ANC Follow-up Research Articles

A comparative study of antenatal depression among urban and rural pregnant women in Gimbi District, Oromia, Ethiopia

BackgroundAntenatal depression (AND) is a form of clinical depression that can be caused by stress and worries that can bring pregnancy to more severe levels. It has negative impacts on women, the family, and the community at large. The comparative study of antenatal depression among rural and urban pregnant women was less studied in Ethiopia and in this study area in particular.ObjectiveThe objective of the study was to compare the prevalence of antenatal depression and its associated factors among pregnant women in Gimbi rural and urban residents in Ethiopia in 2023.MethodsA community-based comparative cross-sectional study design was used from 1 February to 30 March 2023. A systematic random sampling method was used to select study participants. Data were collected using pretested interviewer-administered structured questionnaires. Binary logistic regression analysis was used to identify factors associated with antenatal depression. Variables with a p-value of 0.25 or less in the bi-variable logistic regression model were candidates for a multi-variable logistic regression model.ResultsThe prevalence of antenatal depression was 56 (21.5%), 95% CI: [16.9–25.5] among rural participants and 50 (19.2%) [95%] CI: [14.6–23.8] among urban participants. Having complications during pregnancy (AOR: 4.92, 95% CI: 1.35, 17.88), ever had depression (AOR: 3.20, 95% CI: 1.30, 7.85), consuming alcohol (AOR: 3.78, 95% CI: 1.24, 11.49), and educational status (can read and write) (AOR: 2.14, 95% CI:1.05, 4.67) were factors associated with antenatal depression among urban mothers, while no antenatal care follow-up (AOR: 6.6, 95% CI: 2.63, 16.85), unplanned pregnancy (AOR: 4.51, 95% CI:1.10, 1.86), and having complications during pregnancy (AOR: 2.77, 95% CI: 1.30, 5.92) were factors associated with antenatal depression among rural mothers.ConclusionThe prevalence of antenatal depression among rural mothers was higher than the prevalence of antenatal depression among urban mothers in the Gimbi district. Having complications during pregnancy, ever had depression, consuming alcohol, and educational status were associated factors with antenatal depression among urban mothers; having complications during pregnancy, unplanned pregnancy, and no ANC follow-up were factors associated with antenatal depression among rural mothers. Therefore, quality family planning and ANC services should be provided for the women to reduce unplanned pregnancies and experience complication-free pregnancy periods.

Epidemiological Determinants and Risk Factors Contributing to the Rise in Neonatal Morbidity and Mortality in Liberia: A Quantitative Analysis

Background: Neonatal mortality has remained a significant public health challenge in Liberia, necessitating a thorough understanding of factors contributing to adverse neonatal outcomes. This study aimed to investigate demographic and clinical factors associated with neonatal mortality among infants admitted to the Neonatal Intensive Care Unit (NICU) in Liberia.  Objectives: The primary objective was to identify demographic and clinical factors associated with neonatal mortality in NICU admissions. Secondary objectives include assessing the impact of antenatal care and the follow-up, mode of delivery, gestational age at birth, and multiple births on neonatal mortality rates.  Methods: A retrospective analysis was conducted using data from NICU admissions in Liberia. Demographic and clinical variables, including sex of neonate, ANC follow-up, mode of delivery, multiple births, and gestational age at birth, were analyzed for their association with neonatal mortality using logistic regression models.  Keyresults: The study included various neonatal admissions to the NICU. While male neonates constituted a slight majority of admissions, gender did not significantly influence neonatal mortality rates. Lack of ANC follow-up emerged as a significant risk factor for mortality, with neonates whose mothers did not receive ANC showing a substantially higher risk. C-Section delivery was correlated with a significantly increased risk of neonatal mortality compared to spontaneous vaginal delivery. Preterm birth was also identified as a significant risk factor for mortality, highlighting the vulnerability of preterm neonates. Multiple births presented unique challenges but did not significantly impact mortality rates after adjustment.  Conclusion: This study underscored the critical importance of ANC follow-up, appropriate delivery practices, and specialized care for preterm neonates in reducing neonatal mortality rates in Liberia. Findings provided informed valuable insights for policymakers and healthcare practitioners to develop targeted interventions aimed at improving neonatal health outcomes and reducing mortality rates in the country.

Evaluation of the implementation fidelity of comprehensive emergency obstetric and newborn care at University of Gondar comprehensive specialized hospital, Northwest Ethiopia: a mixed-method evaluation

