Institution-based Unmatched Case-control Study Research Articles

Determinants of neonatal hypoglycemia among neonates admitted to neonatal intensive care units of public hospitals in Wolaita Zone, Southern Ethiopia, 2023: An unmatched case-control study.

Globally, neonatal hypoglycemia is a common child health problem and significantly contributes to morbidity and mortality, with its impact being particularly detrimental in developing countries. Although being a prevalent metabolic condition, it is frequently overlooked. Furthermore, the problem is not adequately studied in Ethiopia, as seen by a few published studies on the topic, highlighting the lack of knowledge about its determinants. This study aims to assess the determinants of neonatal hypoglycemia among neonates admitted to neonatal intensive care units of public hospitals in Wolaita Zone, Southern Ethiopia, 2023. An institution-based unmatched case-control study design was conducted among 249 (83 cases and 166 controls) participants. Data were collected from 29 March to 23 May 2023 using a pretested chart review extraction tool/checklist. A consecutive sampling method was used for participant selection. Data were analyzed using Statistical Package for Social Science version 25. Binary logistic regression analysis was used to identify the determinants of neonatal hypoglycemia, and statistical significance was declared at P < 0.05. A total of 83 cases and 166 controls were included in the study. The following factors were significantly associated with neonatal hypoglycemia: preterm neonates [adjusted odds ratio (AOR) 4.888 (95% confidence interval, CI, 1.113-21.478)], age of the neonate at admission (3-5 h) [AOR 4.205 (95% CI 1.852-9.547)], hypothermia [AOR 5.485 (95% CI 2.360-12.748)], late initiation of breastfeeding [AOR 6.229 (95% CI 2.665-14.599)], mode of delivery [AOR 5.034 (95% CI 1.688-15.011)], and small for gestational age [AOR 3.645 (95% CI 1.286-10.330)]. In the current study, numerous determinants of neonatal hypoglycemia have been identified. Therefore, it is crucial to give due emphasis to providing comprehensive health education to mothers regarding effective breastfeeding methods, strategies to avoid neonatal hypoglycemia, and the various factors that heighten its likelihood. In addition, healthcare professionals should emphasize implementing preventive measures to prevent this grave condition.

Determinants of Disability Among Individuals Living with Schizophrenia Attending Psychiatric Follow-Up Clinic in Jimma, Southwest Ethiopia: An Institution-Based Case-Control Study.

Disability due to schizophrenia ends up with a higher degree of impairment in occupational, social and interpersonal functioning than other chronic illnesses. Despite severe and long-lasting schizophrenia associated disability, little has been explored so far to identify determinants of disability among individuals living with schizophrenia in Ethiopia. To identify the determinants of disability among individuals living with schizophrenia attending the psychiatric follow-up clinic at Jimma Medical Center (JMC). An institution-based unmatched case-control study was conducted among 98 Cases and 98 controls of individuals living with schizophrenia attending the JMC psychiatric clinic from September 1 to October 30, 2022. Consecutive sampling technique was used to recruit the required sample size of both groups. The cases group were participants who scored >12 total on the WHO Disability Assessment Scale version 2-0 (WHODAS 2-0) whereas the control group were those who scored 12 total on the WHODAS 2-0. Being jobless (AOR = 2.29; 95% CI: 1.10-4.77), longer than 5-year duration of illness without treatment (AOR = 3.13; 95% CI: 1.23-7.98), poor social support (AOR = 2.54; 95% CI: 1.04-6.22), negative symptoms (AOR = 2.45; 95% CI: 1.14-5.29), known family history of mental illness (AOR = 3.59; 95%: 1.67-7.73) and risky khat use (AOR = 4.37; 95% CI: 1.86-10.29) were found to be determinants of disability among schizophrenia patients. Joblessness, longer than 5-year duration of illness without treatment, poor social support, negative symptoms, known family history of mental illness and risky khat use were found to be determinants of disability in schizophrenia patients. Interventions targeting reducing of disability and improving quality of life of schizophrenia patients should consider the aforementioned determinants.

Determinants of under-five pneumonia in randomly selected health facilities at Aleta Wondo Woreda, Sidama Region Ethiopia: Case-control study.

