Institution-based Unmatched Case-control Study Research Articles

Risk Factors of Stillbirth Among Women Who Gave Birth in Amhara Region Referral Hospitals, Ethiopia, in 2019: A Case-Control Study.

BackgroundWorldwide, 2.6 million stillbirths occur annually and more than three-quarters of them are recorded in South Asia and Sub-Saharan Africa. Thus, the aim of this study was to identify risk factors of stillbirth among women who gave birth in Amhara region referral hospitals found in northwest and northcentral, Ethiopia in 2019.MethodsA multi-center institution-based unmatched case-control study was conducted among 456 mothers who gave birth in Amhara region referral hospitals from October 1 to December 30, 2019. Consecutive and simple random sampling was used to select the cases and controls, respectively. A semi-structured, interviewer-administered questionnaire and patient chart reviews were used to collect the data. Epidemiological (Epi) data version 4.4.2.1 and Statistical Package for the Social Sciences (SPSS) version 25.0 were used for data entry and analysis, respectively. Binary logistic regression was employed. An adjusted odds ratio with a 95% confidence interval was used to declare statistically significant variables on the basis of p-value<0.05 in the multivariable binary logistic regression model.ResultsAlcohol drinking (adjusted odds ratio (AOR)=3.02, 95% confidence interval (CI)=1.24–7.35), antepartum hemorrhage (AOR=5.74, 95% CI=2.67–12.33), premature rupture of membrane (AOR=2.21, 95% CI=1.09–4.44), meconium-stained amniotic fluid (AOR=8.18, 95% CI=4.29–15.60), non-use of partograph for labor follow-up (AOR=3.89, 95% CI=2.12–7.17), induction of labor (AOR=2.12, 95% CI=1.09–4.11), previous history of stillbirth (AOR=2.15, 95% CI=1.08–4.26), and birthweight less than 2,500 grams (AOR=7.36, 95% CI=3.43–15.81) increase the odds of stillbirth.ConclusionStillbirth was higher among women who drank alcohol during their pregnancy, experienced antepartum hemorrhage, premature rupture of membrane, meconium-stained amniotic fluid, induction of labor, labor not followed by partograph, previous history of stillbirth, and birthweight less than 2,500 grams. As such, education to stop alcohol drinking during pregnancy, monitoring the progress of labor with partograph, and improving the quality of care for mothers and newborns at the time of pregnancy and childbirth will contribute to preventing stillbirth.

Treatment Interruption Among Drug-Susceptible Pulmonary Tuberculosis Patients in Southern Ethiopia.

BackgroundTuberculosis treatment interruption is a failure of attending two scheduled appointments to collect the drugs in either phase of tuberculosis treatment. Even if TB treatment is crucial to achieve a cure and avoid the emergence of drug resistance, treatment interruption is the most testing and deterring factor for successful tuberculosis treatment and one of the problems leading to the development of drug-resistant tuberculosis. TB treatment interruption is the precursor for loss to follow-up and treatment failure, but the magnitude of this problem is unknown in Ethiopia. Thus, this study was intended to identify determinants of treatment interruption among drug-susceptible pulmonary tuberculosis patients in South Ari district, Southern Ethiopia.MethodsAn institution-based unmatched case control study was conducted from February through April 2020 using 255 samples with a ratio of 2:1 (controls to cases). Data were entered into Epi data version 4.2 and exported for analysis using STATA 14.0 statistical software. The variables having a p-value of less than 0.25 in the bivariable analysis were subjected to multivariable logistic regression analysis. In multivariable logistic regression analysis, AORs, 95% CIs, and p-values of <0.05 were used to identify significant variables.ResultsThe median age was 34 (IQR: 18) years in cases and 29 (IQR: 16) years in control groups. Significant factors that were associated with treatment interruption were alcohol consumption (AOR = 2.99, 95% CI; 1.41–6.36); smoking habits (AOR = 2.82, 95% CI; 1.14–6.94); use of traditional medicine (AOR = 2.35, 95% CI 1.05–5.24); co-infected with HIV (AOR=1.58, 95% CI; 1.85–4.29), and waiting time at the health facility ≥30 minutes (AOR = 2.98, 95% CI; 1.31–6.80).ConclusionAlcohol consumption, waiting time at the health facility ≥30 minutes, smoking habits, used traditional medicine, and HIV co-infected were potential determinants. Enhancing public health education, designing strategies that emphasize patients with HIV co-infection, and reducing waiting times are recommended.