BackgroundApproximately 15% of births worldwide result in life-threatening complications during pregnancy, delivery, or postpartum. Comprehensive Emergency Management of Obstetric and Newborn Care (CEmONC) is intended as one of the measures for maternal healthcare services to reduce the high burden with regard to childbirth complications. However, its state of implementation fidelity has not been well investigated. Therefore, this study aimed to evaluate the implementation fidelity of CEmONC services at University of Gondar Comprehensive Specialized Hospital, Ethiopia.MethodA case-study design with an embedded mixed method was employed. Adherence, quality of delivery, and participant responsiveness dimensions from Carroll’s conceptual framework were used in this evaluation. Four hundred four exit interviews, 423 retrospective document reviews and 10 key informants were conducted. Moreover, a binary logistic regression model was fitted. The qualitative data were transcribed, translated, coded, and analysed using a thematic analysis approach. The overall implementation fidelity of the CEmONC was judged based on the pre-seated judgmental criteria.ResultsOverall the implementation fidelity of the CEmONC service was 75.5%. Quality of delivery, participant responsiveness and adherence were 72.7%, 76.6% and 77.2% respectively.Signal functions like parenteral antibiotics and removal of retained products were insufficiently performed against the recommended protocols which was also evidenced by the key informant interviews. Healthcare providers’ respect for the clients was less. Age ≥ 35 years (AOR = 0.48, 95% CI: 0.24,0.98), educational status of college and above (AOR = 2.61, 95% CI: 1.46,4.66), being government employed (AOR = 1.85, 95% CI: 1.08,3.18), having ANC follow-up (AOR = 5.50, 95% CI: 1.83, 16.47) and grand multigravida (AOR = 2.17, 95% CI: 1.08, 4.38) were factors significantly associated with participant responsiveness towards the services.ConclusionsThe overall implementation fidelity of the CEmONC services was implemented in good fidelity. Moreover, the quality of delivery was judged as implemented in fair fidelity. Parenteral antibiotics and removal of retained products were not found to be sufficiently performed. Respect for the clients was insufficiently delivered. Therefore, it is recommended that parenteral antibiotics drugs be adequately provided and training for healthcare providers regarding compassionate and respectful care shall be facilitated. Moreover, healthcare providers are strongly recommended to adhere to the recommended guidelines.

Vitamin A supplementation status and associated factors among children aged 6-59 months in Tanzania: a multi-level analysis.

Vitamin A supplementation every 4-6 months is an economical, rapid, and effective strategy to enhance vitamin A status and minimize child morbidity and mortality due to vitamin A deficiency in the long run. Therefore, this study was aimed at investigating the level as well as the factors influencing VAS status among children aged 6-59 months in Tanzania. This analysis relied on data from the 2022 Tanzania Demographic and Health Survey (TDHS). The study used a weighted sample of 9,382 children aged 6-59 months. Given the effect of clustering and the binary character of the outcome variable, we employed a multilevel binary logistic regression model. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to determine statistical significance, considering the model with the lowest deviation that best fits the data. In this study, vitamin A supplementation among children aged 6-59 months was found to be 53.18% [95% CI: 52.17, 54.19]. Mother's/caregiver's working status; Working [AOR = 1.59, 95% CI: 1.34, 1.89], ANC follow-up [AOR = 1.71, 95%CI: 1.34, 2.2], and health facility delivery [AOR = 1.55, 95%CI: 1.25, 1.91] were individual-level factors associated with vitamin A supplementation. Whereas administrative zones of Western [AOR = 2.02, 95% CI: 1.16, 3.52], Southern highlands [AOR = 3.83, 95% CI: 2.02, 7.24], Southern administrative zone [AOR = 2.69, 95% CI: 1.37, 5.3], and South West highlands [AOR = 0.56, 95% CI: 0.33, 0.95] were community-level factors associated with vitamin A supplementation. The proportion of VAS among children in Tanzania is low compared to UNICEF's target of 80. Mother's/caregiver's working status, antenatal care, place of delivery, community-level media exposure, and administrative zones were significantly associated factors with vitamin A supplementation. Therefore, interventions should be designed to improve the uptake of VAS. Provision and promotion of ANC and institutional delivery and strengthening of routine supplementation are recommended to increase coverage of childhood vitamin A supplementation. Moreover, special focus should be given to regions in the south-western highlands.

Incidence and predictors of acute kidney injury among asphyxiated neonates in comprehensive specialized hospitals, northwest Ethiopia, 2023

Acute kidney injury (AKI) is characterized by a sudden decline in the kidneys' abilities to remove waste products and maintain water and electrolyte homeostasis. This study aims to determine the incidence and predictors of acute kidney injury among neonates with perinatal asphyxia admitted at the neonatal intensive care unit of West Amhara Comprehensive Specialized Hospital, Northwest Ethiopia, 2023. Multicentred institution-based retrospective follow-up study was conducted from October 1, 2021, to September 30, 2023, among 421 perinatal asphyxia neonates. A simple random sampling technique was used. The data were collected using a data extraction checklist from the medical registry of neonates. The collected data were entered into EPI-DATA V.4.6.0.0. and analyzed using STATA V.14. The Kaplan–Meier failure curve and log-rank test were employed. Bivariable and multivariable Cox regression was carried out to identify predictors of Acute kidney injury. Statistical significance was declared at a p ≤ 0.05. The overall incidence of AKI was 54 (95% CI 47.07–62.51) per 100 neonate days. C/S delivery (AHR = 0.64; (95% CI 0.43–0.94), prolonged labor (AHR = 1.43; 95% CI 1.03–1.99) low-birth weight times (AHR = 1.49; (95% CI 1.01–2.20), stage three HIE(AHR: 1.68; (95% CI (1.02–2.77), No ANC follow up (AHR = 1.43; 95% CI 1.9 (1.07–3.43) and Hyperkalemia (AHR = 1.56; 95% CI 1.56 (1.05–2.29); 95% CI) were significant predictors. The incidence rate of acute kidney injury was higher than in other studies conducted on other groups of neonates. Cesarean section delivery, prolonged low birthweight, no Anc follow-up, stage 3 HIE, and neonatal hyperkalemia were predictors of acute kidney injury. However, it needs further prospective study. Therefore, the concerned stakeholders should give due attention and appropriate intervention to these predictors.