Under-five mortality reduction due to pneumonia is not Signiant, particularly in developing countries. Pneumonia contributed to 27.5% to 31.3% of health facility visits by children 2 to 59 months in Aleta Wondo Woreda. Previous studies have shown inconclusive evidence on determinants of pneumonia in children. An institution-based unmatched case-control study was conducted to assess determinants of pneumonia among under-five children at Aleta Wondo Woreda, Sidama Region. One-hundred forty-five cases and 290 controls of children aged 2 to 59 months participated in the study. The mean ± (SD) age of the children was 18.81 months (2.1 ± 11.43) and 28.26 months (2.1 ± 16.007) for cases and controls, respectively. Only 56% (n = 145) of cases open house windows daily, whereas most 68.6% (n = 290) of controls house windows open daily. Ninety five (62.8%) of cases and 68.6% of controls were exclusively breastfed for 6 months. Household income ≥1500 Ethiopian birr (AOR = 0.45, 95% CI, 0.017-0.120, p < 0.000), child location outside of cooking house during cooking (AOR = 0.101, 95% CI, 0.43-0.238, p < 0.000), no formal education of the mother (AOR = 2.398, 95% CI, 1.082-5.316, p < 0.031), and presence of history of upper respiratory tract infections (URTIs) in last 2weeks (AOR = 2.183, 95% CI, 1.684-5.273, P < 0.049) were determinants of pneumonia. Determinants of pneumonia in under-five children were multifactorial (socioeconomic, nutritional, and environmental). Addressing these factors by involving all relevant stakeholders is important to reduce pneumonia-related morbidity and mortality among under-five children in the study area.

Association Between Preeclampsia and Hormonal Contraceptive Use among Pregnant Women in Northwest Ethiopia: A CaseControl Study

Objective: This study was aimed to determine the association between preeclampsia and hormonal contraceptive use among pregnant women admitted in public hospitals in Gojjam zones, northwest Ethiopia. Methods: An institution-based unmatched case-control study was conducted in public hospitals in Gojjam zones, northwest Ethiopia. Women with preeclampsia were cases and without preeclampsia were controls. One hundred ten cases and 220 controls were selected using consecutive sampling method. The data were collected through measurements, and conducting face-to-face interviews. Then it was entered using EPI Info and exported to STATA 14 for analysis. Bivariate and multivariate logistic regressions were done to determine the association between hormonal contraceptive use and preeclampsia. Variables with p-values &lt; 0.05 in the multivariate logistic analysis were considered as statistically significant association with preeclampsia. The results were presented using text, tables and figures. Results: A total of 330 women were involved in this study. The mean age of cases and controls was 28 ± 6 years standard deviations and 27 ± 5 years standard deviations respectively. About 65 (59.1%) of cases and 105 (47.7%) of controls had no formal education. Preeclampsia was associated with multiple gestational pregnancies (AOR = 2.75; 95% CI: 1.20-6.28); and women who used implants (AOR = 0.39; 95% CI: 0.13-0.96). There was no significant association between preeclampsia and other hormonal contraceptives. Conclusion: There was an association between hormonal contraceptive use and preeclampsia. Women who used implants prior to their pregnancy were less likely to be exposed to preeclampsia as compared with controls. Further studies should be conducted on the association of hormonal contraceptive use and preeclampsia to get more consistent findings. Women who have preferred using contraceptive are better to be encouraged to take estrogen free hormonal contraceptives.

Predictors of underweight among adult patients receiving antiretroviral therapy in Bishoftu general hospital, central Ethiopia: Case-control study.

Underweight affects the overall clinical outcome and quality of life and increases the risk of mortalities in Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) patients. Though studies have examined the various determinants of being underweight in people living with HIV/AIDS (PLHIV), scanty evidence exists about the influence of dietary diversity scores and dietary counseling on underweight HIV patients in Ethiopia. This study aimed to identify the determinants of being underweight among adult patients receiving antiretroviral therapy at Bishoftu General Hospital, central Ethiopia. An institution-based unmatched case-control study was conducted among 279 participants (93 cases and 186 controls) from April to May 2022. Cases were selected consecutively as they occur, and then two subsequent controls that visited the antiretroviral therapy(ART) clinic were interviewed until the sample size was attained. Data were collected using a pretested structured questionnaire and involved patient interviews and chart review. Bivariate and Multivariable logistic regression was used to identify determinants of underweight. The presence of statistically significant association was declared with p-value <0.05, and a 95% confidence interval was used to show the precision in the measure of the strength of association. The response rate of participants was 91.2% for each of the cases and controls. Monthly income of patients ≤2000 birr (AOR = 6.63, 95% CI: 2.96-14.85), absence of support giver (AOR = 3.22, 95% CI: 1.38-7.50), being having an eating problem (AOR = 14.48, 95% CI: 5.06-41.40), dietary diversity score of four to five (AOR = 2.36, 95% CI: 1.92, 6.08), not getting dietary counseling support and advice (AOR = 2.53, 95% CI: 1.11, 5.72) and chewing khat (AOR = 3.36, 95% CI: 1.99,11.33) were determinants of underweight in adult HIV patients. This study revealed that household dietary diversity, counseling and education on nutrition, monthly income, eating problems, support giver, and khat chewing were predictors of being underweight in HIV patients. This inquires an integrated nutritional intervention including income-generating activities, counseling and education on nutrition and bad habits, and regular monitoring of the nutritional status during clinic visits.

