Community-based Case-control Study Research Articles

Common Genetic Variants of Response to Hepatitis B Vaccines Correlate with Risks of Chronic Infection of Hepatitis B Virus: A Community-Based Case-Control Study.

Hepatitis B (HB) vaccination effectively reduces the risks of chronic infection with the hepatitis B virus (HBV). It is unknown whether there is a common genetic determinant for response to the HB vaccine and susceptibility to chronic HBV infection. This case-control study, which included 193 chronic HBV carriers and 495 non-carriers, aimed to explore the effects of the most significant single nucleotide polymorphisms (SNPs) in response to the HB vaccine on the risks of chronic HBV infection. Out of 13 tested SNPs, the genotype distributions of four SNPs at the human leukocyte antigen (HLA) class II region, including rs34039593, rs614348, rs7770370, and rs9277535, were significantly different between HBV carriers and non-carriers. The age-sex-adjusted odds ratios (OR) of chronic HBV infection for rs34039593 TG, rs614348 TC, rs7770370 AA, and rs9277535 AA genotypes were 0.51 (95% confidence interval [CI], 0.33-0.79; p = 0.0028), 0.49 (95% CI, 0.32-0.75; p = 6.5 × 10-4), 0.33 (95% CI, 0.18-0.63; p = 7.4 × 10-4), and 0.31 (95% CI, 0.14-0.70; p = 0.0043), respectively. Multivariable analyses showed that rs614348 TC and rs7770370 AA genotypes were significantly independent protectors against chronic HBV infection. The multivariable-adjusted ORs for subjects with none, either one, or both of the protective genotypes were 1.00 (referent), 0.47 (95% CI: 0.32-0.71; p = 3.0 × 10-4), and 0.16 (95% CI: 0.05-0.54; p = 0.0032), respectively. Among eight HBeAg-positive carriers, only one of them carried a protective genotype. This study shows that response to the HB vaccine and susceptibility to chronic HBV infection share common genetic determinants and indicates that HLA class II members are the main responsible host genetic factors.

Association between Helicobacter pylori seropositivity and hypertension among adults in Northern Sudan: a community-based case-control study.

The association between Helicobacter pylori and hypertension is unclear. Herein, we aimed to investigate the association between H. pylori and hypertension among adults in Sudan. We conducted a community-based case-control study (175 participants in each arm) in the Wad Hamid district in northern Sudan. Cases comprised adults with hypertension and controls were non-hypertensive adults. We assessed participants' data using a questionnaire. We also conducted rapid H. pylori antibody tests and binary and linear regression analyses. Multivariable logistic regression revealed age (adjusted odds ratio [AOR] 1.05, 95% confidence interval [CI] 1.03-1.07), female sex (AOR 5.50, 95% CI 2.36-12.80), and body mass index (AOR 1.12, 95% CI 1.07-1.17) were significantly associated with hypertension. Moreover, compared with controls, a significantly higher number of patients with hypertension were positive for H. pylori (82/175, 46.9% vs. 46/175, 26.3%). H. pylori seropositivity was associated with systolic blood pressure (coefficient 3.811), diastolic blood pressure (coefficient 3.492), mean blood pressure (coefficient 3.599), and hypertension (AOR 3.15, 95% CI 1.82-5.46). Our study revealed a significant positive association between H. pylori seropositivity and hypertension. This finding supports literature recommending the eradication of H. pylori to prevent hypertension and its complications.

Factors associated with obstetric fistula among reproductive age women in Ethiopia: a community based case control study

BackgroundObstetric fistula is a major public health concerns in Ethiopia. It is the most devastating cause of all maternal morbidities.MethodData from the 2016 Ethiopian Demographic Health Survey (EDHS) was analyzed. A community-based unmatched case control study was conducted. Seventy cases and 210 non cases were selected using random number table. Data were analyzed by using STATA statistical software version 14. Multivariable logistic regression model was applied to determine the factors associated with fistula.ResultsThe majority of fistula cases were from rural residences. The multivariable statistical model showed that rural residence (Adjusted OR (AOR) = 5, 95% CI 4.26, 7.52), age at first marriage (AOR = 3.3, 95% CI 2.83, 4.60), poorest wealth index (AOR = 3.3, 95% CI 2.24, 5.01) and decision making for contraceptive use by husband alone (AOR = 1.3, 95% CI 1.124, 1.67) were factors significantly associated with obstetric fistula.ConclusionAge at first marriage, rural residence, poorest wealth index and decision making for contraceptive use by husband alone were significantly associated factors for obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels.