Exclusive Breastfeeding Practice and Associated Factors among Mothers having Infants (Aged 0-6 Months) in the Pastoral Community of Sawena District, Bale Zone Oromia, Ethiopia, 2023

Background: Breastfeeding is the recommended feeding method for infants due to its ease, health benefits, and cost-effectiveness. However, there is limited understanding of Exclusive Breastfeeding (EBF) in pastoral communities, such as the Sawena district in Ethiopia. Objective: To assess the prevalence and factors associated with EBF among mothers with infants (aged 0-6 months) in pastoral communities in Southeast Ethiopia. Method: A community-based cross-sectional study design with a convergent mixed-method approach was employed from March 01 to April 2023 G.C and involved 631 women selected through random sampling. Face-to-face interviews were conducted, and the data were analyzed using statistical software. Variables with a p < 0.25 in the analysis were included in the logistic regression model. Results: Out of 631 eligible mothers, 625 participated in the study, resulting in 53.8% (95% CI; 49.8%-57.4%). prevalence of EBF in the study area. Factors significantly associated with EBF included household food security [AOR = 1.6, 95% CI (1.1-2.2)], ANC follow-up during pregnancy, [AOR = 5.3, 95% CI (2.4-11.9)], counselling about EBF during ANC visits [AOR = 5; 95% CI (2.1-11.7)], number of children [AOR = 1.6, 95% CI (1.1-2.3)] and attitudes toward EBF [AOR = 1.8; 95% CI (1.4-2.6)]. The qualitative findings revealed reasons for not practicing EBF, such as concerns about insufficient breast milk, concerns about the baby becoming thirsty, refusing solid foods later, or being negatively affected. Conclusion: The prevalence of EBF in the Sawena district was lower than recommended. The influential factors include household food security, ANC follow-up, counselling during ANC, number of children, and attitudes toward EBF.

Spatial variations and determinants of timely completion of vaccination in Ethiopia using further analysis of EDHS 2019 data: Spatial and multilevel analysis.

Timely vaccination is the practice of administering the vaccine within the first birthday of the child. Not vaccinating the child at the appropriate age is the cause of improper protection of diseases and can be a possible factor in death. The problem of not completing the vaccine in the scheduled period is a globally distributed problem, but especially in sub-Saharan African countries, it is a bottleneck to child health. Even if timely vaccination is crucial for reducing the impact of VPDs, there are no current national-level studies to generate conclusive and tangible evidence in Ethiopia. To assess spatial variations and determinants of timely completion of vaccination in Ethiopia using further analysis of EDHS 2019 data. The secondary data analysis of a community-based cross-sectional study design was employed among 3094 participants. Stata-14 software was used for data cleaning, recording, and analysis. Arc GIS version 10.3 and Kuldorff SAT scan version 9.6 software are used for spatial and SAT scan statistics. A multilevel mixed-effect binary logistic regression analysis was used to identify the predictors of timely vaccination. The clustering effect was also evaluated by Moran's I statistics and intra class correlation. The timely completion of vaccination among Ethiopian women who had a child aged 12-35 months was 19.5% (95%CI: 18.2-20.8), and the spatial distribution of timely completion of vaccinations in Ethiopia was non-randomly distributed. A statistically significant high proportion of timely completion areas were clustered in the eastern part of Amhara, the south part of Afar, Addis Ababa, and Oromia. The primary cluster was located at a 13.11 km radius in Diredawa, which was 3.68 times higher than outside the window (RR = 3.68, LLR = 68.76, p-value < 0.001). History of antenatal care follow-up (AOR = 1.63, 95% CI: 1.3-2.04), giving birth at health facilities (AOR = 1.63, 95% CI: 1.25-2.13), age ≥ 35 years (AOR = 186, 95% CI: 1.35-2.63), age 25-34 years (AOR = 1.72, 95% CI: 1.33-2.21), and being richest (AOR = 2.71, 95% CI: 1.86-3.94) were the factors contributing to the timely completion of vaccination. The prevalence of timely completion of vaccination was low in Ethiopia, and the spatial distribution of timely completion of vaccination in Ethiopia was non-randomly distributed across the regions. The factors associated with the timely completion of vaccinations were ANC follow-up, place of delivery, age of the participant, and wealth index. We recommend expanding facility delivery, antenatal care services, and empowering women to scale up timely vaccination in Ethiopia.

Common Mental Disorder and Associated Factors among Women Attending Antenatal Care Follow-Up in North Wollo Public Health Facilities, Amhara Region, Northeast Ethiopia: A Cross-Sectional Study.

Common mental health disorders (CMD) during pregnancy are a public health concern because of the implications for the mother and infant's health during pregnancy and after birth. The prevalence and factors related to common mental disorders vary globally. Therefore, this study assessed the magnitude and factors associated with common mental disorder among pregnant women attending ANC follow-up in North Wollo Zone, Northeast Ethiopia. An institutional-based cross-sectional study was conducted in North Wollo, Amhara Region, Northeast Ethiopia. A multistage sampling technique was used to select 777 study participants. The common mental disorder was assessed by using SRQ-20. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Logistic regression analysis was done to identify the independent variables associated with common mental disorders. Independent variables with a p value less than 0.05 were considered significantly associated with CMD. The magnitude of CMD was 18.1% (95% CI: 15.5, 21.0). Factors significantly associated with CMD were the educational level of participants (AOR = 0.17, 95% CI: 0.06, 0.48), husband's educational status (AOR = 11.13, 95%: 4.18, 29.66), unplanned pregnancy (AOR = 2.54, 95% CI: 1.26, 5.09), self-reported complication on the current pregnancy (AOR = 0.11, 95% CI: 0.05, 0.21), self-reported complication during the previous delivery (AOR = 3.38, 95% CI: 1.39, 8.18), undernutrition (AOR = 2.19, 95%: 1.26, 3.81), high psychosocial risk (AOR = 20.55, 95% CI: 9.69, 43.59), having a legal issue (AOR = 2.06, 95%: 1.12, 3.79), and relationship problem (AOR = 7.22, 95% CI: 3.59, 14.53). Conclusions and Recommendation. One in five pregnant women has common mental disorder. Educational status of the participants and their spouses, unplanned pregnancy, self-reported complication during current and previous pregnancy, psychosocial risk, and legal and relationship problems were the main determinants of common mental disorders. Therefore, screening pregnant women for mental disorders and provision of necessary mental health services are recommended to minimize the adverse health outcome of CMD during pregnancy.