Factors Influencing Blood Donation Practice Among Health Care Providers of Public Hospitals in Bahir Dar City, North West Ethiopia: A Case Control Study.

Blood donation is a technique in which blood is collected from a healthy individual for transfusion to someone else. WHO estimates that it is necessary to donate blood to 2% to 3% of the country's population to meet blood needs. However, blood donation remains challenging in developing countries. This study aimed to identify factors influencing blood donation practices among healthcare providers in public hospitals in Bahir Dar City. This institution-based unmatched case-control study was conducted in Bahir Dar City Public Hospitals from May 01 to May 25, 2022. Total sample size was 491 (123 cases and 368 controls) and then the study subject was selected by using simple random sampling technic and collect data through self-administered questionnaire. Bi-variable and multi-variable binary logistic regression analyses were used to determine the association between dependent and independent variables. Finally, the results are presented in charts and tables, and the AOR and CI are reported. Statistical significance was set at P < 0.05. Fear of anemia (adjusted odds ratio (AOR): 0.02; 95% CI 0.007-0.078), lack of opportunity (AOR: 0.42; 95% CI 0.22-0.83), lack of time (AOR: 0.03; 95% CI, 0.005-0.199), profession (AOR: 0.15; 95% CI, 0.05-0.42), aware of free medical checkup (AOR: 31.79; 95% CI 13.13-76.94), willingness to donate blood (AOR: 5.09; 95% CI 2.25-11.50), blood group type (AOR: 5.67; 95% CI 1.42-22.68), and higher work experience (AOR: 7.99; 95% CI 2.59-24.67) were found to be significantly associated with blood donation practice. This study revealed that multiple factors influenced the practice of blood donation among healthcare providers. Therefore, access to blood donation areas and emphasizing the importance of donor blood donation are important for facilitating blood donation.

Determinants of term premature rupture of membrane: case-control study in Saint Paul’s Millennium Medical College Hospital, Addis Ababa, Ethiopia

BackgroundThe term premature rupture of the membranes is the rupture of the membranes before the onset of labor beyond 37 weeks of gestation. Several factors, including obstetric, gynecologic, socioeconomic, and medical, are identified as potential risk factors. This clinical event has detrimental maternal and neonatal complications.ObjectivesThis study aimed to investigate the determinants of the term premature rupture of the membranes in Ethiopia.MethodsThis institution-based unmatched case-control study was conducted on 246 women admitted to Saint Paul’s hospital millennium medical college from October 2019 to January 2020 (82 cases and 164 controls). Data were collected using an interviewer-based questionnaire and data extraction tools, and data were entered using Epi data 3.1 and analyzed using SPSS 20. The association between independent variables and premature rupture of the membrane was estimated using an odds ratio with 95% confidence intervals and P-value < 0.05.ResultsFactors like a history of vaginal discharge (AOR 3.508;95% CI:1.595.7.716), place of Antenatal care follow-up (health center and Mercy Ethiopia) (AOR 5.174;95% CI:2.165,12.362), the previous history of rupture of membrane (AOR 9.955;95% CI:3.265,20.35), and gestational age (AOR 3.018;95% CI:1.338,6.811) were associated with term premature rupture of membrane. There were more maternal and neonatal complications, including puerperal sepsis, wound infection, anemia/PPH, a hospital stays of more than seven days, clinical amnionitis, neonatal hypoglycemia, early onset neonatal sepsis, and respiratory distress encountered by women who presented with premature rupture of membrane.ConclusionProper screening, close monitoring, and early interventions in those mothers with identified risk factors would help to reduce its negative consequences. Moreover, the provision of continuous professional skill development and improving the quality of ANC service is needed.

Determinants of puerperal sepsis among postpartum women at public hospitals of Hawassa city, Southern Ethiopia: Institution-based unmatched case-control study

BackgroundWorld health organization reported that from 358,000 maternal deaths occurring during labor and childbirth about 15% were attributed to puerperal sepsis. In Ethiopia, puerperal sepsis is the fourth leading direct cause of maternal death next to hemorrhage, obstructed labor, and pregnancy-induced hypertension. Early recognition and management of the contributing factors would help to modify the problem. Therefore, this study was aimed to identify the determinants of puerperal sepsis among postpartum women at Hawassa city public hospitals in South Ethiopia. Methods& materials: Institution-based unmatched case-control study was conducted among 305 postpartum women (61 cases & 242 controls; with a ratio of 1:4) at Hawassa city public hospitals from June 17 to August 20/2021. Cases were all postpartum women admitted with puerperal sepsis and controls were randomly selected postpartum women admitted with other cases. A pre-tested interviewer-administered questionnaire was used to collect the data. Data were entered into Epi data version 4.6 and then exported to STATA version 14 for analysis. Bivariable analysis was performed and variables having a p-value <0.25 made candidates for the multivariable logistic regression model. Adjusted Odds ratio (AOR) with 95% confidence interval was computed to identify the presence and strength of association and statistical significance was declared at p-value <0.05. ResultIn this study, a total of 61 cases & 242 controls were included. Cesarean section delivery (AOR = 2.85; 95% CI; 1.36–5.98), manual removal of placenta (AOR = 6.0; 95% CI = ; 0.39–26.26), ≥5 times Per-vaginal Examination during labor (AOR = 4.53; 95% CI; 2.10–9.80), presence Gestational Diabetes Mellitus (AOR = 8.50; 95% CI; 1.99–36.33) & prolonged labor (AOR = 3.43; 95% CI; 1.20–9.76) were identified as determinants of puerperal sepsis. ConclusionIn this study, cesarean delivery, Per-vaginal Examination ≥5 times during labor, manual removal of placenta, Gestational Diabetes Mellitus & prolonged labor were factors that significantly increased the odds of developing puerperal sepsis among postpartum women. So, labor & delivery procedures should be conducted as per labor & delivery management protocols.