Measles Outbreak Investigation in Garda Marta District, Southwestern Ethiopia, 2022: Community-Based Case-Control Study.

A measles outbreak can occur in the presence of an increased number of unvaccinated children; however, the vaccine was available many decades ago, and it is the foremost cause of child mortality, claiming 568 lives (mostly children) worldwide each day. The investigation was aimed at assessing the magnitude and identifying contributing factors for the measles outbreak in the Garda Marta District of Gamo Zone, Southwestern Ethiopia. From January 20 to February 10, 2022, a descriptive and unmatched case-control study was used to describe the measles outbreak and identify the associated risk factors for measles infection. The descriptive analysis employed all 140 cases from the line list, while the case-control study used 51 cases and 102 controls to investigate factors associated with measles infection. Epi-data version 4.6.0.6 was used to code and enter data, which was then exported to SPSS version 27 for analysis. A standardized questionnaire was used to collect data. To declare statistical significance for the association, multivariable logistic regression with an adjusted odds ratio (AOR) and 95% CI was used. From a total of 140 measles cases reported from October 12, 2021, to March 09, 2022, 75 (54%) were females. Marta Laddo kebele was most affected (104 cases). Being unvaccinated (AOR: 2.84, 95% CI: 1.10-7.32), having a travel history (AOR: 4.24, 95% CI: 1.61-11.15), having a contact history (AOR: 6.34, 95% CI: 2.35-17.40), being unaware of the mode of transmission (AOR: 2.68, 95% CI: 1.16-6.37), and having moderate acute malnutrition (AOR: 4.44, 95% CI: 1.74-11.31) were factors significantly associated with the measles outbreak. Being unvaccinated, travel history to measles outbreak area, contact history, knowledge of caretakers/mothers on the mode of transmission, and acute malnutrition were associated with the measles outbreak in the district. Therefore, strengthening routine measles immunization, mounting vaccination awareness and nutritional screening are recommended.

Factors Contributing to Rapidly Increasing Rates of Caesarean Section in Andhra Pradesh, India: A Case-Control Study.

Introduction In some obstetric situations, a caesarean section (CS) can be a crucial, life-saving treatment for both the mother and the infant. Nonetheless, unnecessary CS can raise the risk of morbidity for both. The present study was conducted to study the factors associated with CS deliveryand to study the patterns of utilization of health facilities by pregnant women in the state of Andhra Pradesh in India. Materials and methods A community-based case-control study was done in Mangalagiri mandal, Guntur district, Andhra Pradesh, India in 2022. A total of 268 mothers (134 CS and 134 normal vaginal childbirth) who delivered between 2019 to 2022with at least one biological child less than three years of age were studied. The data was collected using a structured questionnaire. Robson's 10-Group Classification was used to differentiate the type of deliveries of the participants.A p-value less than 0.05 was considered to be significant. Results The mean age of the 268 women studied was 25.49±3.73 years. We found that 47 of the 82 (57.3%) women who went to government healthcare facilities and 87 of the 181 (48.1%) women who went to private healthcare facilities had a CS. Of the total CS studied, approximately 83.5% were emergency CSs. All four mothers who had twins had undergone CS. All women with oblique or transverse fetal lie underwent CS irrespective of parity. On multivariate analysis, participants' education status less than or equal to 10th standard was positively associated withCSandidentification of complications in the third trimester by healthcare provider was significantly protective for CS. Conclusion CS rate reduction necessitates a multi-faceted strategy that includes a variety of programming initiatives. Audits of CS performed as part of health programs and other creative monitoring techniques can be useful tools for assessing the standard of maternity care, particularly emergency CS.

Determinants of Female Genital Mutilation Among Under Five-Year Children in Motta Town, Northwest Ethiopia, 2022: Unmatched Case Control Study.