Determinants of Opportunistic Infections Among HIV-Positive Patients on HAART in Debre Berhan Referral Hospital, North Shoa Zone, Ethiopia, 2020: A Case-Control Study.

IntroductionOpportunistic infections are an illness that exists more frequently and is more severe in people with HIV. In HIV/AIDS patients, opportunistic infections still cause morbidity and mortality even after the era of highly active antiretroviral therapy (HAART) and most patients die as direct or indirect complications of opportunistic infections. This study was aimed to identify the determinants for the occurrence of opportunistic infections in HIV-positive patients having HAART follow-up in DBRH, Debre Berhan, Ethiopia.MethodsA total of 339 study subjects were involved under institution-based unmatched case–control study design and simple random sampling technique. A pre-tested structured questionnaire was used for data collection. Data were entered using Epidata version 3.1 and analyzed for descriptive and logistic regression models by SPSS version 21. A P-value of less than 0.05 was considered as statistically significant.ResultsAfter adjusting potential confounders, drinking alcohol (AOR=3.12, 95% CI: 1.07–9.06), BMI <18.5 (AOR= 3.36, 95% CI: 1.49–7.55), previous history of opportunistic infections (AOR= 2.96, 95% CI: 1.51–5.8) were independent predictors of opportunistic infections in people living with HIV/AIDS on HAART.ConclusionIn this study, the poor clinical and biochemical status, and behavioral factors were being the predictors of the occurrence of opportunistic infections. HIV/AIDS patients must be assessed and screened for opportunistic infections.

Determinants of diabetes ketoacidosis among diabetes mellitus patients at North Wollo and Waghimra zone public hospitals, Amhara region, Northern Ethiopia

BackgroundDiabetes Mellitus (DM) is a metabolic disorder associated with acute and chronic complications. Diabetic ketoacidosis (DKA) is the most serious diabetic emergency in patients with type one and type two diabetes mellitus. It is the leading cause of mortality in children and young adults. Even though the burden of DKA has increased, no research has been conducted on the determinants of Diabetes ketoacidosis in Ethiopia, particularly in the Amhara region. Thus, this study aimed to identify the determinants of diabetes Ketoacidosis among Diabetes Mellitus patients at North Wollo and Waghimra Zone public Hospitals.MethodsAn institution-based unmatched case-control study design was employed among 408 patients at North Wollo and Waghimra Zone Public Hospitals from March 1st to April 30th, 2020. A consecutive sampling method was used to select study participants. The data were collected using structured interviewer-administered questioners and reviewing of patient charts. The analysis was done using a binary logistic regression model. Then, P-value < 0.05 was considered statistically significant.ResultThe mean (±SD) age of the study participants was 46.96 (± 15.175 SD) years. Irregular follow-up in diabetes clinic (AOR:4.19, 95% CI: 2.28–7.71), not received diabetic education (AOR: 2.87, 95% CI:1.44–5.72), alcohol drinking (AOR:2.99, 95% CI: 1.46–6.12), discontinuation of medications (AOR: 4.31, 95% CI:1.92–9.68), presence of comorbidity (AOR:2.57, 95% CI: 1.37–4.84), and being type one of diabetes mellitus (AOR: 2.01, 95% CI:1.11–3.63) were determinant factors of diabetic ketoacidosis .ConclusionsThis study showed that the behavioral and clinical characteristics of diabetic patients were determinant factors of DKA. Follow-up in the diabetic clinic, diabetic education, discontinuation of medications, alcohol drinking, presence of comorbidities, and type of diabetes mellitus were independent determinants of diabetic ketoacidosis.