Factors associated with poor glycemic control among adult patients with type 2 diabetes mellitus in Gamo and Gofa zone public hospitals, Southern Ethiopia: A case-control study.

Diabetes mellitus is a serious global public health problem that affects the whole life of people in terms of their biological, psychological, and social effects. Complications and death from diabetes occur from poorly controlled blood glucose levels. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess factors associated with poor glycemic control among type2 diabetes patients in public hospitals of Gamo and Gofa zone southern, Ethiopia, 2021. An institution-based unmatched case-control study was employed among 312 randomly selected participants using a pre-tested, interviewer-administered, and structured questionnaire. Bivariate and multivariable logistic regression analysis was conducted to identify factors associated with poor glycemic control using IBM SPSS version 25. The strength of association was assessed by using an Adjusted odds ratio (AOR) with a 95% confidence interval (CI). Factors associated with poor glycemic control based on multivariable analysis were, having comorbidity (AOR = 2.35, 95% CI (1.39-3.95)), adhering to dietary recommendations (AOR = 0.31, 95% CI (089-0.51)), poor social support (AOR = 3.31, 95% CI (1.59-6.85)), physical exercise (AOR = 1.86 95% CI (1.11-3.12)), and having poly-pharmacy (AOR = 2.83, 95% CI (1.39-5.74)). This study indicated a significant association of comorbidity, physical exercise, poly-pharmacy, low social support, and adherence to dietary recommendations with poor glycemic control. We suggest that the health care providers and concerned bodies encourage patients to have regular check-ups and work on providing necessary social support.

Predictors of death among severe COVID-19 patients admitted in Hawassa City, Sidama, Southern Ethiopia: Unmatched case-control study.

Since COVID-19 was announced as a worldwide pandemic, the world has been struggling with this disease. In Ethiopia, there is some information on the epidemiological characteristics of the disease and treatment outcomes of COVID-19 patients. But, there is limited evidence related to predictors of death in COVID-19 patients. To assess the predictor of death among severely ill COVID-19 patients admitted in Hawassa city COVID-19 treatment centers. An institution-based unmatched case-control study was conducted at Hawassa city COVID-19 treatment centers from May 2021 to June 2021. All severe COVID-19-related deaths from May 2020 to May 2021 were included in the case group whereas randomly selected discharged severe COVID-19 patients were included in the control group. Extracted information was entered into Epi-data 4.6 and exported to SPSS 25 for analysis. Multivariable binary logistic regression was run to assess predictors. The result was presented as an adjusted odds ratio with a 95% confidence interval. Variables with a 95% confidence interval which not included one were considered statistically significant. A total of 372 (124 cases and 248 controls) patients were included in the study. Multivariable analysis revealed age ≥ 65 years (AOR = 2.62, 95% CI = 1.33-5.14), having shortness of breath (AOR = 1.87, 95% CI = 1.02-3.44), fatigue (AOR 1.78, 95% CI = 1.09-2.90), altered consciousness (AOR 3.02, 95% CI = 1.40, 6.49), diabetic Mellitus (AOR = 2.79, 95% CI = 1.16-6.73), chronic cerebrovascular disease (AOR = 2.1, 95% CI = 1.23, 3.88) were found to be predictors of death. Older age, shortness of breath, fatigue, altered consciousness, and comorbidity were predictors of death in Severe COVID-19 patients.

Determinates of anemia among Human Immune Deficiency Virus positive children on Anti-retro Viral Therapy in selected health facilities, Northwest Ethiopia: A Case-Control Study.