Female genital mutilation is the removal of a woman's external genitalia in whole or in part for a non-obvious medical reason. Female genital mutilation causes short- and long-term complications like bleeding, pain, infection and exposes girls to sexually transmitted diseases. The determinants of female genital mutilation among children under the age of five have received less attention. As a result, the purpose of this study was to determine the factors that influence female genital mutilation in children under the age of five. A community-based unmatched case control study design was used. The study participants were chosen using computer-generated simple random sampling technique. With a ratio of 1:4 between cases and controls, 323 participants were recruited. Data were collected using an interviewer-administered questionnaire. The association between each independent variable and the dependent variable was determined using binary logistic regression. In a multivariable analysis, variables were considered statistically significant if they had a P-value of less than 0.05 at a 95% confidence interval. In this study, mothers' circumcision status (AOR = 4.6; 95% CI: 2.29-9.25), mothers who had an unfavorable attitude (AOR = 4.15; 95% CI: 1.96-8.82), households in the poorest wealth quintile (AOR = 3.65; 95% CI: 1.2-11.54), mothers who had inadequate knowledge (AOR = 3.31; 95% CI: 1.51-7.25) and antenatal care visit of mothers (AOR = 2.46; 95% CI: 1.03-5.83) were found to be determinant factors of female genital mutilation. Mothers' circumcision status, mother's attitude, wealth quintile, knowledge of mothers, and number of antenatal care visits were factors associated with female genital mutilation. Regular awareness-building on the impacts of the practice and special attention to the mother's attitude are important to eliminate female genital mutilation.

Associations of genetic markers of diabetes mellitus with carotid atherosclerosis: a community-based case–control study

BackgroundDiabetes mellitus (DM) is a well-established determinant of atherosclerosis and cardiovascular diseases (CVD). Recently, genome-wide association studies (GWAS) identified several single nucleotide polymorphism (SNP) significantly correlated with DM. The study aimed to explore the relationships of the top significant DM SNPs with carotid atherosclerosis (CA).MethodsWe used a case–control design and randomly selected 309 cases and 439 controls with and without, respectively, carotid plaque (CP) from a community-based cohort. Eight recent GWAS on DM in East Asians reported hundreds of SNPs with genome-wide significance. The study used the top significant DM SNPs, with a p-value < 10–16, as the candidate genetic markers of CA. The independent effects of these DM SNPs on CA were assessed by multivariable logistic regression analyses to control the effects of conventional cardio-metabolic risk factors.ResultsMultivariable analyses showed that, 9 SNPs, including rs4712524, rs1150777, rs10842993, rs2858980, rs9583907, rs1077476, rs7180016, rs4383154, and rs9937354, showed promising associations with the presence of carotid plaque (CP). Among them, rs9937354, rs10842993, rs7180016, and rs4383154 showed significantly independent effects. The means (SD) of the 9-locus genetic risk score (9-GRS) of CP-positive and -negative subjects were 9.19 (1.53) and 8.62 (1.63), respectively (p < 0.001). The corresponding values of 4-locus GRS (4-GRS) were 4.02 (0.81) and. 3.78 (0.92), respectively (p < 0.001). The multivariable-adjusted odds ratio of having CP for per 1.0 increase in 9-GRS and 4-GRS were 1.30 (95% CI 1.18–1.44; p = 4.7 × 10–7) and 1.47 (95% CI 1.74–9.40; p = 6.1 × 10–5), respectively. The means of multi-locus GRSs of DM patients were similar to those of CP-positive subjects and higher than those of CP-negative or DM-negative subjects.ConclusionsWe identified 9 DM SNPs showing promising associations with CP. The multi-locus GRSs may be used as biomarkers for the identification and prediction of high-risks subjects for atherosclerosis and atherosclerotic diseases. Future studies on these specific SNPs and their associated genes may provide valuable information for the preventions of DM and atherosclerosis.

Determinants of household dropout from community-based health insurance program in northwest Ethiopia; A community-based case-control study.

