Attending Antenatal Care Clinic Research Articles

Prevalence, Associated Factors, Barriers and Facilitators for Oral HIV Self-Testing among Partners of Pregnant Women Attending Antenatal Care Clinics in Wakiso, Uganda.

Oral HIV self-testing (HIVST) among men is relatively low and still inadequate in Sub-Saharan Africa. Delivering HIVST kits by pregnant women attending antenatal care to their partners is a promising strategy for increasing HIV testing among men. However, even amidst the interventions, most men do not know their HIV status. This study, aimed to determine the proportion of partners who received and used oral HIVST kits delivered by pregnant women, associated factors, barriers, and facilitators for uptake among partners. We conducted an exploratory sequential mixed methods study among 380 sampled partners. Lists of partners in the HIVST log books whose women picked an HIVST kit were obtained and systematic random sampling was done to obtain participants. 14 male partners were purposively selected for in-depth interviews (IDIs) to identify barriers and facilitators. We used modified poison regression to determine the association between oral HIVST and independent variables. We used an inductive analysis for the qualitative analysis. Out of 380 participants, 260(68.4%) received an oral HIVST kit from their pregnant women, and 215(82.7%) used the kit for HIVST. Oral HIVST was associated with; Information Education and Communication (CPR = 1.64, 95%CI 1.48-1.82), being reached at home (CPR = 1.04, 95%CI 1.01-1.08), and being aware of the woman's HIV status (CPR = 1.04, 95%CI 0.99-1.09). In-depth results identified barriers to uptake as, lack of trust in the HIVST kit results, fear of test outcome in the presence of the partner and inclination that the HIV status of their women is the same as theirs, and facilitators included convenience, ease to use, prior awareness of their HIV status, and fear of relationship consequences and breakup. Delivery of oral HIVST kits to men through pregnant women reached a high number of men and achieved a high uptake. Accessing information, education, communication and convenience nature were the major reasons for uptake among men who received the Oral HIVST kit as trust issues of the kit affected use among partners. Scaling up the delivery of oral HIVST kits at all departments of the hospital through women seeking health services is paramount to support HIV screening among men to reach the UNAIDS 95 strategy.

Effectiveness of the Preterm Labor Prevention Program for High-Risk Pregnant Women: A Randomized Controlled Trial

Preterm labor significantly impacts premature birth, influencing infant development and health outcomes. This randomized controlled trial aimed to develop and test the effectiveness of the Preterm Labor Prevention Program on primary outcomes (knowledge, attitudes, self-care practices) and secondary outcomes (preterm labor, preterm birth rates). Sixty-six high-risk participants aged 15-49 attending antenatal care clinics in Northeastern Thailand were selected using multi-stage random sampling. They were randomly assigned to either the experimental group (n = 32) receiving the Preterm Labor Prevention Program in addition to routine care or the control group (n = 34) receiving routine care. Data collection employed questionnaires on knowledge, attitude, self-care practice, preterm labor, and preterm birth rates. Data were analyzed using one-way repeated measures ANOVA for knowledge, attitudes, and self-care practice scores across three-time points at baseline before the intervention, immediately and four weeks after program completion, and chi-square tests for comparing preterm labor and premature birth rates across groups. Results indicated that the mean score of knowledge, attitude, and self-care practice in the experiment group was significantly increased over time immediately and four weeks after program completion and significantly higher than that of the control group at both time points. Furthermore, the incidence of preterm labor and the preterm birth rate in the experiment group were 6.25% and 3.10%, respectively. However, the incidence of preterm labor and the preterm birth rate in the control group were equal at 20.60%. Nurses and midwives can apply this program to increase knowledge, more positive attitudes, and practice to reduce preterm labor and preterm birth in high-risk pregnancies, but first, testing of the program is required with an increased number of participants.