Determinants of Second-Trimester Safe Termination of Pregnancy in Public Health Facilities of Amhara Region, Northwest Ethiopia: An Unmatched Case-Control Study

Background. Second-trimester medical abortion is the termination of pregnancy between 13 and 28 weeks of gestational age. Although the majority of abortions are performed in the first trimester, 10–15% of terminations of pregnancies have taken place in the second trimester globally. Objective. To identify the determinant factors of second-trimester safe termination of pregnancy in public health facilities of the Amhara region, northwest Ethiopia. Methods. An institution-based unmatched retrospective case-control study conducted from 01/10/2019–30/02/2020. A systematic random sampling technique was used to select 119 cases and 238 controls. An interviewer-administered questionnaire was used to collect the data. A binary logistic regression model was fitted to identify determinant factors. The odds ratio with 95% CI was computed to assess the strength and significance of the association between dependent and independent variables. Result. Rural resident (adjusted odds ratio (AOR) = 1.9; 95% CI 1.07–3.25), irregular menses (AOR = 1.8; 1.06–3.13), had no known symptoms of pregnancy (AOR = 1.9; (95% CI 1.06–3.46)), not knowing the abortion law (AOR = 3.0; (95% CI 1.63–5.60)), low level of education (1st–8th grade) (AOR = 2.7; (95% CI 1.06–6.60), opposition against abortion care (AOR = 2.6; (1.22–5.42)), delayed referral (AOR = 10.1 (95% CI 4.02–29.18)), and not undertaking pregnancy test (AOR = 2.2; (95% CI (1.21–4.04)) were determinants of second-trimester safe termination of pregnancy. Conclusion. Women being rural residents, irregular menses, not undertaking pregnancy test, not knowing the abortion law, low-level educational status, delayed referral, no knowledge about signs and symptoms of pregnancy, and opposition of safe abortion were determinants of second-trimester safe termination. The Regional Health Bureau and Health Facilities should give emphasis to women living in rural areas, and they should increase awareness towards abortion law and sign and symptoms of pregnancy and encourage female education.

Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study

BackgroundPreterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia.MethodsAn institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05.ResultThe current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study.ConclusionsThe present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

Determinants of Stillbirth Among Deliveries Attended in Bale Zone Hospitals, Oromia Regional State, Southeast Ethiopia: A Case-Control Study.

BackgroundStillbirth is one of the adverse outcomes of pregnancy, and it is among the major public health problems in developing countries including Ethiopia. Stillbirth has wide-reaching consequences for parents, care providers, community and society at large.PurposeTo assess the determinant of stillbirth among deliveries attended in Bale zone hospitals Southeast Ethiopia.MethodsAn institution-based unmatched case–control study was conducted. Cases were deliveries whose birth outcome was stillbirth and controls were deliveries with live birth. A pretested and structured checklist was used to collect data from a sample of 402 (134 cases and 268 controls). Systematic random sampling was used to recruit samples from a list of charts in the delivery registration book. Data were entered into EpiData version 4.2 and exported to SPSS version 20 for analysis. Crude and adjusted odds ratio with 95%CI was calculated and P-value <0.05 was used to declare statistical significance.ResultsA total of 402 charts of mothers (134 cases and 268 controls) were included in the analysis. Preceding birth interval <24 months (AOR: 2.991; 95%CI: 1.351–6.621), antenatal visit started at third trimester (AOR: 2.739; 95%CI: 1.048–7.158), referred from other health facility (AOR: 3.215; 95%CI: 1.430–7.229), labor length ≥24 h (AOR: 3.169; 95%CI: 1.241–8.091), presence of meconium stained amniotic fluid (AOR: 2.670; 95%CI: 1.082–6.592) and giving birth to a baby <2500 g (AOR: 3.155; 95%CI: 1.235–8.07) were determinants of stillbirth.ConclusionPreceding birth interval of <24 months, antenatal visit started at third trimester, referred from other health facility, presence of meconium stained amniotic fluid, labor length ≤24 h and giving birth to a baby <2500 g were found the determinants of stillbirth. Intrapartum care, early identification of labor complications and referral system are required.