Even though antiretroviral therapy (ART) access for human immunodeficiency virus (HIV)-infected children increased dramatically, anaemia has continued as a challenge regardless of a cluster of differentiation (CD4) count and viral load. Hence, the present study aimed to assess the determinants of iron deficiency anaemia among children living with HIV after the initiation of ART. An institution-based unmatched case-control study was conducted among consecutively selected 712 children on HIV care from 1 September to 30 October 2022 in the Metekel zone. A pre-tested and structured data extraction checklist was used to collect the data. Data were analysed using STATA version 16 software. Binary logistic regression was used to find the association between independent variables and anaemia. The level of statistical significance was declared at a value of P < 0⋅05. A total of 712 HIV-positive children (178 cases and 534 controls) were included in this study, with a completeness rate of 98⋅8 %. In multivariable analysis, variables that have a statistically significant association with anaemia were as follows: CD4 count <350 (Adjusted Odds Ratio [AOR] 2⋅76; 95 % CI 1⋅76, 4⋅34), World Health Organization (WHO) clinical stage III (AOR 7⋅9; 95 % CI 3⋅5, 17⋅91) and stage IV (AOR 7⋅8; 95 % CI 3⋅37, 18⋅1), cotrimoxazole prophylaxis therapy (AOR 0⋅5; 95 % CI 0⋅31, 0⋅8) and mid-upper arm circumference (MUAC) ≤11⋅5 mm (AOR 2⋅1; 95 % CI 1⋅34, 3⋅28). The present study found that CD4 count, WHO clinical stage, cotrimoxazole prophylaxis therapy and MUAC were significantly associated with anaemia in children on ART. Therefore, continuous screening of anaemia and nutritional treatment is essential in these patients.

Determinants of cervical cancer screening utilization among women attending health facilities of Dessie town, Northeast Ethiopia

IntroductionDespite the higher burden of cervical cases, screening programs in highly affected developing countries remained low. This made the disease to be present at an advanced stage which is almost always fatal, causing enormous pain and suffering for the individual and having significant adverse effects on the welfare of their families and community. Thus, this study aimed to assess determinants of cervical cancer screening utilization among women attending health facilities in Dessie Town, Northeast Ethiopia.MethodsAn institution-based unmatched case–control study design was employed on 430 women (146 cases and 284 controls) at selected health facilities of Dessie town, South Wollo Zone, from July 1/2020 to August 30/2020. Cases were selected for all women screened for cervical cancer during the data collection period until the required sample size was attained and using a consecutive sampling technique, every 3 participants from women who come for services other than cervical cancer screening. were included as controls. Pretested and structured questionnaires were used to collect the data. Data were analyzed by SPSS version 25 software. Bivariable and multivariable logistics regression analysis was done. An adjusted odds ratio with 95% CI was estimated to measure the strength of the association. The level of statistical significance was declared at a p-value < 0.05.ResultAge group of 35 and more [AOR = 11.52(6.09–21.77)], being a private employee [AOR = 4.67(2.41–9.03)], having symptoms of vaginal bleeding or pelvic pain or postcoital bleeding or vaginal discharge [AOR = 3.08(1.37–6.95)], being recommended by a physician for screening [[AOR = 3.07(1.45–6.49)] and positive attitude towards cervical cancer screening [AOR = 5.3(2.8–10.59)] were determinants of cervical cancer screening.ConclusionAge group of 35 and more, current occupation as a private employee, having symptoms of cervical cancer, being recommended by a physician for screening, and positive attitude towards cervical cancer screening were determinants of cervical cancer screening utilization.

Risk factors for childhood pneumonia at Adama Hospital Medical College, Adama, Ethiopia: a case-control study

BackgroundPneumonia is an acute respiratory infection of the lungs. A child dies of pneumonia every 39 s globally. Even though pneumonia affects children worldwide, the risk and repercussions of the disease are more prevalent in poor and middle-income nations. Despite the initiatives by the Ethiopian government, there are still numerous instances and deaths caused by childhood pneumonia. Therefore, this study aimed to identify the risk factors for pneumonia among 2–59 months-old children visiting Adama Hospital Medical College, Adama, Ethiopia.MethodsAn institution-based unmatched case-control study was conducted among 124 cases and 124 controls from January 1, 2021, to March 15, 2021. Cases were selected using a consecutive sampling technique. For each case, the next patient from the same pediatric outpatient room who met the inclusion criteria was taken as a control. Data were collected using a pretested, structured interviewer-administered questionnaire containing sociodemographic, environmental, and nutritional factors, comorbid illnesses, and related care practices. A multiple logistic regression model was fitted.ResultsFamily size of ≥ 5 compared to < 5 (Adjusted odds ratio (AOR): 3.08, 95% CI: 1.23, 7.71), household monthly income of < 2500 compared to > 5000 birr (AOR: 3.94, 95% CI: 1.06, 14.6), use of charcoal as the main fuel for cooking (AOR: 7.03, 95% CI: 2.38, 20.78), and wood or dung as the main fuel for cooking compared to electricity (AOR: 6.58, 95% CI: 2.07, 20.9), malnutrition compared to no malnutrition (AOR: 4.77, 95% CI: 1.89, 12.06), diarrhea compared to no diarrhea in the past 2 weeks (AOR: 3.3, 95% CI: 1.52, 7.14) and upper respiratory tract infection (URTI) compared to no infection in the past 2 weeks (AOR: 3.29, 95% CI: 1.31, 8.23) were found to be risk factors for pneumonia.ConclusionIn this study, risk factors for pneumonia were family size, monthly income, type of energy used for cooking, malnutrition, and diarrhea or URTI in the past 2 weeks. Relatively simple interventions such as cooking with electricity, and other interventions like prevention, early detection and treatment of malnutrition, diarrhea, and URTI, and promotion of family planning are important.