Community-Based Health Insurance (CBHI) is an evolving program for delivering financial protection against the cost of illness and enhancing access to quality health services for low-income informal households. The study aimed to identify determinants of household dropout from a CBHI program in Mecha district, North West Ethiopia, 2019. A community-based case-control study was conducted in the Mecha district from March 10 to June 10, 2018. The final sample was 634 (317 cases and 317 controls) determined by the two-population proportion formula, and these samples were selected using a multi-stage sampling technique. The collected data was entered into Epi-data version 3.1 and analyzed using R version 4.0 software. Descriptive statistics computed. A simple logistic analysis was run (at 95% CI and p-value < 0.05) to identify the determinants for the dropout from CBHI. Poor perceived quality of care (AOR = 3.66; 95%CI: 2.35, 5.69), low knowledge of community-based health insurance (AOR = 6.02; 95%CI: 2.97, 12.26), no active community communication (AOR = 5.41; 95%CI: 3.29, 8.90) no chronic illness (AOR = 10.82; 95%CI: 5.52, 21.21) premium fee is not affordable (AOR = 2.35; 95%CI: 1.47, 3.77), and out of pocket money not reimbursed (AOR = 9.37; 95%CI: 4.44, 19.77) were the determinants for the dropout from CBHI. Poor perceived quality of care, low knowledge of CBHI, no active community participation, no chronic illness, premium fees are not affordable, and out-of-pocket money not reimbursed were the determinants for the dropout from CBHI.

Determinants of Trachomatous Inflammation-Follicular Among Children Aged 1 to 9 Years Old in a Rural Area of Gozamn District, Northwestern Ethiopia: A Matched Case-Control Study

Approximately 1.9 million people worldwide are blind or visually impaired due to trachoma, and trachoma remains endemic in 44 countries. Amhara in Ethiopia has the highest burden of trachoma in the world. A key indicator of whether active trachoma requires public health intervention is the incidence of trachomatous inflammation-follicular in children aged 1 to 9 years. However, limited study has been conducted on the determinants in rural communities. This study therefore aimed to fill this gap by identifying determinants in the Gozamn district of northwestern Ethiopia. A community-based case-control study was carried out between March 15 and April 30, 2021. Five or more follicles on the epitaxial conjunctivae that are larger than 0.5 mm were considered a case. Controls were free of any sign of trachoma. A semi-structured questionnaire and an observational checklist were used to gather the data, and STATA version 14 was used for the analysis. Using a 95% confidence interval, both bivariable and multivariable conditional logistic regression was performed. A total of 726 mothers/caregivers participated in this study, with a participation rate of 98.4%. Children from poor families (mAOR = 4.68; CI: 2.80-6.21), households where the water source is far from home (>30 minutes) (mAOR = 4.91; KI: 1.37-12.56), mean daily water consumption (<20 l/c/d) (mAOR = 4.42; CI:1.71-11.39), face washing frequency less than once a day (mAOR = 10.64; CI: 2.58-18.84), cloth washing frequency once a month or less (mAOR = 9.18; CI: 2.20-18.62), and mothers or caregivers with poor knowledge of active trachoma (mAOR = 3.88; CI: 1.47-10.22) were determinants of trachomatous inflammation-follicular. We conclude that infrequent faces and clothes washing; unavailability of water, children in poor families, and poor knowledge of mothers/caregivers were risk factors. Health education initiatives about active trachoma, its prevention, and control methods focusing on personal hygiene are so required.

Parkinson's Disease and the Gut Microbiome in Rural California.

Increasing evidence connects the gut microbiome to Parkinson's disease (PD) etiology, but little is known about microbial contributions to PD progression and its clinical features. We aim to explore the association between the gut microbiome with PD, and the microbial association with PD-specific clinical features. In a community-based case-control study of 96 PD patients and 74 controls, microbiome data were obtained from 16S rRNA gene sequencing of fecal samples, and analyzed for microbial diversity, taxa abundance, and predicted functional pathways that differed in PD patients and controls, and their association with PD-specific features (disease duration, motor subtypes, L-DOPA daily dose, and motor function). PD patients' gut microbiome showed lower species diversity (p = 0.04) and were compositionally different (p = 0.002) compared to controls but had a higher abundance of three phyla (Proteobacteria, Verrucomicrobiota, Actinobacteria) and five genera (Akkermansia, Enterococcus, Hungatella, and two Ruminococcaceae) controlling for sex, race, age, and sequencing platform. Also, 35 Metacyc pathways were predicted to be differentially expressed in PD patients including biosynthesis, compound degradation/utilization/assimilation, generation of metabolites and energy, and glycan pathways. Additionally, the postural instability gait dysfunction subtype was associated with three phyla and the NAD biosynthesis pathway. PD duration was associated with the Synergistota phylum, six genera, and the aromatic compound degradation pathways. Two genera were associated with motor function. PD patients differed from controls in gut microbiome composition and its predicted metagenome. Clinical features were also associated with bacterial taxa and altered metabolic pathways of interest for PD progression.