Determinants of non-Hodgkin's lymphoma at Felegehiwot specialized hospital, North West Ethiopia: A case-control study.

The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors. Hence, the purpose of this study was to identify determinants of Non-Hodgkin lymphoma cancer among individuals who diagnosed at the Felegehiwot specialized hospital, North West Ethiopia, 2019. An institution-based unmatched case-control study was conducted at the Felegehiwot Specialized hospital from December 2018 up to June 2019. The sample size calculated using the two-population proportion formula. The final sample size was 486, (162 cases and 324 controls). The simple random sampling method was employed to catch up with the estimated samples. The collected data entered into the Epi-data version 3.1 software and analyzed using SPSS version 21 software. Descriptive statistics computed. Simple logistic analysis was run (at 95% CI and p-value < 0.05) to identify the determinants of non-Hodgkin's lymphoma. A total of 486 patients participated. Nearly one-third of the cases and controls were in the age group of 46-60 years. About 90% of cases and 91% of controls were orthodox Christian. Monthly income of ≤28 dollars (AOR = 2. 73, 95%CI: 1. 8, 4.2), male sex (AOR = 1. 8, 95%CI: 1.2, 2.8), ever had chemical exposure, (AOR = 11. 9, 95%CI: 7.6, 18.8), no regular physical exercise (AOR = 15. 5, 95%CI: 5.7, 42.3), and having hypertension [AOR = 0. 03; 95%CI:0.005, 0.2), lung disease (AOR = 0. 2; 95%CI: 0.06, 0.7), and chronic kidney and cardiac diseases (AOR = 0. 06; 95%CI: 0.01, 0.2) were the determinants of non-Hodgkin's lymphoma. The findings in this study suggest that having a low monthly income, being male sex, ever had chemical exposure, not engaged in regular physical exercise, and being diabetic were the determinants of non-Hodgkin's lymphoma.

Determinants of Virologic Failure Among Adults on Second Line Antiretroviral Therapy in Wollo, Amhara Regional State, Northeast Ethiopia.

BackgroundTreatment failure among the population on second line antiretroviral therapy is a major public health threat. In Ethiopia there has been limited research done on second line treatment failure.ObjectiveTo identify determinants of virologic failure among adults on second line antiretroviral therapy in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia.MethodsAn institution-based unmatched case–control study was conducted from February 1, 2020 to April 30, 2020 on a total of 377 clients in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia. Clients whose viral load result >1,000 copies/mL in two consecutive results at least 3 month apart were cases, while ≤1,000 copies/mL were controls. The sample size was calculated by using Epi-Info version 7. Cases (94) and controls (283) were selected using a simple random sampling method in a ratio of cases-to-controls of 1:3. The model fitted and binary logistic assumptions were fulfilled with 95% confidence level and P-values<0.05 were taken as statistically significant.ResultsVirologic failure was predicted by poor adherence (AOR=6.060, 95% CI=2.837–12.944), not disclosing their HIV status (AOR=4.178, 95% CI=1.431–12.198), OI (AOR=4.11, 95% CI=1.827–9.246), CD4 count <100 cells/mm3 (AOR=3.497, 95% CI=1.233–9.923) and 100–350 cells/mm3 (AOR=5.442, 95% CI=2.191–13.513), low BMI <16 kg/m2 (AOR=7.223, 95% CI=2.218–23.520), and young age 15–29 years (AOR=2.898, 95% CI=1.171–7.170).Conclusion and RecommendationsDeterminants of second line ART virologic failure were patients who had poor adherence to ART, not disclosed, opportunistic infection, low CD4 counts <350 cell/mm3, low BMI (<16 kg/m2), and young age 15–29 year patients. Social support, disclosing their HIV status, and getting early treatment for any opportunistic infection is crucial to patients.

Predictors of Neonatal Sepsis in Hospitals at Wolaita Sodo Town, Southern Ethiopia: Institution-Based Unmatched Case-Control Study, 2019.