Determinants of Preeclampsia Among Pregnant Women in Public Hospitals of Wolaita and Dawuro Zones, Southern Ethiopia: A Case-Control Study.

Preeclampsia is a leading cause of maternal and fetal morbidity and mortality in Ethiopia. It is defined by the onset of new hypertension (HTN) and proteinuria in the second trimester of pregnancy. There is a research gap in the study area and there is an inconsistency of findings in previous studies. Therefore, this study aimed to determine the factors of preeclampsia among pregnant women in public hospitals. An institution-based unmatched case-control study was conducted in public hospitals in Wolaita and Dawuro Zones from February 1 to June 26, 2021. Women who were diagnosed with preeclampsia were cases, while those who did not have it were controls. They were selected using a consecutive sampling method. Descriptive statistics and logistic regression were done by STATA. A total of 349 cases and 698 controls participated in this study. The average age of the cases and controls was 26.1 ± 4.6 standard deviation (SD) and 24.6 ± 4.8 SD years, respectively. The determinants of preeclampsia in this study were a family history of HTN (adjusted odds ratio [AOR = 11.5; 95% confidence interval, CI: 6.46-20.41], family history of diabetes mellitus [AOR = 2.1; 95% CI: 1.10-3.90], having two or multiple pregnancies [AOR = 6.33; 95% CI: 2.28-17.51], primigravida [AOR = 1.49; 95% CI: 1.01-2.21], and being gravida 5-9 [AOR = 2.47; 95% CI: 1.34-4.58]). In this study, family history of HTN, family history of diabetes mellitus, history of preeclampsia, primigravida, and multiple gestation pregnancies were the determinants of preeclampsia. As a result, health care providers should pay special attention to pregnant women with a family history of HTN, primigravida, and two or multiple gestation pregnancies during antenatal care follow-up.

Determinants of neonatal mortality among neonates admitted to neonatal intensive care unit of Dessie comprehensive and specialized hospital, Northeast Ethiopia; An unmatched case-control study.

BackgroundAccording to the World health organization, neonatal mortality is defined as the death of babies within the first 28 days of their lives. The newborn period is the most vulnerable period for a child's survival, with the bulk of neonatal deaths occurring on the first day and week. According to a recent study, about a third of all newborn deaths occur within the first day of life, and nearly three-quarters occur within the first week. This study aimed to assess the determinants of neonatal mortality among neonates admitted to the neonatal intensive care unit in Dessie comprehensive and specialized hospital, northeast Ethiopia.MethodologyHealth institution-based unmatched case-control study was conducted among neonates admitted to Dessie comprehensive and specialized hospital, Ethiopia from February 01 up to March 30, 2020. After keeping cases and controls in separate frames, study participants were chosen using a simple random sampling procedure until the sample size was met. Epi data version 7.0 and SPSS version 25 were used for data entry and analysis respectively. P ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression.ResultsA total of 698 (233 cases and 465 controls) participated in the study. Pregnancy induced hypertension (AOR = 3.02; 95% CI; 1.47–6.17), public hospital delivery (AOR = 3.44; 95% CI; 1.84–6.42), prematurity (AOR = 2.06; 95% CI; 1.43–2.96), being referred (AOR = 4.71; 95% CI; 3.01–7.39), and hypothermia (AOR = 2.44; 95% CI; 1.56–3.82) were determinant factors of neonatal mortality.ConclusionPregnancy-induced hypertension, public hospital delivery, prematurity, referral, and hypothermia were found to be the determinant factors of neonatal mortality. It would be important to give due attention to neonates delivered from mothers with a history of hypertensive disorder. Besides better to give due attention to neonates delivered in public health institutions, prematurely delivered, referred, and hypothermic neonates. Lastly, further research should be conducted to investigate the additional determinants of neonatal mortality.

Determinants of neonatal near-miss among neonates delivered in public hospitals of Ilu Abba Bor Zone, Southwest Ethiopia: An unmatched case-control study during the COVID-19 pandemic.