Determinants of stunting in children under five years in dibate district of Ethiopia: A case-control study

Chronic malnutrition is the consequence of long-term nutritional deficiency resulting in non-communicable disease and reduced productivity in later life. This situation primarily manifests through physical stunting, a term used to individuals short for their age in comparison to reference population of same age. . is defind based on the world health organization (WHO) 2006 reference population. Children whose height for age z score for height ≤ −2 SD while. is children whose z score for height > -2 SD to z score for height +2 SD. to find determinants of stunting among children aged between 6- 59 months. A community-based unmatched case-control study was conducted on 566 study participants (188 case and 378 controls) from March to May 2019. Nutritional status was determined using the WHO reference population. A structured questioner was used to collect data through interviews and anthropometric measurement. Data entry was made in Epi-data version 4.6.02, and the analysis was carried out using IBM SPSS version 26 software. Binary logistic and multivariable logistic regression was done. Multicollinearity was checked using the tolerance testand variance inflation factors. Hosmer- Lemeshow goodness of fit test was used to see model fitness. Adjusted odds ratios and 95% CI at P-values ≤ 0.05 were considered to affirm statistically significant factors. The study participants' response rate was 100% for both cases and controls. The mean age of the children was 28 ± 11.2 months for the case and 28.6 ± 6 months for control with the standard deviation. Factors significantly associated with stunting were poor household dietary diversity (AOR = 10.37, 95% CI; 5.39–19.94), middle household dietary diversity (AOR = 3.78, 95% CI; 1.38–10.38), family size ≥5 (AOR = 6.27, 95% CI; 3.37–11.66) and have no consumption of animal food source (AOR = 7.43, 95% CI; 4.3–12.8) This study relived that four variables were significantly associated with stunting. These are low household dietary diversity, medium household dietary diversity, family size, and animal source food. Based on the findings of this study, the following recommendations are made. provide health information to families regarding the importance of good household dietary diversity, provide health information to families regarding the importance of limiting family size, and provide nutritional counseling about the benefits of animal source food.

Severe acute respiratory syndrome coronavirus 2 infection altered the factors associated with headache: evidence from a multicenter community-based case-control study.

Headache is one of the significant global public health concerns. Furthermore, it is a standard feature of patients with acute and postacute COVID-19. This study aimed to estimate and compare the prevalence of headaches among postacute COVID and non-COVID individuals and identify and contrast the risk factors between both groups. This was a multicenter case-control study. Individuals who had recovered from acute SARS-CoV-2 infection were considered "case", and those who never tested positive for COVID-19 were considered "control." Headaches were measured using the musculoskeletal subscale of the subjective health complaints scale. Multiple logistic regression analysis was used to identify the predictors of headaches. A total of 878 individuals (439 cases) aged 38.30 ± 12.77 years (mean ± standard deviation) participated in this study. The prevalence of headaches was 26.2% among COVID-19 survivors; however, only 10.7% of unaffected participants reported headaches at the same time. Regression analyses suggested that the recovery duration from acute COVID-19 ≤ 90 days (adjusted odds ratio [AOR] = 2.03, CI = 1.13-3.65) was the only predictor of headache among postacute COVID-19 survivors. However, the female gender (AOR = 3.09, 95% CI = 1.51-6.32), members of a joint family (AOR = 1.99, 95% CI = 1.02-3.90), and city dwellers (AOR = 2.43, 95% CI = 0.94-6.25) were the predictor of headache among non-COVID participants. This study found a higher prevalence of headaches among COVID-19 survivors. In addition, predictors of headache among cases and controls were unmatched, indicating heterogenous impact of COVID-19 on human health. The health care providers should be informed of the study's results when discussing better practices to mitigate the burden of headaches.

Determinants of incomplete childhood immunization among children aged 12-23 months in Dabat district, Northwest Ethiopia: Unmatched case- control study.