Factors Associated with Malaria in Pregnancy among Women Attending Fort Portal Regional Referral Hospital in Fort Portal City, Western Uganda

Globally, there was a significant decrease in the number of malaria-risk pregnancies between 2007 and 2020. The risk of Plasmodium falciparum or Plasmodium vivax malaria increased by 25% in Africa compared to 2007. Due to the fast-expanding population and associated rise in pregnancies in malaria-endemic areas, the number of people at risk in Africa has increased despite malaria rates declining in the region. This study determined the prevalence and factors associated with malaria in pregnancy among women attending Fort Portal Regional Referral Hospital. This was a single-center health facility-based cross-sectional study. Data was collected using a face-to-face interview through a structured questionnaire from willing participants. After collecting the data, the principal investigator checked the completed questionnaires for consistency and completeness. Data was coded, cleaned, and entered into the computer using Microsoft Excel, and then analyzed using SPSS version 20. Logistic regression analysis was done to ascertain the relationship between dependent and independent variables. Descriptive statistics were summarized in the form of frequency tables, pie charts, p-values, and odds ratios. A total of 253 pregnant mothers attending ANC were enrolled in this study. The majority (38.3%) of the study participants were aged 30-39 years, attained secondary education (52.2%), earned 100,000–200,000 per month (56.9%), and were housewives (51.0%). In this study, the prevalence of malaria in pregnancy was 10.3%. Age, level of education, income status, and residence, use of an ITN, gravidity, and ANC follow-up were significantly associated with malaria in pregnancy at multivariate logistic regression analysis. Malaria continues to be a major public health issue among pregnant mothers. Age, level of education, income status, and residence, use of an ITN, gravidity, and ANC follow-up were factors significantly associated with malaria in pregnancy. Keywords: Pregnancies, Malaria, Plasmodium, ITN, ANC.

Effective breast feeding techniques and associated factors among lactating mothers: a community-based cross-sectional study in Dugda district, central Ethiopia

Background: Breastfeeding technique is defined as the positioning of the mother and baby, the baby's attachment to the breast, and suckling during nursing, all of which are crucial for successful breastfeeding. Appropriate and longer breastfeeding practices have numerous benefits for both mothers and babies. Moreover, ineffective breastfeeding techniques are a cause of death for thousands of newborns every year. In Ethiopia, the practice of effective breastfeeding techniques remained low. Therefore, this study aimed to assess the practice of effective breastfeeding techniques and associated factors among breastfeeding mother-infant pairs in Dugda district, Central Ethiopia, 2023. Methods: A community-based cross-sectional study was conducted from June 20 to August 20, 2023, in Dugda district on a total of 620 breastfeeding mother-infant pairs who were selected using a multistage sampling technique. Ethical clearance and approval were secured from the Ethical Review Board of Salale University with reference number SLU-IRB/53/23. The WHO's breastfeeding observational checklist and a face-to-face interview were used to collect the data. Bi-variable and multivariable binary logistic regression analyses were employed. An adjusted odds ratio coupled with a 95% CI was used to determine a significant association. Bi-variable and multivariable binary logistic regression analyses were employed. An adjusted odds ratio coupled with a 95% CI was used to determine a significant association. Results: The prevalence of effective breastfeeding techniques in this study was 43.4% (95% CI: 39.1%, 47.4%). Having antenatal care follow-up (AOR: 2.24; 95% CI: 1.21, 4.14), having prior information about breast feeding techniques (AOR: 5.78; 95% CI: 3.95, 8.46), being multipara (AOR: 2.21; 95% CI: 1.47, 3.33), and having educational levels of primary education (AOR: 2.42; 95% CI: 1.44, 4.06) and secondary education and above (AOR: 2.85; 95% CI: 1.73, 4.69) were significantly associated with effective breastfeeding techniques. Conclusion: The prevalence of effective breastfeeding techniques in the study area was relatively low. Therefore, empowering women in education, promoting utilisation of ANC follow-up and disseminating information about breastfeeding techniques could be the key implication for effective breastfeeding techniques. Special emphasis should be given to primipara mothers because they are new for nursing their infants.