Survey of Hepatitis B Virus Infection among Pregnant Women Attending Antenatal Care Clinic in two Selected Health Centers in Lugbe, AMAC, FCT, Abuja

Background: Hepatitis B Virus is a small, double-stranded DNA, and perinatal transmission from mother to infant at birth is highly efficient as many as 90% of infants. This was aimed at investigating the Knowledge and Status of Hepatitis B among pregnant women attending antenatal care in two selected health centres in Lugbe, Abuja.
 Method: A total of 220 pregnant women ranging from 15- 45+ years were randomly selected and assessed on demographic characteristics, HBV, knowledge and prevention of HBV infection using a well-structured self-administered questionnaire. The data obtained were analyzed using SPSS Version 20.0.
 Result: The result revealed that more than half (70.0%) of the respondents have not suffered the infection, while 26.8% have. More than three-quarters (85.0%) of the participants had only a single sexual partner, and 1.4% had more than three sexual partners. The majority (58.6%) identified HBV as the cause of hepatitis. Nevertheless, the majority were not knowledgeable about the risk factors of hepatitis, as more than half of them, believed that avoiding multiple sexual partners, sharing sharp objects, blood transfusion and vaccination do not prevent the contraction of the infection. There is a significant relationship between the participant's marital status, educational level and hepatitis status(p=0.044).
 Conclusion: The status of Hepatitis B virus infection was higher (26.8%) than what has been reported, and can be attributed to a low level of knowledge among the respondents on the causes of the infection. An aggressive campaign to increase knowledge and create more awareness among the respondents in the area should be mounted.

Antenatal Care Utilization Factors Among Pregnant Women Attending Antenatal Care Clinic at Kakanju Health Centre III Bushenyi District

The study aimed to determine the factors influencing the utilization of antenatal care (ANC) among pregnant women aged 18-40 attending ANC clinics at Kakanju Health Centre III in Bushenyi District. The research used a descriptive cross-sectional study design, with a sample size of 384 respondents. The results showed that 86.2% of participants had adequate knowledge about ANC utilization, while 13.8% had inadequate knowledge. Women aged 15-20 years, house wives, maids, and shop attendants were also more likely to have inadequate knowledge. Women without education were six times more likely to have inadequate knowledge about ANC utilization. Women in their first pregnancy were three times more likely to have inadequate knowledge. Women with a history of previous stillbirth were three times more likely to have inadequate knowledge. Women with a history of previous cesarean section were two times more likely to have adequate knowledge about ANC utilization. Age, occupation, marital status, and education level were found to be statistically significantly associated with knowledge regarding ANC utilization. Keywords: ANC utilization, Pregnant women, Cesarean section, Stillbirth, ANC services.

Prevalence and Antibiotic Susceptibility Pattern of Urinary Tract Infection Among Pregnant Women Attending Antenatal Care at Maternity Clinic in Dambam, Bauchi State

Urinary tract infections (UTI) constitute the most common morbidity during pregnancy resulting in severe complications and fatality. This study aimed to determine the prevalence and antibiotic susceptibility pattern of urinary tract infection among pregnant women attending Antenatal Care Clinic (ANC), at Dambam, Bauchi State. A total of 290 pregnant women aged 15 – 40 years (Mean age, 23.4 SD± 2.1 years) were screened for bacteriuria using standard microbiological method. Antimicrobial sensitivity pattern of the bacterial isolates was determined by Modified Kirby-Bauer disc diffusion method. Questionnaires were used to obtain information on biodata and socio-demographic characteristics of the study population. The prevalence of urinary tract infection among pregnant women screened was 17.24% (n = 50). Pseudomonas aeruginosa constitutes the most prevalent organism, 15 (5.17%) cultured, followed by Klebsiella spp 12, (4.14%) while Staphylococcus aureus, Staphylococcus saprophyticus and Enterococcus spp constitute the least isolates (1.38%) each. The study revealed a significant association (P_ < 0.05, P = 0.000) between the frequency of bacterial isolates and marital status while other demographic characteristics such as educational status, age and occupation of the subjects did not indicate any significant relationship. Majority of the bacterial isolates were resistant to Cefalexin, Levofloxacin, and Clindamycin but were however, sensitive to Ciprofloxacin, Ceftriaxone and Amoxicillin-clavulanic acid. Considering the significant bacterial isolates from pregnant women investigated expressing some resistance against commonly used antibiotics, hence there is need for educational campaign to enlighten women about UTIs during pregnancy and useful prevention/control measures to checkmate associated complications and fatality. Keywords: Antenatal Care, Bacteriuria, Infection, Pregnant Women, Prevalence, Urinary Tract Infection.