Despite the effort to increase access to routine immunization, majority of children in low-resource countries including Ethiopia are still either unvaccinated or under-vaccinated. In Ethiopia for the past four decades, the completion rate of routine childhood immunization remains low particularly in a rural area. In this study setting, evidence regarding the socio-economic, maternal continuum care, and caregiver characteristics effect on child immunization is limited. Hence, this study aimed to identify the determinants of incomplete vaccination among children aged 12-23 months in Dabat district, Northwest Ethiopia. A community-based unmatched case-control study design was employed among 132 cases and 262 controls. Multi-stage sampling method was used to recruit eligible study participants. Logistic regression analysis was used to identify the determinants to children's incomplete vaccination. Caregivers' attitude towards vaccine (AOR: 6.1, 95% CI 3.4 to 11.1), knowledge on the schedule of vaccination (AOR: 4, 95% CI 2.2 to 7.1), Place of delivery (AOR: 2.7, 95% CI 1.3 to 5.5), and marital status (AOR: 2.36, 95% CI 1.22 to 4.56) were statistically significant association with incomplete childhood vaccination. Home delivery, caregivers' poor knowledge on the schedule of vaccination, caregivers' negative perception towards vaccine and unmarried marital status were predictors to incomplete vaccination. Therefore, to enhance full vaccination coverage, immunization health education program needs to address vaccine related safety enquiries in a meaningful method to caregivers, in order to improve the perception of caregivers towards vaccine. Moreover, improving maternal continuum care coverage is crucial.

Determinants of postpartum depression among mothers in Debre Tabor town, North-central, Ethiopia: Community-based unmatched case-control study.

BackgroundPostpartum depression (PPD) is a non-psychotic depressive disorder of variable severity, and it can begin as early as 2 weeks after delivery and can persist indefinitely if left untreated. In Ethiopia, the prevalence of postpartum depression is high. There is a dearth of literature to determine factors associated with postpartum depression in Ethiopia, specifically in the study area.ObjectiveThis study aimed to identify factors associated with postpartum depression among mothers in Debre Tabor Town, Northcentral Ethiopia.MethodA community-based unmatched case-control study was conducted among mothers who were living in Debre Tabor Town and fulfilled the inclusion criteria. Postpartum mothers were selected using a simple random sampling technique from the listed sampling frame at the health center. Then, the sample cases and controls were interviewed until the sample size was fulfilled by using a consecutive sampling method. The data were entered into the EPI data version 4.6 and then imported and analyzed using SPSS version 25. Descriptive statistics of different variables were done by cross-tabulation. Binary logistic regression was used to assess the determinant factors with the outcome variable. A P-value of < 0.05 was considered to declare statistical significance.ResultsA total of 308 postnatal mothers living in Debre Tabor Town were included, with a 97.5% response rate. History of substance use in the previous 3 months (AOR: 6.47, 95% CI; 2.61, 15.74), current baby illness (AOR: 3.9, 95% CI; 1.5, 10.12), marital dissatisfaction (AOR: 2.41, 95% CI; 1.22, 4.75), unplanned current pregnancy (AOR: 3.46, 95% CI; 1.32, 9.12), and breastfeeding (AOR: 0.22, 95% CI; 0.09, 0.55) were independent factors that affected the occurrence of PPD.ConclusionThis study revealed that a recent history of substance use (in the past 3 months), current baby illness, marital satisfaction, unplanned current pregnancy, and breastfeeding were associated with postpartum depression. Healthcare providers working in maternal and child health clinics and health extension workers should give special attention to postpartum mothers who have had a history of substance use, current baby illness, unplanned pregnancy, non-breastfeeding mothers, and mothers with poor marital satisfaction.

Long-term effects of caesarean delivery on health and behavioural outcomes of the mother and child in Bangladesh

BackgroundMedically unnecessary caesarean section (CS) is now an ongoing concern worldwide including in Bangladesh. This intensifies the occurrence of adverse maternal and child health outcomes. We investigated the associations of CS with some basic health and behavioural outcomes of the mothers and their children in Bangladesh.MethodsWe conducted a community-based case–control study from May to August 2019. A total of 600 mother–child dyads were interviewed using a structured questionnaire, 300 of them had CS, and 300 had vaginal delivery (VD) in their most recent live births. The exposure variable was the mode of delivery, classified as 1 if mothers had CS and 0 if mothers had VD. The outcome variables were a group of health and behavioural problems of the mothers and their children. Multivariate or multiple logistic regression model, separately for each health and behavioural outcome, was used to determine the effect of exposure variable on outcome variable after adjusting for possible confounders.ResultsThe mean age and weight of mothers were 25.1 years and 53.1 kg, respectively. Likelihoods of headache, after delivery hip pain, problem of daily activities, and breastfeeding problem were reported higher among mothers who had CS in their most recent live birth than mothers who had VD. Similarly, children who were born through the CS operation were more likely to report breathing problem, frequent illness, lower food demand and lower hours of sleeping.ConclusionThe use of CS increases the risks of health and behavioural problems of the mothers and their children. Policies and programs to avoid medically unnecessary CS and increase awareness over its adverse effects are important.