Birth Outcomes of Twin’s Pregnancy and Associated Factors in Selected Public Hospitals of Addis Ababa, Ethiopia, 2022

Background: Twin birth is a type of multiple births when the mother gives birth to two offspring from the same pregnancy. The prevalence rates range from less than 8 twin pregnancies per 1,000 births in the East and Southern Asia, India, and Oceania to 17 or more per 1,000 births in Africa. There are factors to increase the negative birth outcome of twin delivery; from these, some of them are associated with increased maternal age, prim parity, low birth weight, chronic disease, low ANC follow-up, and PROM. Adverse birth outcome for twin delivery is a critical health issue in developing countries such as Ethiopia. It resulted in many bad consequences, neonatal and infant morbidity and mortality. Objective: The objective of this study was to assess birth out come and associated factors of twin’s pregnancy in selected public Hospitals, Addis Ababa, Ethiopia. Methods: Facility based cross sectional study was conducted on 246 maternal records of twin delivery in selected public hospitals of Addis Ababa to assess birth out come and associated factors of twin’s pregnancy from December, 2020-June, 2021.A pretested questionnaire which will be analyzed by SPSS and result will be reported in tables, bivariate and multivariate regression will be done to show correlations by Crude and adjusted odds ratio. A confidence limit of 95% and p- value less than 0.05 will be used as cut of point to see presence of statistical significance. Result: The prevalence of adverse birth outcome (Both maternal and fetal) among twin delivery in the three selected public hospitals of Addis Ababa is 234 (95%). majority, 156(63.4%) were in the age group 18-28 years, with the mean age of 29.78 and Standard deviation of±6.53.Most of the mothers 227(92%) were married. Mothers who had Pregnancy induced hypertension (AOR= 10.465, 95% CI (2.922-37.474)), Mothers who had ruptured membrane before the onset of Labor (AOR= 3.577, 95% CI (1.198-10.682)) and Mothers who labor for more than 12 hours were (AOR= 3.324, 95% CI (1.101-10.034)) were significantly associated with adverse maternal birth outcome. While mothers who had ANC follow up at private clinic (AOR= 0.252, 95% CI (0.098-0.649)) and Mothers who live outside Addis Ababa were unlikely to have adverse fetal outcome (AOR= 0.343, 95% CI (0.143-0.826)). Conclusion: Adverse birth outcome of Twins pregnancy is relatively higher when compared to similar studies conducted in Ethiopia. The Health facilities should have effective risk assessment in Antenatal care unit and labor ward. It is also recommended to have guidelines and protocols for the management of twin’s pregnancy. Since the Prevalence of Adverse twin’s Birth outcome is higher greater attention should be given on both Antepartum and Intrapartum care.

Discrimination against HIV/AIDS patients and associated factors among women in East African countries: using the most recent DHS data (2015–2022)

IntroductionThe biggest health problem in East Africa is the human immunodeficiency virus (HIV). Combating stigma and discrimination related to HIV/AIDS is a key goal of many international organizations in their efforts to ensure universal access to HIV/AIDS prevention, treatment, care, and support programs. However, previous studies in various regions of Africa have shown that the prevalence of discriminatory attitudes related to HIV/AIDS is particularly high. Furthermore, there is a current evidence gap in the region. Therefore, the aim of this study was to determine the prevalence of discriminatory attitude toward HIV/AIDS patients, and its associated factors among women in East African countries.MethodsThe data we utilized were gathered from the most recent Demographic and Health Surveys (DHS), which were carried out in east African nations between 2016 and 2022. We integrated DHS data from ten countries into our investigation. For our analysis, a weighted sample of 139,812 women overall was employed. The analysis used multiple logistic regressions. The adjusted odds ratio and its 95% confidence interval were then shown, and components with binary logistic regression p values of less than or equal to 0.2 and < 0.05 were regarded as significant predictors of discrimination against HIV/AIDS patients.ResultsIn this study, 32.73% (95% CI 34.48–32.97) of respondents had a discriminatory attitude toward HIV/AIDS patients. In the multiple logistic regression analysis, being in the older age groups, having a better education level, being from a wealthy household, having employment status, having ANC follow-up, institutional delivery, mass media exposure, and having female household heads were associated with higher odds of not having a discriminatory attitude toward HIV/AIDS patients. However, being unmarried and living far from the health facilities were associated with higher odds of discriminatory attitudes toward HIV/AIDS patients.ConclusionThis study concluded that women in East Africa still had a very discriminatory attitude toward HIV/AIDS patients. The good news for East Africa is that prevalence has decreased when compared to earlier findings. Improving women's empowerment, maternal health services, and health facilities' accessibility are crucial.

Determinants of Syphilis among Pregnant Women Attending Antenatal Care Clinic at Public Hospital in South West Shoa, Ethiopia, Unmatched Case-control Study, 2023

