body temperature [AHR= 6.94 (95 % CI [2.94-16.4], Shock (AHR=3.15 (95 % CI [1.5-6.5]), IV infusion (AHR=3.24 (95 % CI [1.54-6.8]) and septicemia/meningitis (AHR=2.88(95 % CI [1.413-5.9]) were independent predictors of mortality. Conclusion and recommendation: The incidence of death and treatment outcomes was in acceptable ranges. Intervention to further reduce deaths has to focus on children with comorbidities and altered general conditions. Key words: Severe acute malnutrition, Incidence, Under-five children, Dilla, Hospita
Correlates of maternal mortality in developing countries: an ecological study in 82 countries
No full textAbstract Background Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern. With appropriate strategy and intensive implementation programs, some countries have made remarkable progress, however in developing countries where 99% of maternal death is occurring; little or no progress has been made. Identifying determinants and designing intervention will have important role to overcome the problem. Therefore this study aimed to identify correlates of maternal mortality in developing countries. Methods This study was conducted using international data bases of health metrics from 2008 to 2016 using aggregates of health indicator data from WHO, World Bank, UNDP and UNICEF data bases for 82 developing countries. The dependent variable was the maternal mortality ratio, while the independent variable was socio-economic, health care related and morbidity variables. Data was compiled in excel and analyzed using SPSS version 21. Results Maternal mortality ratio is very high in developing countries and enormously varies among countries. A significant relationship between the maternal mortality ratio and socio-economic, health care and morbidity indicator variables was observed. There was an inverse and significant correlation of the maternal mortality ratio with Antenatal care coverage, skilled birth attendance, access to an improved water source and sanitation, adult literacy rate, the Gross National Income per capita and positive relation with disease incidence, unmet need and others. Conclusions Maternal mortality is correlated with multiples of socio-economic factors, health care system associated factors, disease burden and their complex interactions. Therefore Policy and programs targeted to improve maternal health and reduce maternal deaths should consider population dynamics, socio-economic influence and health system factors that impose a major risk on mothers
Knowledge about Obstetric Danger Signs and Associated Factors among Antenatal Care Attendants
No full text<p><span lang="EN-US">Knowledge of mothers about obstetric danger sign is the basic influencing factor for utilization of skilled maternal and neonatal cares which reduce maternal and new born mortality and morbidity. Therefore this study intended to assess knowledge about obstetric danger sign and identify associated factors among antenatal care attendants. Institutional based cross- sectional study was conducted from April to June 2015 among 358 randomly selected antenatal care attendants. Epi Info version 7 and SPSS version 20 software were used for data entry and analysis respectively. Logistic regression was run to look for the association between dependent and explanatory variables; and using variables which have p-value ≤ 0.25 binary logistic regression was fitted. Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05. </span><span>M</span><span lang="EN-US">ost of the respondents able to name some of the accepted danger signs. Two hundred eight (58%), 182(51%) and, 161(45%) of mother were knowledgeable for obstetric danger sign which could occur during pregnancy, at child birth and post-partum period respectively. The most mentioned dander signs were bleeding, retained placenta and prolonged labor. The factors that associated with Knowledge of obstetric danger signs were urban residence (AOR=2.6; 95% CI: 1.8, 4.2), being literate (AOR=2.54; 95% CI: 1.14, 5.76), multiparity (AOR 1.5; 95% CI: 1.14, 2.3) and being informed (AOR=3; 95% CI: 1.6, 6.4). The study showed that attendant’s knowledge was low. This could be averted through strategies designed to address women’s through health extension workers and health professionals</span><span>.</span></p></jats:p
Correction: Return of fertility after discontinuation of contraception: a systematic review and meta-analysis
No full textPrevalence and associated factors of thinness among adolescent girls attending governmental schools in Aksum Town, Northern Ethiopia
No full textIntroduction: Thinness among adolescent girls has not received due to attention in many developing countries including Ethiopia. However, adolescence period is the last window of opportunity to implement strategies to correct potential growth deficits thereby breaking the vicious cycle of intergenerational malnutrition. Objectives: The aim of this study is to assess the prevalence of thinness and associated factors among adolescent girls. Methods: School-based cross-sectional study design was employed from April to May 2014. Multi-stage sampling technique was used to select a total of 823 adolescent girl students. Data were collected using interviewer-administered technique using a pretested semi-structured questionnaire and anthropometric measurements. Five nurses as data collectors and three BSc nurse