‘If there is joy… I think it can work well’: a qualitative study investigating relationship factors impacting HIV self-testing acceptability among pregnant women and male partners in Uganda

ObjectivesSecondary distribution of HIV self-test (HIVST) kits from pregnant women attending antenatal care (ANC) to their male partners is shown to increase HIV couples testing and disclosure, and is being...

Perceived Factors Influencing Delay in Attending Antenatal Care Clinic among Expectant Mothers in Anyigba, Kogi State, Nigeria

Antenatal care is a key strategy for reducing maternal and neonatal morbidity and mortality in Nigeria because adequate utilization of antenatal health care services is associated with improved maternal and neonatal health outcomes. However, some expectant mothers delay the utilization of these health care services, hence, the need to investigate the social factors causing their delay. This cross-sectional descriptive survey examined the factors associated with delay in the utilization of Antenatal Care Services among pregnant women in Anyigba, Dekina Local Government Area of Kogi State, Nigeria. The sample size consists of 400 pregnant women which cut across a public hospital and three private clinics that are not in close proximity to one another. Specific objectives include: to determine if expectant mothers in Anyigba, Kogi State attend Antenatal Care Clinic early (that is, in their first trimester which is before 14 weeks of gestation), to establish factors responsible for delay in attending Antenatal Care, to identify perceived benefits of Antenatal Care services and to explore the perceived consequences for delay in attending Antenatal Care among expectant mothers. The study made use of primary data. The questionnaire method was used to gather the needed data. Descriptive statistical method was used to analyze the data generated and hypotheses were tested using multiple linear regression and level of significance was set at 5% (0.05).The Findings from the study revealed among others, that expectant mothers in Anyigba delay in attending Antenatal Care Clinic and that majority of the respondents agreed that cost, long waiting time during Antenatal Care visit, attitudes of the expectant mothers are major factors influencing delay in the utilization of Antenatal Care Clinic in Anyigba, Kogi State. The study also found that delay in attending Antenatal Care Clinic come with consequences such as poor opportunity to monitor pregnancy, general complications and detection of diseases. Socio demographic factors, the perceived benefits of Antenatal Care (ANC), and the knowledge of the consequences associated with delay in attending ANC significantly influenced the utilization of ANC in Anyigba, Kogi State. The study concludes that, delayed Antenatal Care visit is dangerous to both the health of the expectant mother and that of the unborn child. Hence to reduce the risk of maternal and neonatal morbidity and mortality, expectant mothers should be encouraged through the policy developments and governments interventions to book early for Antenatal Care within the first trimester of their pregnancy as recommended by the World Health Organization (WHO) and that government and non-governmental institutions should increase enlightenment drive on both the benefits of early antenatal attendance and the consequences of delayed or non antenatal attendance.

First trimester screening and prediction of preeclampsia by Application of Fetal Medicine Foundation Algorithm at Tanta University