Background: Syphilis is an infectious, sexually transmitted disease caused by the Spirochete Treponema palladium. Untreated maternal syphilis causes adverse pregnancy outcomes such as spontaneous miscarriage, low birth weight, neonatal death, and congenital syphilis. This is a limited case control study to identify determinants of syphilis infections at the study area. Objectives: The aim of this study is to identify determinants of syphilis infections among pregnant women attending ANC clinic at Public hospital in South West Shoa, Ethiopia, 2023. Methods: A facility based unmatched case-control study among 240 women (48 case and 192 control) with 1:4 ratios were conducted from March 10, 2023–May 20, 2023, among pregnant women attending antenatal care follow up at public hospital, South West Shoa. Cases were selected by convenience and systematic sampling techniques were employed to select control and data was collected by using structured and pretested questionnaire. The collected data were entered into Epi info version 7.2.2 and exported to SPSS version 25 for analysis. Variables having p-value &lt;0.25 in the bi-variable analysis were entered into logistic regression model for multi variable analysis. Statistical significance was declared at p-value &lt;0.05. Adjusted odd ratio along with 95% confidence interval was used to show strength of association. The results were presented using text, tables, and graphs. Results: In this study 235 women (47 cases and 188 controls) had completed the interview resulting in a response rate of 97.92%. After multivariable logistic regression analysis, significantly associated factors with syphilis infection were status of current pregnancy [AOR = 2.697, 95% CI (1.003-7.249, ANC follow-up [AOR = 4.556, 95% CI (1.759-11.80)], history of STI [AOR = 3.080, 95% CI (1.347-7.043)], alcohol intake [AOR = 3.965, 95% CI (1.56-10.078)], age at first sexual intercourse [AOR = 8.951, 95% CI (3.70-21.646)], and multiple sexual partners [AOR = 2.754, 95% CI (1.065-7.118)]. Conclusion: Status of current pregnancy, ANC follow-up, history of STI, alcohol intake, age at first sexual intercourse, and multiple sexual partners were variables significantly associated with syphilis infections among pregnant women. Therefore, health care providers and managers should focus to give health education on these determinants, and strengthening early diagnosis and treatment for syphilis infections among pregnant women.

Anemia Prevalence and Risk Factors in Two of Ethiopia's Most Anemic Regions among Women: A Cross-Sectional Study.

In Sub-Saharan African (SSA) nations, including Ethiopia, anemia is a significant public health issue. Ethiopia has continued to bear the enormous burden of anemia infections. Over time, the prevalence of anemia has significantly increased in Ethiopia. In addition, there is a paucity of literature and regional variations in the pace of increment expansion. Therefore, the primary goal of this study was to evaluate the prevalence of anemia and risk factors among women in Ethiopia's two most anemic regions. 2,519 women participated in a community-based cross-sectional study from January 18 to June 27, 2016. In order to determine the causes of anemia in women in two of Ethiopia's most anemic regions, an ordinal logistic regression model was taken into consideration. The applicability of the proportional odds test was evaluated using the chi-square test of the parallelism assumption. A p value of 0.05 or below was used to define crucial and statistically significant predictor variables. The overall prevalence rate of anemia was 56.8% (95% CI (54.8%-58.7%)). The chi-square test of the parallelism assumption indicated that the odds ratios were constant across all cut-off points of women's anemia levels at a 5% significance level (p value = 0.122). Of the severity of anemia levels among women, 48.2, 46.1, and 5.7% had mild, moderate, and severe anemia levels, respectively. In multivariable ordinal logistic regression analyses, being born (lived) in the Somali region (AOR = 1.6, 95% CI: 1.37, 1.90), having a parity of 4-5 (AOR = 1.3, 95% CI: 1.05, 1.66), and having ≥6 children (AOR = 1.4, 95% CI: 1.1, 1.7), being a contraceptive user (AOR = 3, 95% CI: 2.5, 3.6), being currently pregnant (AOR = 2.8, 95% CI: 2.3, 3.4), having no ANC follow-up (AOR = 1.9, 95% CI: 1.6, 2.3), being married women (AOR = 1.4, 95% CI: 1.1, 1.9), and user of unimproved toilet facility (AOR = 1.3, 95% CI: 1.1, 1.6) were significantly positively associated with anemia. Finally, the anemia burden was dangerously greater than the national average. The region, usage of contraceptives, being pregnant at the time, ANC follow-up, toilet facilities, parity, and marital status all had a substantial impact on anemia. Therefore, to lessen the prevalence of anemia in certain parts of Ethiopia, public health initiatives that improve maternal health service utilization are required, such as ANC follow-up to minimize parity.

Plasmodium infections and associated risk factors among parturients in Jawi district, northwest Ethiopia: a cross-sectional study

BackgroundPregnant women have an increased risk of Plasmodium infections and disease. Malaria in pregnancy is a major public health problem in endemic areas. Assessment of the burden and risk factors of malaria in pregnancy across different malaria transmission settings is required to guide control strategies and for malaria elimination. Thus, the current study is generating such evidence from parturient women in northwest Ethiopia.MethodsA cross-sectional study was conducted among 526 pregnant women admitted to the delivery rooms of selected health facilities in Jawi district, northwest Ethiopia, between November 2021 and July 2022. Data on the socio-demographic, clinical, obstetric, and malaria prevention practices of pregnant women were collected using interviewer-administered questionnaires and from women’s treatment cards. Malaria was diagnosed by light microscopy, rapid diagnostic test, and multiplex real-time polymerase chain reaction. Risk factors for malaria were evaluated using bivariable and multivariable logistic regression models. A P-value of < 0.05 was considered statistically significant.ResultsAmong the examined parturient women, 14.3% (95% CI 11.4–17.5%) had Plasmodium infections. The prevalence of peripheral, placental, and congenital malaria was 12.2% (95% CI 9.5–15.3%), 10.9% (95% CI 8.2–14.1%), and 3.7% (95% CI 2.3–6.1%), respectively. About 90.6% of peripheral and 92% of placental Plasmodium infections were asymptomatic. Plasmodium infection at parturiency was independently predicted by maternal illiteracy (AOR = 2.03, 95% CI 1.11–3.74), primigravidity (AOR = 1.88, 95% CI 1.01–3.49), lack of antenatal care follow-up (AOR = 2.28, 95% CI 1.04–5.03), and history of symptomatic malaria during pregnancy (AOR = 4.2, 95% CI 2.32–7.59). Moreover, the blood group O phenotype was significantly associated with placental malaria among the primiparae.ConclusionsOverall, asymptomatic Plasmodium infections were prevalent among parturients in northwest Ethiopia. Maternal illiteracy, primigravidity, lack of antenatal care follow-up, and history of symptomatic malaria during pregnancy were the risk factors for malaria during parturiency. Thus, promotion of a healthy pregnancy through ANC follow-up, strengthening malaria prevention and control practices, and screening of malaria in asymptomatic pregnant women are suggested to reduce its burden in pregnancy.