supervisors were included in the study. Data were entered into EPI INFO version 7 and then exported to SPSS version 20 software and WHO AnthroPlus software for analysis. Descriptive statistics was performed. Binary logistic regression was fitted, odds ratio (OR) with 95% confidence interval (CI) and P value was calculated to identify associated factors. Results: The overall prevalence of thinness in this study area was 12.6%. Age of the respondent (adjusted OR [AOR] =2.7, 95% CI: 1.4, 5.3), education status of mother (AOR = 5.4, 95% CI: 3.3, 6.5), menstruation status (AOR = 0.5, 95% CI: 0.3, 0.9), individual dietary diversity (AOR = 3.9, 95% CI: 2.3, 7.0), and wealth index (AOR = 3.8, 95% CI: 1.5, 5.6) were significantly associated with thinness of adolescent girls. Conclusion and Recommendation: Thinness was found to be a serious problem in the study area. Strategies are needed to improve the nutritional status of adolescent girls before they reach conception to break the vicious cycle of intergenerational malnutrition
Return of fertility after discontinuation of contraception: a systematic review and meta-analysis
No full textReturn of fertility after discontinuation of contraception: a systematic review and meta-analysis
No full textAbstract Introduction Along with increasing availability and utilization of contraception, It is also important to confirm that the effects of contraception use on resumption of fertility after discontinuation However currently evidences on resumption of fertility after contraception use are inconclusive and practically fertility after termination of contraception remains a big concern for women who are using contraception. This fear poses a negative impact on utilization and continuation of contraception. Therefore, Estimating the rate of pregnancy resumption after contraceptive use from the available reports and identifying the associating factors are important for designing a strategy to overcome the problem. Methods The review was conducted through a systematic literature search of articles published between 1985 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of conception was estimated with a random-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot. Results Twenty two studies that enrolled a total of 14,884 women who discontinued contraception were retained for final analysis. The pooled rate of pregnancy was 83.1% (95% CI = 78.2-88%) within the first 12 months of contraceptive discontinuation. It was not significantly different for hormonal methods and IUD users. Similarly the type of progesterone in specific contraception option and duration of oral-contraceptive use do not significantly influence the return of fertility following cessation of contraception. However the effect of parity in the resumption of pregnancy following cessation of contraception was inconclusive. Conclusion and recommendation Contraceptive use regardless of its duration and type does not have a negative effect on the ability of women to conceive following termination of use and it doesn’t significantly delay fertility. Therefore, appropriate counseling is important to assure the women to use the methods as to their interest
Prevalence of anemia and its associated factors Among women of reproductive age using contraceptive In bale-goba town, south east ethiopia: a comparative Cross sectional study
No full textntroduction: Anemia is decrease in oxygen delivery due to decrease in circulating red blood cells
(RBC) which is revealed by decrease in hemoglobin or hematocrit. Oral contraceptives have folate
reducing effect and increase the oxidative stress, which lead to reduced production or reduced
survival of red blood cells. Globally, anemia affects one-third of the world population. The
prevalence of anemia among modern contraceptives is unclear.
Objective: Therefore, this study aimed to assess the prevalence of anemia and its associated factors
among women of reproductive age who use modern contraceptive in Bale Goba town from
September 15 to November 15, 2021.
Methods A community-based comparative cross-sectional study was conducted among 202 (104
contraceptive users and 98 non-contraceptive users) reproductive-age women in Bale-Goba town.
Systematic random sampling technique was used to select study participants. Sociodemographic,
and other relevant variables were collected using structured questionnaire. Four milliliters of
venous blood were collected and added to EDTA test tube for hematological parameter analysis
by Sysmex XN-550 automated hematology analyzer and hemoglobin level was used for
determination of anemic status. The data were entered in to Epidata manager version 4.6.0.2 and
its analysis was performed using SPSS Statistical software version 21. Independent t-test was used
to determine hemoglobin mean difference and factors associated with anemia were identified using
binary and multiple logistic regression analyses.
Result: The prevalence of anemia among contraceptive users was higher than non-users (75%
versus 44.9%). There was a significant reduction in hemoglobin among contraceptive users than
non-users which was 11.10 g/dl ± 1.29 g/dl and 11.86 g/dl ± 1.47 g/dl respectively with P-value <
0.001. Type of contraceptive used were significantly associated with anemia. Accordingly,
injectable contraceptive users were 7 times (AOR = 7.10) more likely to have an anemia.