Background Neonatal sepsis plays a significant role in neonates' mortality in developing countries accounting for 30-50% of total deaths each year. Gaining insight into neonatal sepsis predictors will provide an opportunity for the stakeholders to reduce the causes of neonatal sepsis. This research is aimed at determining the predictors of neonatal sepsis at Wolaita Sodo University Teaching Referral Hospital and Sodo Christian General Hospital, Ethiopia, April-July 2019. Method This study employed an institution-based unmatched case-control study by selecting neonates in selected hospitals through consecutive sampling technique. The cases of this study are neonates diagnosed with sepsis. The study used a pretested structured questionnaire for a face-to-face interview to collect data from index mothers. Besides, the review of the record was done using checklists. The data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences version 24.0 for analysis. The study used descriptive, bivariate, and multivariate analyses. The odds ratio with 95% confidence interval was used to measure the association's strength. p < 0.05 was the cut-off point for declaration of statistical significance for the multivariate analysis. Results Factors significantly associated with neonatal sepsis among neonates were maternal age of 15-20 years and 21-30 years, mothers with low income/wealth, history of urinary tract infections/sexually transmitted infections, presence of intrapartum infections, antenatal care follow‐up < 3 visits, Apgar (Appearance, Pulse, Grimace, Activity, and Respiration) score < 7, low birth weight, and the time in which breastfeeding started after delivery < 60 minutes. Conclusion Maternal age, wealth/income, maternal urinary tract infections/sexually transmitted infections, intrapartum fever, antenatal care visit ≤ 3 times, Apgar score < 7, low birth weight, and starting time of breastfeeding were independent predictors of neonatal sepsis. Therefore, maternal health education during antenatal care visits, perinatal and newborn care, and early initiation of breastfeeding might decrease neonatal mortality and morbidity due to sepsis.

Determinants of Diabetic Foot Ulcer Among Adult Patients with Diabetes Attending the Diabetic Clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: Unmatched Case-Control Study.

BackgroundDiabetic foot ulcer is among the commonest complications of diabetic mellitus attributed to a number of morbidity and mortality cases in diabetic patients. Nowadays, the incidence of diabetic foot ulcer is increasing due to the increased prevalence of diabetes. However, the risk factors of the problem are less studied in Ethiopia. Hence, this study was conducted to assess the determinants of diabetic foot ulcer among adult patients with diabetes attending a diabetic clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia in 2019.Patients and MethodsAn institution-based unmatched case–control study was conducted on 161 patients with diabetes (53 patients with diabetes with foot ulcer and 108 patients with diabetes without foot ulcer). Cases were selected from patients with diabetes with foot ulcer by consecutive sampling technique and controls from patients with diabetes without diabetic foot ulcer by systematic random sampling technique. A binary logistic regression model was used to assess the association between the dependent and independent variables. All variables with a P-value<0.25 were included in the multivariable analysis. Statistical significance was declared at P-value<0.05 with 95% confidence interval.ResultsIn this study, 28 (52.8%) cases and 55 (50.9%) controls were male. Taking insulin alone (AOR=2.75, 95% CI=1.04–7.23), having peripheral neuropathy (AOR=7.56, 95% CI=2.82–20.24), not inspecting feet daily (AOR=5.61, 95% CI=2.24–14.05), and using moisturizing cream between toes (AOR=3.35, 95% CI=1.35–8.32) were positively associated with diabetic foot ulcer, whereas employed (AOR=0.35, 95% CI=0.14–0.87) and combined treatment (insulin and oral hypoglycemic agents) (AOR=0.11, 95% CI=0.02–0.57) were negatively associated with diabetic foot ulcer.ConclusionDiabetic foot ulcer was significantly associated with occupation, kind of treatment of diabetes mellitus taking, peripheral neuropathy, inspecting feet daily, and putting moisturizing cream between toes. It will be helpful if diabetic patients inspect their feet on a daily basis and do not put moisturizing cream between their toes.

Determinants of Acute Diarrhea Among Children Under-Five in Northeast Ethiopia: Unmatched Case-Control Study.