Background: Preeclampsia (PE) is a complex illness linked to conception that affects a variety of bodily functions and is usually connected with perinatal morbidity and deaths. Early PE anticipation will reduce this linked morbidity and death by allowing for routine maternal and foetal monitoring and the use of preventative measures. Aim of the work: the goal of this study is to investigate whether the measurement of maternal serum placental growth factor (PlGF) combined with uterine artery Doppler ultrasound, are useful in early predicting PE and to examine the diagnostic accuracy of the Fetal Medicine Foundation (FMF) Algorithm for the early screening and anticipation of the high- risk PE at 11-13 weeks conception in a group of pregnant women. Patients and Methods: one hundred and twenty primigravida women with living, singleton fetus at 11-13 weeks conception without risk factors other than being primigravida attending antenatal care clinic at the Department of Obstetrics and Gynecology at Tanta University Hospitals. All cases were subjected to ; A signed informed written consent, proper history taking, full clinical examination, estimation of body mass index (BMI), blood pressures and determination of mean arterial blood pressure (MAP), ultrasound, Uterine artery doppler ultrasound examination with the determination of the mean Pulsatility index (PI) of the uterine arteries. Maternal serum levels of PlGF were also measured by specific immunoassay (ELISA). The measured values of MAP, mean uterine artery pulsatility index (PI) and PlGF were converted into multiples of the median (MoM). Then the FMF model was used for the determination of patient-specific risk of PE at 11-13 weeks conception in each case. Results: The main results of the present study revealed that; Only 11 of 120 normal pregnant women were categorized as a high PE risk with a percentage of 9.2% and the rest 109 cases were low PE risk with a percentage of 90.8% by application of FMF algorithm. There was a significant difference between the high and low risks regarding the mean uterian UtA-Pi and PIGF levels at 11–13 weeks. Receiver operating characteristic curve (ROC) demonstrate to what extent it can be depended on PlGF, mean UtA-PI and MAP as a predictor for PE denoting the significant diagnostic performance for PIGF and mean uterine artery pulsatility index (PI). The optimal cutoff value of PlGF value using the ROC curve was ≤40 leading to a sensitivity of 90.91%, a specificity of 96.33%, a PPV of 71.4, a NPV of 99.1% and an accuracy of 95.83%. While the optimal cutoff measure of mean uterine artery PI value using the ROC curve was >1.91 leading to a sensitivity of 90.91%, a specificity of 96.33%, PPV of 71.4, NPV of 99.1% and an accuracy of 95.83%. Conclusion: On the basis of these results, it could be concluded that the combined measurement of maternal serum PlGF concentrations and mean PI of the uterine arteries at 11–13 weeks of conception may help to predict the high-risk PE in primigravida when other parameters of PE anticipation are normal. And The FMF screening algorithm for the high-risk PE group performing satisfactorily. PE estimated by the competing risk model incorporated in the FMF algorithm may be applicable locally, and the earlier screening in conception would allow women at a higher risk to be monitored accordingly, participate in early intervention trials, and commence prophylactic therapy.

Prevalence of High-Risk Pregnancy Among Pregnant Women Attending Antenatal Care Camps in Primary Health Centres in Kinaye and Vantamuri and Their Sub-Centres.

IntroductionIdentifying pregnancy-related complications and high-risk pregnancies early on and effectively managing care for these pregnant women through a holistic approach guided by the main objectives of antenatal care (ANC) and efficient, good-quality health care through ANC services can reduce the risk of pregnancy-related complications, being favourable for both mother and child. This study was intended to identify the percentage of pregnant women in high-risk groups attending ANC clinics.ObjectiveThis study’s aim was to understand the prevalence of high-risk pregnancies in women attending ANC camps in Kinaye and Vantamuri villages in Belagavi, India.MethodsA community-based cross-sectional study was carried out in a primary healthcare (PHC) setting that included all pregnant women attending antenatal camps and residing in the same areas. With a total study sample size of 200, consisting of pregnant women attending ANC camps in Kinaye and Vantamuri PHC, the data were collected using a pre-tested, pre-designed questionnaire after obtaining written informed consent from the participating pregnant women.ResultsThe data were analysed using a chi-square test to uncover the relationship between socio-demographics, obstetric history, medical variables, and high-risk pregnancy. The results demonstrated that 48.5% of women attending ANC clinics were in the high-risk pregnancy group.ConclusionPregnancy outcomes are greatly affected by a woman’s socio-demographic, obstetric, and medical variables. The WHO recommends a minimum of four ANC visits to safely identify and mitigate the risks and complications of high-risk pregnancy to ensure positive outcomes for both mothers and children.

Impact of Coronavirus Disease Pandemic on Antenatal Care Utilization among Primigravida Women in Asir Region, Saudi Arabia