Evaluation of Risk Factors for Chronic Obstructive Pulmonary Disease in the Middle-Aged and Elderly Rural Population of Northeast China Using Logistic Regression and Principal Component Analysis.

PurposeTo investigate the environmental, immune, and inflammatory factors associated with chronic obstructive pulmonary disease (COPD) in middle-aged and older Chinese individuals.Patients and MethodsA community-based case–control study was conducted among 471 patients with COPD and 485 controls. The information on COPD of the participants was collected through face-to-face interviews, and serum samples were measured at the laboratory. The main risk factors for COPD were analyzed using principal component analysis (PCA) and logistic regression.ResultsNine hundred and fifty-six respondents were included in the analysis. The results of the PCA-logistic regression analysis showed significant differences in the environmental factors, medical history, and serum C-reactive protein (CRP) levels between patients and controls. COPD was markedly more usual in those with smoking index >200 (OR, 1.42; 95% CI, 1.28–1.57); exposure to outdoor straw burning (OR, 1.64; 95% CI, 1.47–1.83); use of coal, wood, and straw indoors (OR, 2.31; 95% CI, 1.92–2.78); history of respiratory disease and coronary heart disease (OR, 3.58; 95% CI, 3.12–4.10), congestive heart failure (OR, 1.23; 95% CI, 1.09–1.38), and cerebrovascular disease (OR, 1.15; 95% CI,1.02–1.31); and higher serum level of CRP (OR, 1.20; 95% CI, 1.11–1.30). Compared to the logistic regression analysis, PCA logistic regression analysis identified more important risk factors for COPD.ConclusionPCA-logistic regression analysis was first utilized to explore the influencing factors among rural residents in Northeast China Environmental aged 40 years and above, it was found that environmental factors, medical history, and serum CRP levels mainly affected the prevalence of COPD.

Determinants of wasting among children aged 6–59 months in North-East Ethiopia: a community-based case-control study

ObjectiveChildhood acute malnutrition, in the form of wasting defined by Weight-for-Height Z-Scores, is a major public health concern. It is one of the main reasons for the death of children...

Determinants of Long-Acting Reversible Contraceptive Methods Utilization Among Married Women of Reproductive Age Group In Ambo Town, Oromia Region, West Ethiopia, 2016: A Case Control Study

Background: The contraceptive utilization rate in Ethiopia is approximately 29%. In contrast, only 3.7% of married women in Ethiopia use the most effective and convenient methods, i.e., long-acting contraceptive methods. This rate is approximately 3.2% in the Oromia region, the most populous region in Ethiopia. In regard to this, the current study aimed to identify determinants of long-acting reversible contraceptive method utilization among married women in Ambo town, Ethiopia. Objective: To identify determinants of long-acting reversible contraceptive method utilization among married women of reproductive age in Ambo town, 2016 Methods: A community-based unmatched case-control study was carried out in Ambo town on 420 married women of reproductive age who were randomly selected. The study population comprised users [case group; n=140] and nonusers [control group; n=280] of one of the longacting reversible methods. Multivariable logistic regression analysis was performed to determine independent predictors. Adjusted odds ratios together with their corresponding 95% CIs were calculated to assess the strength of association and declare statistical significance. Result: A total of 418 married women participated in the study, with a response rate of 99.45%. Moderate level of knowledge on long-acting reversible contraceptive methods [AOR= 8.73, 95%CI: 3.08 - 24.77], good level of knowledge [AOR=13.99, 95%CI:4.93-39.71], spousal discussion on long-acting reversible contraceptive methods [AOR=2.88, 95%CI:1.3-6.36], positive attitude toward long-acting reversible contraceptive methods [AOR=7.07, 95% CI: 3.77-13.24], women from households in the poorest wealth quintile [AOR= 6.83, 95%CI: 2.68- 17.38], women from households in the medium wealth quintile [AOR=5.83, 95%CI: 2.23- 15.23] were positive determinants, whereas intention to give birth in the future [AOR=0.09, 95% CI: 0.02- 0.36] and women’s expectations of restriction to methods use [AOR=0.2, 95% CI: 0.08- 0.48] were negative determinants of long-acting reversible contraceptive method utilization. Conclusion: Good knowledge, moderate knowledge, positive attitude, wealth index and spousal discussion were positive determinants, whereas intention to give birth in the future and woman’s expectation of restriction to method use were negative determinants of long-acting reversible contraceptive method utilization. Stakeholders should emphasize behavioral change communication to increase knowledge on long-acting reversible contraceptive methods, strengthen inter-spousal discussion and bring a positive attitude towards long-acting reversible contraceptive methods.