Conclusion: Modern contraceptive users had higher prevalence of anemia and lower mean
hemoglobin level than non-contraceptive users. Type of contraceptive used were an independent
predictor of anemia
Factors affecting prevention and control of malaria among endemic areas of Gurage zone: an implication for malaria elimination in South Ethiopia, 2017
No full textAbstract Background Globally malaria remains one of the most severe public health problems resulting in massive morbidity particularly in developing countries. Ethiopia as one of the sub-Saharan country it is highly endemic to malaria. It was noted that early detection and prompt treatment of malaria cases, selective vector control and epidemic prevention and control are the major strategies for malaria prevention and control; So far, a lot have been done and remarkable improvements were seen. However, in what extent the prevention strategy was running in the community and what factors are hindering the prevention strategy at community level was not well known in Ethiopia. Therefore this study aimed to assess measures taken to prevent malaria and associated factors among households in Gurage zone, south Ethiopia. Methods Community based cross- sectional study was conducted in Gurage zone, southern Ethiopia. A total of 817 randomly selected households were included in the study. After checking for completeness the data was entered in to Epi info 7 and analyzed through SPSS (Statistical Package for Social Sciences) version 21. Descriptive summary was computed and presented by tables, graphs and figures. After checking for assumptions Bivariate analysis was run to look for the association between dependent and explanatory variables; and using variables which have p-value ≤0.25 binary logistic regression was fitted. Association was presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05. Goodness of fit of the final model checked by Hosmer and Lemshow test. Results Overall 496 (62%) of households practiced good measure of malaria prevention and control. Educated households (AOR = 2.15 (95% CI [1.21–4.67]), higher wealth index (AOR = 3.3 (95% CI [2.3–6.2]), iron corrugated house owners (AOR = 2.7 (95% CI [1.7–3.5]), who received ITN from HC (AOR = 3.6 (95% CI [1.7–4.5] and involved in malaria prevention campaign AOR = 2.6, (95% CI [1.8–3.6]) were independently and significantly determined the practice of malaria prevention measures. Conclusion The practice of malaria prevention measures were at acceptable and comparable level to other national findings and standards. Further strengthening of the program is important
Comparative Analysis of the Survival Status and Treatment Outcome of Under-five Children Admitted with Severe Acute Malnutrition Among Hospital-based and Health Center Based Stabilization Centers, South Ethiopia
No full textBackground:Severe acute malnutrition has been managed at Hospital stabilization centers until the management at health center based stabilization centers was started recently. However, the treatment outcome was not assessed in relation to the existing hospital-based management. Therefore, this study comparatively assessed the treatment outcome and survival status of severe acute malnutrition among Health center-based and hospital-based stabilization centers. The finding will be used by healthcare providers, planners and policymakers at large.Methods:Randomly selected 400 records of under-five children admitted to five stabilization centers (2 hospitals and 3 health center) in Gedeo Zone was included. Data was entered by Epi Info version 7 and analyzed by STATA version 11. Survival difference was checked by life table and Kaplan-Mier with Log-Rank test. Cox proportional hazards model was built by forward stepwise procedure; compared to likely hood ratio test and Harrell’s concordance and fitness checked by the cox-snell residual plot.Result:The study showed that the cumulative probability of Survival is significantly different at Hospital stabilization center and health center stabilization centers (p.value <0.001) with shorter survival at hospitals. During the follow-up period, 28(13.86%) children from hospital and 5(2.5%) children from health center died, while 155(76.73%) children from the hospital and 145(73.23%) children from health center got cured. Eighteen (4.5%)children were defaulted. Death is significantly higher at the hospital, while default rate and cure rate are not significantly different. Altered pulse rate [AHR=2.44, 95% CI =1.47-4, p<0.001], NG tube insertion [AHR=1.8, 95% CI =1.04-3.1, p=0.038], Anemia [AHR=1.53, 95% CI =1.02-2.3, p<0.041] and Hypoglycemia [AHR=2.78, 95% CI =1.8-4.3, p<0.001] were found to be independent predictors of death.Conclusion:The survival of children in hospital is shorter and mortality is higher. An overall treatment outcome was in acceptable ranges. Intervention to further reduce deaths at hospitals has to focus on children with comorbidities and altered general conditions and early detection.</jats:sec
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