Background: By the end of 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, Hubei province, China. In Saudi Arabia, the government applied prompt preventive measures against coronavirus disease 19 (COVID-19). COVID-19 associated restrictions have been affected the antenatal care (ANC) services that made careful surveillance of the pregnant women health requirement to protect them from COVID-19 infection. The current study was conducted to assess the COVID-19 pandemic effect on ante-natal care utilization among primigravida women in Asir region, Saudi Arabia.
 Methods: A descriptive cross-sectional study was conducted targeting all females with their 1st pregnancy during COVID-19 pandemic. The questionnaire covered pregnant females’ demographic data, medical history, COVID-19 infection history, ante-natal care visits. Final questionnaire was distributed among woman attending antenatal care clinics at primary health care centres (PHCCs) and Abha Maternity and Children Hospital clinics in Asir region during the period from December 2020 to December 2021
 Results: A total of 555 women attend to antenatal care clinics participated in the study. Primigravida women, who got pregnant during the COVID-19 pandemic were included. Exact of 114 primigravida women meet the inclusion criteria. Participants’ ages ranged from 21 to more than 40 years with mean age of 24.6 ± 9.4 years old. Ante-natal care visits of 1st pregnancy women during a period of quarantine in Asir regions. Exact of 90 (78.9%) pregnant females were compliant to ANC visits during COVID-19 pandemic. A total of 63 (70%) of these visits were in the private sector while 21 (23.3%) were at the governmental hospitals and 18 (6.7%) at the PHCCs.
 Conclusion: The current study revealed that pregnant primigravida females were adequately adherent for the ANC visits during COVID-19 pandemic especially those with multiple pregnancies. The most settings provided ANC visits were the private sector with reported good pregnancy outcome.

Occurrence of Erythrocyte Alloimmunization in Women Attending Antenatal Care Clinic

Background and Objectives: There is limited literature available on the alloimmunization rates among pregnant women in India. Our primary aim was to estimate the occurrence of irregular erythrocyte alloantibody (IEA) immunization amongst women attending our antenatal care (ANC) clinic and to guide our obstetricians for improved ANC as well as their fetal outcomes. Methods: A cross-sectional study was performed at the blood center in North India over 12 months. We recruited a total of 212 study participants. Antibody screening and identification were performed by using semi-automated column agglutination technology and commercially available 3-red cell antibody screen panel with reagent cards having anti-human globulin (AHG) (Ortho Clinical Diagnostics Inc., USA) and 11-red cell antibody identification panel with reagent cards having AHG (Resolve Panel A; Ortho Clinical Diagnostics Inc., USA) respectively. Once identified, the semi-quantitative doubling dilutions, i.e., serial titrations of the respective IEA were performed by the conventional tube technique to assess their potency. The association of various antibodies identified was analyzed using the Pearson's Chi-square test. Results: Of the 7248 pregnant women attending our ANC clinics, the antibody screening was requested for 212 cases. Out of these, 10.8% (n = 23/212) of women were positive and were sensitized both by active and passive immunization. Their average age (in years) was 27.6 ± 3.52 (20 to 34). The majority belonged to the Dehradun district of Uttarakhand. ABO system-wise, the most common type amongst the included subjects was A as recorded in 34.4%, followed by B (30.18%), O (24.12%) and AB (11.3%), respectively. Rh system-wise, nearly 47% (n=100/212) of subjects had Rh (D) negative blood group. Interestingly, amongst these 23 ANC cases with positive IAT, nearly 13% had a history of having received a blood transfusion. Conclusion: To sum up, the screening of majority of ANC in our hospital is restricted to Rh (D) negative pregnancies. Perhaps, more awareness among obstetricians regarding the universal screening of all ANC cases irrespective of their Rh (D) status is the need of the hour.

Provision of inadequate information on postnatal care and services during antenatal visits in Busega, Northwest Tanzania: a simulated client study

BackgroundMost (94%) of global maternal deaths occur in low- and middle-income countries due to preventable causes. Maternal health care remains a key pillar in improving survival. Antenatal care (ANC) guidelines recommend that pregnant women should be provided with information about postnatal care in the third trimester. However, the utilization of postnatal care services is limited in developing countries including Tanzania. The aim of this study was to investigate the practice of health care workers in providing information on postnatal care to pregnant women during antenatal care visits.MethodsA cross sectional study was conducted among health care workers from 27 health facilities that offer reproductive and child health services in Busega district Northwest Tanzania. A simulated client approach was utilized to observe quality of practice among health care workers with minimal reporting bias (i.e., the approach allows observing participants at their routine practices without pretending). Selected pregnant women who were trained to be simulated clients from the community within facility catchment area attended antenatal care sessions and observed 81 of 103 health care workers. Data analyses were carried out using STATA 13.ResultsOnly 38.73% (95% CI; 28.18–49.49%) of health care workers were observed discussing subtopics related to postnatal care during the ANC visit. Few health care workers (19.35%), covered all eight subtopics recommended in the ANC guidelines. Postnatal danger signs (33.33%) and exclusive breast feeding (33.33%) were mostly discussed subtopics by health care workers. Being a doctor/nurse/clinical officer is associated by provision of postnatal education compared to medical attendant, aOR = 3.65 (95% CI; 1.21–12.14).ConclusionThe provision of postnatal education during ANC visits by health care workers in this district was limited. This situation could contribute to the low utilization of postnatal care services. Health care workers need to be reminded on the importance of delivering postnatal education to pregnant women attending ANC clinic visits. On job training can be used to empower health care workers of different cadres to deliver postnatal health education during ANC visits. These efforts could increase women’s utilization of postnatal care and improve outcomes for mothers and newborns.