Association of primary postpartum hemorrhage with inter-pregnancy interval in urban South Ethiopia: A matched nested case-control study.

Globally, postpartum hemorrhage is the leading preventable cause of maternal mortality. To decrease postpartum hemorrhage-related maternal mortalities, identifying its risk factors is crucial to suggest interventions. In this regard, little is known about the link between primary postpartum hemorrhage and inter-pregnancy interval in Ethiopia, where more than half of pregnancies occur shortly after the preceding childbirth. Therefore, we aimed to elucidate the association of primary postpartum hemorrhage with an inter-pregnancy interval in urban South Ethiopia. A community-based matched nested case-control study was conducted among a cohort of 2548 pregnant women. All women with primary postpartum hemorrhage during the follow-up (n = 73) were taken as cases. Women who were randomly selected from those without primary postpartum hemorrhage (n = 292) were taken as controls. Cases were individually matched with controls (1:4 ratio) for age group and location. A conditional logistic regression analysis was done using R version 4.0.5 software. Statistically, a significant association was declared using 95% CI and p-value. Attributable fraction (AF) and population attributable fraction (PAF) were used to estimate the public health impacts of the inter-pregnancy interval. This study found out that more than half (66%) of primary postpartum hemorrhage was attributed to inter-pregnancy interval <24 months (AF = 66.3%, 95% CI: 37.5, 82.5%). This could be prevented if the inter-pregnancy interval was increased to 24-60 months. Likewise, nearly half (49%) of primary postpartum hemorrhage in the study population could be prevented if the inter-pregnancy interval <24 months was prevented. Additionally, primary postpartum hemorrhage was attributed to antepartum hemorrhage, prolonged labour and multiple pregnancies. Primary postpartum hemorrhage was associated with inter-pregnancy interval under 24 months, highlighting the need to improve postpartum modern contraceptive utilization in the community. Counseling couples about how long to wait until subsequent pregnancy and the risk when the inter-pregnancy interval is short need to be underlined.

Determinants of utilization of cervical cancer screening among women in the age group of 30-49 years in Ambo Town, Central Ethiopia: A case-control study.

Globally, cervical cancer is the second most common and the leading cause of death in women in low-income countries. It is one of the potentially preventable cancers, and an effective screening program can result in a significant reduction in the morbidity and mortality associated with this cancer; however, evidence showed that only a small percentage of the women were screened. As a result, predictors of cervical cancer screening usage among women in Ambo town, central Ethiopia, were identified in this study. Unmatched, a community-based case-control study was conducted among 195 randomly sampled women in the age group of 30-49 years in Ambo town from February 1 to March 30, 2020. Data was collected using an interviewer-administered questionnaire. Descriptive, bivariate, and multivariable binary logistic regression analysis was done using SPSS. A total of 195 study participants, sixty-five cases and one hundred thirty controls, participated in this study, making a response rate of 100%. Being in the age group of 30-34 years old (AOR = 0.2; 95% CI: 0.06-0.7), being Para five and above (AOR = 4.5; 95% CI: 1.4-14.1), modern contraceptive utilization (AOR = 5.4; 95% CI: 1.8-16.3) and having high-level knowledge regarding cervical cancer screening and its predisposing factors (AOR = 5.9; 95% CI: 2-17) were significantly associated with the utilization of cervical cancer screening. The age of women, parity, use of modern contraception, and level of knowledge regarding cervical cancer screening and its predisposing factors were the determinants of the utilization of cervical cancer screening among women. As a result, the media, the health bureau, and health professionals should advocate raising awareness about cervical cancer and its preventative methods, which are primarily focused on screening.