Home delivery among women who had optimal ANC follow-up in Sub-Saharan Africa: A multilevel analysis.

Home deliveries, where most births take place, are significantly responsible for the majority of maternal mortality. In order to develop appropriate policies and methods that could aid in addressing the issue, it is important to understand the scope of home delivery and its determinants in developing countries. Therefore, this study aims to ascertain the prevalence and factors associated with home delivery among women who had optimal ANC follow up in the Sub-Saharan Africa countries. A population based cross-sectional study was conducted. Data from the most recent Demographic and Health Surveys, which covered 23 Sub-Saharan Africa countries from 2014 to 2020, were used. The study used a total of 180,551 women who had optimal ANC follow up weighted sample. Stata 14 was used to analyze the data. The determinants of home delivery were determined using a multilevel mixed-effects logistic regression model. Factors associated with home delivery in the multilevel logistic regression model were declared significant at p-values <0.05. The adjusted odds ratio and confidence interval were used to interpret the results. In Sub-Saharan Africa, three in ten (30%) women who had optimal ANC follow-up gave birth at home. Individual-level variables such as maternal age (20 to 35 years) (AOR = 1.27, 95% CI: 1.10, 1.46), no formal education (AOR = 3.10, 95% CI: 2.68, 3.59), pregnancy complications (AOR = 0.74, 95% CI: 0.67, 0.82), distance to a health facility (AOR = 1.43, 95% CI: 1.30, 1.58), and poor wealth status (AOR = 2.71, 95% CI: 2.37, 3.10) had higher odds of home delivery. Community-level variables such as rural residence (AOR = 2.83, 95% CI: 2.48, 3.22), living in central Sub-Saharan Africa (AOR = 7.95, 95% CI: 5.81, 10.9), and eastern Sub-Saharan Africa (AOR = 2.74, 95% CI: 2.09, 3.59), were significantly associated with home delivery. This study concludes that home delivery in sub-Saharan Africa among women who had optimal ANC follow-up were high. The study identified that both individual and community-level variables were determinants of home delivery. Therefore, the Government and ministries of health in Sub-Saharan Africa countries should give attention to those women who reported distance as a big problem to health facilities and for rural resident women while designing policies and strategies targeting reducing home delivery in sub-Saharan Africa.

Assessment of Place of Delivery and Associated Factors among Pastoralists in Ethiopia: A Systematic Review and Meta-Analysis Evaluation.

Pastoralist communities rely on their livestock for at least 50% of their food supply and source of income. Home births raise the risk of maternal morbidity and death, whereas institutional births lessen the likelihood of difficulties during labor. Around 70% of labors in pastoralist regions of Ethiopia were assisted by traditional birth attendants. Studies done from January 2004 to January 2023, accessed in PubMed, EMBASE, Medline, and other search engines, were included. PRISMA guidelines and JBI critical appraisal checklist were used to assure the quality of the review. Ten articles were included in this review. Data were extracted with Excel and exported to STATA 16 for analysis. Heterogeneity of literatures was evaluated using I2 statistics and publication bias using the Egger regression asymmetry test and the Duval and Tweedie trim-fill analysis. Statistical significance was declared at p value less than 0.05. The pooled estimate of institutional delivery among the pastoralist community in Ethiopia is 21.2% (95% CI: 16.2-26.1). Husbands who were involved to decide place of delivery (OR = 3.47; 95% CI: 1.61, 7.50), women with good knowledge of MCH services (OR = 2.283; 95% CI: 1.51, 3.44), women who had a positive attitude towards MCH services (OR = 1.69; 95% CI: 0.79, 3.6), availability of health institutions (OR = 2.6; 95% CI: 0.95, 7.20), and women who had an ANC follow-up (OR = 2.78; 95% CI: 2.07, 3.73) were higher institutional delivery prevalence among pastoralist women. Moreover, institutional delivery among women who were educated above the college level was more than two times (OR = 2.56; 95% CI: 1.985, 3.304) higher than among women who were not educated. Pastoralist women in Ethiopia were found to be a disadvantaged group for institutional delivery at national level. Husband involvement, educational level, ANC visit, knowledge and attitude for MCH service, and health facility distance were identified to have significant association with institutional delivery.

Group B Streptococci recto-vaginal colonization, antimicrobial susceptibility pattern, and associated factors among pregnant women at selected health facilities of Wolaita Sodo Town, Southern Ethiopia.