Facilitators and barriers to routine intimate partner violence screening in antenatal care settings in Uganda

BackgroundUganda clinical guidelines recommend routine screening of pregnant women for intimate partner violence (IPV) during antenatal care (ANC). Healthcare providers play a critical role in identifying IPV during pregnancy in ANC clinics. This study explored facilitators and barriers for IPV screening during pregnancy (perinatal IPV screening) by ANC-based healthcare workers in Uganda.MethodsWe conducted qualitative in-depth interviews among twenty-eight purposively selected healthcare providers in one rural and an urban-based ANC health center in Eastern and Central Uganda respectively. Barriers and facilitators to IPV screening during ANC were identified iteratively using inductive-deductive thematic analysis.ResultsParticipants had provided ANC services for a median (IQR) duration of 4.0 (0.1–19) years. Out of 28 healthcare providers, 11 routinely screened women attending ANC clinics for IPV and 10 had received IPV-related training. Barriers to routine IPV screening included limited staffing and space resources, lack of comprehensive gender-based violence (GBV) training and provider unawareness of the extent of IPV during pregnancy. Facilitators were availability of GBV protocols and providers who were aware of IPV (or GBV) tools tended to use them to routinely screen for IPV. Healthcare workers reported the need to establish patient trust and a safe ANC clinic environment for disclosure to occur. ANC clinicians suggested creation of opportunities for triage-level screening and modification of patients’ ANC cards used to document women’s medical history. Some providers expressed concerns of safety or retaliatory abuse if perpetrating partners were to see reported abuse.ConclusionsOur findings can inform efforts to strengthen GBV interventions focused on increasing routine perinatal IPV screening by ANC-based clinicians. Implementation of initiatives to increase routine perinatal IPV screening should focus on task sharing, increasing comprehensive IPV training opportunities, including raising awareness of IPV severity, trauma-informed care and building trusting patient-physician relationships.

Hepatitis C seroprevalence among people living with HIV/AIDS and pregnant women in four provinces in Cambodia: an integrated bio-behavioral survey

BackgroundUnderstanding the extent of viral hepatitis burden in specific subgroups, such as pregnant women and people living with HIV/AIDS (PLWHA), and their geographic distribution is essential for evidence-informed policy and mobilizing resources for targeted treatment and prevention efforts. However, in Cambodia, the epidemiology of hepatitis C remains uncertain. We estimated the hepatitis C virus (HCV) burden and transmission risk factors among PLWHA and pregnant women attending antenatal care (ANC) in Cambodia.MethodsBetween March and April 2016, we conducted a cross-sectional survey in four diverse geographical areas: the capital city of Phnom Penh and three provinces. We collected information on demographic characteristics and risk behaviors and performed HCV antibody (Anti-HCV) testing among pregnant women attending public ANC clinics and among those receiving HIV care at the hospitals. We computed the prevalence of HCV among the two population subsets and performed logistic regression analyses to identify risk factors associated with HCV antibody positivity.ResultsOf 935 participants enrolled, 510 (54.6%) were pregnant women and 425 (45.4%) were PLWHA. Anti-HCV prevalence was significantly higher in PLWHA than in pregnant women (29/425, 6.8% vs 5/510, 0.9%, P < 0.001). Of the geographic regions, Preah Sihanouk province (Southwest) had the highest anti-HCV prevalence among PLWHA (12.0%, P = 0.031). There was no significant geographic difference in anti-HCV prevalence among pregnant women. In multivariable analyses (data subset to PLWHA), HCV infection was significantly associated with having a family member positive for HCV (OR = 7.6 [95% CI: 1.01–57.84], P = 0.048) and a history of intravenous medication injection in the last 5 years (OR = 7.1 [95% CI: 2.79–18.10], P < 0.001).ConclusionsHCV infection is relatively common among Cambodian PLWHA, likely related to intravenous medication injection and intra-familial viral transmission. Systematic HCV testing and care among PLWHA (and possibly their family members) might be necessary. Setting up a surveillance system for HCV might also be beneficial for some geographical regions and populations.