BackgroundThe neonatal period is the time with the highest risk of neonatal and infant mortality. The COVID-19 pandemic diverted resources from routine maternal health services, which raises the possibility of neonatal near misses (NNMs). To implement prompt treatments that could improve the standard of infant care and lower neonatal mortality, it has been theorized that pinpointing the determinants of NNM during this outbreak is crucial. In light of this, the current study identified the determinants of NNM in neonates delivered in public hospitals of Ilu Abba Bor Zone, South West Ethiopia.MethodsAn institution-based unmatched case–control study was conducted among randomly selected 303 (101 cases and 202 controls) neonates admitted to Mettu Karl Comprehensive Specialized Hospital (MKCSH) and Darimu Primary Hospital (DPH) from 1 November to 28 December 2020. Data were collected using interviewer-administered structured questionnaire and checklist. The collected data were coded and entered into Epi-Data version 4.6 and then exported to SPSS version 20 for analysis. Adjusted odds ratios (AOR) along with a 95% confidence interval was used to assess the strength of the association, and a p-value < 0.05 was considered to declare the statistical significance in the multivariable logistic regression analysis.ResultA total of 303 (101 cases and 202 controls) neonates admitted to MKCSH and DPH were included in the study making a 97.4% response rate. In the multivariable logistic regression analysis, no formal maternal education [AOR = 3.534, 95% CI: (1.194–10.455)], Breech presentation during birth [AOR = 3.088, 95% CI: (1.029–9.268)], < 4 antenatal care (ANC) visits [AOR = 1.920, 95% CI: (1.065–3.461], cesarean section delivery [AOR = 4.347, 95% CI: (1.718–10.996)], antepartum hemorrhage (APH) [AOR = 3.37, 95% CI: (1.23–9.24)], and hypertensive disorders of pregnancy (HDP) [AOR = 4.05, 95% CI: (2.36–11.05)] were independent determinants of NNM.ConclusionThe study's result revealed that factors such as education level, birth presentation, ANC visit, mode of delivery, APH, and HDP continued to be important determinants of the NNM in Ethiopia during this pandemic. Therefore, much work is needed to improve neonatal health by providing adequate ANC services and other identified potential determinant factors that predispose the newborn to life-threatening (near-miss) conditions especially during this pandemic.

Determinants of early discontinuation of etonogestrel sub-dermal implant among reproductive-age women in Legambo district, Northeast Ethiopia: An unmatched case-control study.

Objective:Etonogestrel sub-dermal implant discontinuation is very common in the study area. But evidence on the determinants was limited. So, this study aimed to identify determinants of early discontinuation of etonogestrel sub-dermal implant among reproductive-age women in Legambo district, Northeast Ethiopia.Methods:An institution-based unmatched case–control study was conducted on 252 reproductive-age women (84 cases and 168 controls) from 1 February up to 30 April 2020. Systematic random sampling was used to select women, and the data were collected by face-to-face interview using a structured, pretested, and interviewer-administered questionnaire. The collected data were entered into Epi Data version 3.1 and analyzed by SPSS version 23. A binary logistic regression model was used to identify determinants of early discontinuation of etonogestrel sub-dermal implant. Statistical significance was declared at a p value of less than 0.05, and adjusted odds ratio with a 95% confidence interval was used to identify determinants of early discontinuation of etonogestrel sub-dermal implant in the final model.Result:In this study, not receiving pre-insertion counseling (adjusted odds ratio = 3.19, 95% confidence interval: (1.61, 6.30)), having a history of abortion (adjusted odds ratio = 2.89, 95% confidence interval: (1.50, 5.54)), contraceptive side effects (adjusted odds ratio = 2.45, 95% confidence interval: (1.99, 3.91)), and not receiving an appointment for a follow-up visit at the time of insertion (adjusted odds ratio = 3.45, 95% confidence interval: (1.89, 5.99)) were determinants of early discontinuation of etonogestrel sub-dermal implant.Conclusion:Not receiving pre-insertion counseling, having a history of abortion, contraceptive side effects, and not receiving an appointment for a follow-up visit at the time of insertion were predictors of early discontinuation of etonogestrel sub-dermal implant. Thus, healthcare professionals should give an appointment for a follow-up visit at the time of insertion and provide detailed counseling for all women, not only for those who had had an abortion and contraceptive side effects.

Determinants of pelvic organ prolapse among gynecologic patients attending public referral hospitals in Amhara region, Ethiopia, 2020: Institution-based unmatched case-control study design.