Streptococcus agalactiae or Group B Streptococcal colonization of the gastrointestinal and genital tracts of pregnant women usually remains asymptomatic, even though it is the critical determinant of infection in neonates and young infants. It causes early and late onset of invasive Group B Streptococcus (GBS) disease manifesting as septicemia, meningitis, and pneumonia. Now it is recognized as an important cause of maternal and neonatal morbidity and mortality in many parts of the world including Ethiopia, where the magnitude of the problem has been little studied. The aim of this study was to assess the prevalence of GBS colonization and to identify associated risk factors and antimicrobial susceptibility patterns among pregnant women at selected health facilities of Wolaita Sodo Town, Southern Ethiopia. A health-facility-based cross-sectional study design was conducted at WSUCSH & Wolaita Sodo Health Center from June to August, 2022. A total of 279 pregnant women who were in ANC follow-up at 35-37 weeks of gestation were included. For GBS isolation, recto-vaginal swabs were inoculated in 1 mL Todd-Hewitt broth medium supplemented with 10 μg/mL colistin and 15 μg/mL nalidixic acid, followed by identification of isolates based on colonial morphology, gram stains, catalase reaction, and CAMP tests. Antimicrobial susceptibility testing was performed using a modified Kirby-Bauer disc diffusion method. All collected data were entered in Epi info 4.6.0.2, then transferred and tabulated using SPSS version 20. Logistic regression analysis was used to see the association between variables. Finally, a p-value <0.05 was considered statistically significant. In the present study, 279 pregnant mothers, aged between 15 to 38 years with a mean of 26.5 ± 4.5 years, were included. Of all participants, the highest proportion (120) (43.01%) were housewives. The overall carriage rate of GBS was 67 (24.0%). GBS colonization showed a statistically significant association with college and above levels of maternal education [AOR = 6.610, 95% CI (1.724-25.349), p = 0.01]. High susceptibility of GBS isolate was seen with Penicillin G & Chloramphenicol (92.5%), Ampicillin, Ceftriaxone (89.6%), Vancomycin (74.62%), and Erythromycin (77%). Relatively, GBS showed high resistance to Tetracycline (88%). In this study, the overall prevalence of GBS colonization was 24.0%. College and above educational level was statistically significant with GBS colonization. This study aimed to draw attention to the management of Group B Streptococci in pregnant women by making GBS culture one of the routine diagnoses during ANC follow-up and to prevent infection with early detection.

Antenatal care follow-up was significantly associated with a higher probability of high dietary diversity score among pregnant women in okra-producing areas of western Ethiopia: proportional odds model.

Dietary diversity is important for pregnant women since it has been associated with nutrient adequacy. It is very crucial to ensure optimal fetal health and development. There is no evidence at the community level on the magnitude of dietary diversity and its predictors among pregnant women in okra-producing areas of western Ethiopia. This study aimed to assess the level of dietary diversity and its associated factors among pregnant women. A community-based cross-sectional study was employed among randomly selected 224 pregnant women in western Ethiopia. An interviewer-administered questionnaire was used to collect the data. The qualitative open 24-h recall was used to assess the level of dietary diversity. Ordinal logistic regression analyses were used by SPSS version 25. An adjusted proportional odds ratio along with a 95% confidence interval [CI] was computed to measure the strengths of the association at a P ≤ 0.05. This study revealed that more than one-fourth, 64 (28.6%), of the respondents were found to have high dietary diversity scores. Antenatal Care [ANC] visits (Adjusted Odds Ratio [AOR] = 2.10, [95% CI: 1.13, 3.90], P = 0.01), changing food intake (AOR = 2.97, [95% CI: 1.16, 3.67], P = 0.002), and being food secure household (AOR = 2.63, [95% CI: 1.38, 5.00], P = 0.003) were significantly associated with a higher probability of having high dietary diversity score. However, lack of formal education (AOR = 0.34, [95% CI: 0.61, 0.89]) was inversely associated with the probability of having high dietary diversity. More than half of pregnant women in western Ethiopia were found to have low dietary diversity. Therefore, ANC follow-up, dietary modification, and promotion of frequent use of wild edible plants (okra) to maintain household food security were very crucial.

Systematic review and meta-analysis of knowledge on PMTCT of HIV/AIDS and Association factors among reproductive age women in Ethiopia, 2022

BackgroundDespite increased interventions implemented for the prevention of mother-to-child transmission of HIV, There is still a vertical transmission. Hence, this study tried to assess the pooled prevalence of knowledge on PMTCT and factors associated with residence, ANC follow-up, and knowledge about HIV/AIDS among reproductive age women in Ethiopia.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review either published or unpublished studies in Ethiopia regarding knowledge on PMTCT. A comprehensive search of international databases, including Google Scholar, Cochrane Library, PubMed, HINARI, Embrace, Web of Science, Scopus, ProQuest, CINAHL, and Global Health, were searched. The data were analyzed using STATA/SE version 14. The random-effect model was used to estimate the effect size, and I-squared statistics and Egger’s test were used to assess the heterogeneity and publication bias, respectively.Results14 out of 14,091 assessed articles met inclusion criteria and were included in the analysis. The estimated pooled level of knowledge on PMTCT among reproductive-age groups was 62.15% [(95% CI: 43.63–80.66)]. Residence [(OR = 4.8, 95%CI: 2.99, 7.85)], ANC follow-up [(OR = 4.2, 95%CI: 2.21, 7.98)], and having sufficient knowledge about the diseases [(OR = 4.9, 95% CI: 3.6, 6.66)] were found to be significant predictors of knowledge on PMTCT among reproductive-age groups.ConclusionStrategies to improve the knowledge of PMTCT in Ethiopia should focus on rural women, improving knowledge about HIV/AIDS, and ANC follow-up. Efforts are also needed to involve husbands and related organization in the prevention of mother to child transmission of HIV.