Complementary and Alternative Medicine Utilization among Pregnant Women Attending Antenatal Care Clinics in Tongaren Sub-County, Kenya: a Cross-sectional Survey

Background: In Kenya, Complementary and Alternative Medicine (CAM) has been used in almost every culture to manage intolerable symptoms of pregnancy since ancient times. However, studies in Kenya have focused on herbal medicine which is just one of CAM practices. In rural settings (such Tongaren Sub-County), no studies have ever evaluated the prevalence and determinants of CAM use during pregnancy including the common CAM modalities used, and so there is need to bridge these knowledge gaps. Purpose: This study aimed at determining the prevalence of CAM utilization and associated factors among pregnant women attending antenatal care clinics in Tongaren Sub-County, Bungoma County. Methods: A cross-sectional descriptive study design was employed in collecting data from 340 pregnant women attending antenatal clinics in Tongaren, Kenya. Quantitative data was collected through semi-structured questionnaires. Chi-square test was used to establish the associations between socio-demographic variables and CAM usage, and multiple logistic regressions were used to examine the relative effects of the various aspects of the variables which were significantly associated with CAM usage. Results: Among the 340 participants, 50.7% indicated using CAM modalities during pregnancy, indicating that CAM use prevalence in Tongaren is about 50%. 55.80% of CAM users concomitantly use CAM and conventional medicine. The high CAM use prevalence among participants was motivated by the preference of CAM over conventional medicine for certain illnesses (31.4%) and the perceived lack of response to conventional medicine (20.1%). It was noted that marital status, educational attainment of the spouse, employment status, occupation type, and household monthly income level are the major determinants of CAM usage. From the logistic regression analysis, the variables positively associated with CAM use among pregnant women were married status (Odds ratio (OR) = 2.341, p = 0.008), having a spouse with informal education (OR = 5.371, p &lt; 0.001), self-employed status (OR = 0.415, p = 0.028), farming occupation (OR = 2.777, p = 0.206), and household monthly income higher than 35,000 Kshs (OR = 0.093, p = 0.012). Conclusions: Due to the widespread trust in the safety and efficacy of CAM, the utilization of CAM during pregnancy is common among women in Tongaren Sub-County, which is a rural setting, and therefore CAM can be regarded as the backbone of rural health care in Kenya.

Awareness and Practice of COVID -19 Preventive Measures among Pregnant Women Attending Antenatal Care Clinic in a Tertiary Health Centre in North-Western Nigeria

Covid-19 pandemic has resulted in death of millions of people across the world. The impact of the disease on human health and the economic hardship on the affected countries have been severe. The public must routinely practice precautionary measures to control the spread of the disease, as no antiviral treatments are currently available. However, the level of awareness and practice of these preventive measures against Covid-19 infection among pregnant women, which constitute vulnerable groups have not been evaluated in our environment. The aim of the study was to determine the awareness and knowledge of pregnant women on Covid-19, its preventive measures and the practice of those preventive measures. It was a cross-sectional study among pregnant women attending antenatal care clinic at Usmanu Danfodiyo University Teaching Hospital, Sokoto. An interviewer administered questionnaire was used to obtain relevant information on sociodemographic characteristics and also their knowledge and practice of Covid-19 preventive measures. All the respondents were aware of Covid-19 infection and the source of information was from Television. All the respondents were aware of the various preventive measures of Covid-19 and the knowledge was good among 98.7% of the respondents. However, only 19.1% had good practice of the preventive measures. Educational status of the respondents was found to have significant association with knowledge of preventive measures (χ2= 9.5, p = 0.014).