Background:Pelvic organ prolapse is a common disorder, with up to 40% of women worldwide having some form of anatomical prolapse, and it is a significant public health problem in developing countries including Ethiopia. The prevalence of pelvic organ prolapse in Ethiopia is 13% in Benchi Maji. This study is designed to provide information about the determinants of pelvic organ prolapse among gynecologic patients attending public referral hospitals in the Amhara region, 2020.Method:Institution-based unmatched case-control study design was conducted from March to June 2020 among randomly selected 348 mothers (116 cases and 232 controls). A convenient sampling technique was used to select cases, and controls were selected by systematic random sampling technique. A pre-tested and structured interviewer-administered questionnaire was used to collect the data. Data were coded and entered into Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Finally, adjusted odds ratio and 95% confidence intervals were used to declare statistical significance.Result:The result showed that being unable to read and write (illiterate) (adjusted odds ratio = 3.91; 95% confidence interval = 1.06–14.39), age of women >= 40 (adjusted odds ratio = 2.91; 95% confidence interval = 1.255–6.736), giving first birth before age of 20 (adjusted odds ratio = 5.72; 95% confidence interval = 1.73–18.94), carrying heavy objects (adjusted odds ratio = 2.296; 95% confidence interval = 1.102–4.785), parity ⩾ 4 (adjusted odds ratio = 7.02; 95% confidence interval = 1.16–42.45), and family history of pelvic organ prolapse (adjusted odds ratio = 3.09; 95% confidence interval = 1.24–7.71) were significantly associated with pelvic organ prolapse.Conclusion:This study concluded that being unable to read and write, age ⩾ 40, multiparity, family history of pelvic organ prolapse, early childbirth, and carrying heavy objects were the risk factors of pelvic organ prolapse. Providing health education on planning the number of children, and the impact of carrying heavy loads on pelvic organs, preventing early childbirth, and encouraging women to pursue their education at least up to primary school level is recommended.

Risk Factors of Anencephaly: A Case-Control Study in Dessie Town, North East Ethiopia.

IntroductionAnencephaly is a form of neural tube defect, which develops when the cranial neuropore is unable to close. It is one of the fatal anomalies of the neural tube. Although most of the causes of anencephaly are unknown, multiple risk factors are associated with this defect. Therefore, this study aimed to investigate the incidence and associated risk factors of anencephaly in Dessie town, in the north eastern region of Ethiopia.MethodsAn institution-based unmatched case–control study was conducted. Sociodemographic characteristics of pregnant women were collected with a structured questionnaire and clinical data were recorded during an ultrasound examination. Data were entered into Epi Info 7 and analyzed by SPSS version 20. Binary logistic regression was applied to detect the associations between risk factors and the occurrence of anencephaly.ResultsThe incidence of anencephaly was 3.3/1000 pregnancies. The multivariate logistic regression model indicated that maternal age between 26 and 30 years and khat chewing during pregnancy were significantly associated with anencephaly (OR 0.13, 95% CI 0.02–0.97, p=0.046; and OR 3.571, 95% CI 1.06–12.06, p=0.04, respectively). Exposure to typhus and typhoid and the use of antihypertensive drugs during early pregnancy were also significantly correlated as anencephaly risk factors. Furthermore, spina bifida simultaneously occurred with anencephaly significantly (p<0.05).ConclusionIt is suggested that exposure to risk factors such as khat chewing during pregnancy may predispose to the development of anencephaly.

DETERMINANTS OF PREGNANCY AMONG LATE ADOLESCENTS VISITING PUBLIC HEALTH FACILITIES OF ARBA MINCH TOWN, SOUTHERN ETHIOPIA: A CASE CONTROL STUDY

Background: Adolescent period is characterized by having physical, social, and psychological behaviors that put themselves for different problems like pregnancy. Those pregnancies which occur during the adolescent period result in poor maternal and child health. Objective: The aim of this study is to identify determinants of pregnancy among late adolescents who visit public health facilities of Arba Minch town, Ethiopia 2019 Methods: An institution-based unmatched case-control study was conducted from Feb 9-Apr 9 2019. Cases were pregnant Adolescents age (15-19 years) who came for delivery, abortion or antenatal care on other hand controls were non-pregnant adolescents age (15-19 years) who visited outpatient department or youth-friendly services for other cases (ruled out by history and HCG pregnancy test). The total sample size was 380 (85 cases and 285 controls) which were randomly selected. Data was collected by using face-to-face interviews and entered into Epi-data version 3.4 then exported to SPSS version-23 for analysis. Multivariable logistic regression was used to assess determinants. Statistically, significance was considered at a p-value ? 0.05. Result: Finding of this study show that family monthly income less than one thousand Ethiopian Birr (AOR=11.11; 95%CI 2.65-46.65), family history of pregnancy before age 19 years (AOR=2.85; 95%CI 1.04-7.79), starting first sex without desire (AOR=2.52; 95%CI1.07-5.93) and poor modern contraceptive methods (AOR=4.84; 95%CI 2.09-11.20) were determinate of adolescents in the study area. Conclusion: Family income, family history of adolescent pregnancy, starting first sex without desire, and poor modern contraceptive methods were determinants of adolescents’ pregnancy. Therefore, respective stakeholders should develop interventions especially about modern family planning methods for adolescents. Keywords: Late adolescent pregnancy; Determinants; Arba Minch town public health facilities