Self-Medication During First Trimester among Pregnant Women Attending Antenatal Care Clinic at a District Hospital in Mwanza, North-western Tanzania

Self-Medication During First Trimester among Pregnant Women Attending Antenatal Care Clinic at a District Hospital in Mwanza, North-western Tanzania

Knowledge, Attitude, and Practice toward Corona Virus Infection among Pregnant Women Attending Antenatal Care Clinics at Kafrelsheikh, Egypt

Knowledge, Attitude, and Practice toward Corona Virus Infection among Pregnant Women Attending Antenatal Care Clinics at Kafrelsheikh, Egypt

Sero-prevalence and associated factors of hepatitis B virus among pregnant women in Hawassa city public hospitals, Southern Ethiopia: Cross-sectional study design.

This study aimed to determine the prevalence and identify associated factors of hepatitis B virus infection among pregnant women attending antenatal care (ANC) follow-up. An institution-based cross-sectional study was conducted from March 04 to April 03, 2020. A total of 381 women were selected using systematic random sampling after every two consecutive women. Structured and interviewer administered questionnaire was used to collect the data. A 2 ml of venous blood sample was drawn from each participant. The plasma was separated from the collected blood samples and was analyzed using a rapid hepatitis B surface antigen (HBsAg) kit to determine hepatitis sero status. Data were entered into the EPI-Data version 3.1, then exported to the statistical package for social sciences version 25 software and analyzed. Multivariable logistic regression was performed to identify independent predictors of HBsAg B seroprevalence at a p-value <0.05. The prevalence of HBsAg sero-positivity among pregnant women was 6.6%, 95% CI (4.2, 8.9). History of hosptal admission (adjusted odds ratio (AOR) = 4.11; 95% CI = 1.33-12.71), surgical history (AOR = 6.8; 95% CI = 1.93-23.93), history dental procedures (AOR = 4.93; 95% CI = 1.31-18.53), and body tatoo practices (AOR = 6.822; 95% CI = 1.89-24.69) were found to be associated with HBsAg sero-positivity. This study found that HBsAg sero positivity among pregnant women in the study area was in intermediate edemicity. Factors such as history of hospital admission, history of surgery, history of dental procedures, and body tattoo practices were found to be associated with HBsAg sero-positivity. The government of Ethiopia should strengthen screening of all pregnant women for HBV as a part of routine ANC in ANC clinics and treating if they are positive to prevent mother to child transmission.

Maternal early pregnancy body mass index, gestational weight gain and pregnancy outcomes among urban slum dwellers in Pune, India-A retrospective analysis.

ABSTRACTContext:Studies on prepregnancy body mass index (BMI), gestational weight gain (GWG), and pregnancy outcomes among urban Indian slums are sparse.Aims:To study BMI during early pregnancy, GWG, and maternal and neonatal outcomes among slum-dwelling women in Pune, India.Design:A retrospective study among pregnant women attending antenatal care (ANC) facility.Methods and Material:Anthropometric and clinical data throughout pregnancy and pregnancy outcomes postdelivery were collected during hospitalization for delivery using ANC cards. Asian BMI cut-offs were used to define underweight (UW), normal weight (NW), overweight (OW), and obesity (OB). GWG was classified into insufficient, adequate, and excessive categories (2009 Institute of Medicine). Statistical analysis was performed using R (v 4.0).Results:Slum-dwelling pregnant women (n = 509, mean age 24 (3.6) years) were studied. Seventy-five percent of the women visited ANC clinics at least thrice during pregnancy. Only 17.5% (n = 89) of the women registered before 12 weeks of gestation, and higher education and being primiparous were the correlates. A total of 28% of the women were UW, whereas 25% of the women were OW/OB as per early pregnancy BMI. The highest percentage of preterm deliveries and cesarean/instrumental deliveries were observed in OW/OB categories. A total of 27% gained appropriate gestational weight. This cohort had 508 live births (mean BW- 2.8 kgs) and one stillbirth. One baby had macrosomia (BW >4 Kg), whereas 19% were low birth weight (LBW) (BW <2.5 Kg).Conclusions:Double burden of malnutrition (UW and OW) was observed among young slum-dwelling women. The proportion of slum-dwelling women attending ANC clinics during early pregnancy is still low. Increased uptake of government programs is required to enhance maternal and child health.