BackgroundDiarrheal disease is the second leading causes of death among under-five children. Most of the death due to diarrhea is reporting in developing countries. To prevent this highly prevalent problem, identifying the contributing factors across different settings is necessary. Therefore, this study aimed to identify the determinants of acute diarrhea among under-five children in the Northeast part of Ethiopia.MethodsAn institution-based unmatched case–control study was conducted among 306 under-five children from March to April 2019. A systematic random sampling technique was employed to select study participants. Data were collected by face to face interviews using a pretested structured questionnaire. Data were entered using Epi-info 7 and analyzed with SPSS version 20.0. We applied logistic regression analysis. Those variables with p-value <0.05 were significant determinants of acute diarrhea.ResultsImproper child’s stool disposal [AOR=4.12; 95% CI (1.25,13.5)], absence of home-based water treatment [AOR=2.85; 95% CI (1.27,6.42)], did not wash hand at critical times [AOR=5.47; 95% CI (1.68,17.8)], did not practice exclusive breastfeed [AOR=3.32; 95% CI (1.21,9.14], unable to get counseling from health professionals [AOR= 3.23; 95%,CI (1.15,13.5)], provide left over food to the child [AOR=2.96; 95% CI (1.19,7.32)], and maternal diarrhea [AOR=6.06; 95% CI (2.42,15.22)] were determinants of acute diarrhea among under five children.ConclusionMost of the determinants of acute diarrhea could be preventable. Thus, collaborative intervention by emphasizing health education about the importance of personal and environmental hygiene, safe food handling, exclusive breastfeeding practice, and home-based water treatment are essential.

Family history of chronic illness, preterm gestational age and smoking exposure before pregnancy increases the probability of preeclampsia in Omo district in southern Ethiopia: a case-control study

BackgroundPreeclampsia is a complex syndrome that is considered a disorder specific to pregnancy. However, research indicates that diffuse maternal endothelial damage may persist after childbirth. On the other hand, women who had a history of pre-eclampsia are at an increased risk of vascular disease. Considering that the multifactorial nature of pre-eclampsia in a remote health setting, knowledge of risk factors of preeclampsia gives epidemiological significance specific to the study area. Therefore, this study aimed to identify the determinants of preeclampsia among pregnant women attending perinatal service in Omo district Hospitals in southern Ethiopia.MethodsAn institution-based unmatched case-control study design was conducted among women visiting for perinatal service in Omo District public hospitals between February to August 2018. A total of 167 cases and 352 controls were included. Data were collected via face-to-face interviews. Bivariable and multivariable logistic regression analysis were computed to examine the effect of the independent variable on preeclampsia using Statistical Package for Social Sciences version 26 window compatible software. Variables with a p-value of less than 0.05 were considered statistically significant.ResultsFactors that were found to have a statistically significant association with pre-eclampsia were primary relatives who had history of chronic hypertension (AOR 2.1, 95% CI: 1.06–4.21), family history of diabetes mellitus (AOR 2.35; 95% CI: 1.07–5.20), preterm gestation(AOR = 1.56, 95%CI, 1.05–2.32), and pre-conception smoking exposure (AOR = 4.16, 95%CI, 1.1–15.4).ConclusionsThe study identified the risk factors for pre-eclampsia. Early detection and timely intervention to manage pre-eclampsia, and obstetric care providers need to emphasize women at preterm gestation and a history of smoking before pregnancy.

Risk Factors for Anemia Among Pregnant Women Attending the Antenatal Care Unit in Selected Jigjiga Public Health Facilities, Somali Region, East Ethiopia 2019: Unmatched Case-Control Study.

BackgroundAnemia is a significant public health concern in many developing countries, particularly during pregnancy, and it has adverse effects on mother and fetus/baby.ObjectiveTo determine the factors associated with anemia among pregnant women attending antenatal care in Jigjiga public health facilities, Somali Region, East Ethiopia.MethodsAn institution-based unmatched case–control study was conducted. The sample size was 228 pregnant women; comprising 114 presenting with anemia and 114 controls. Hemoglobin levels were measured using a portable heme analyzer. Socio-demographic, dietary, medical history, and nutrition-related data were collected using a structured questionnaire. Data were entered into Epidata 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for cleaning and analyses. Bivariate and multivariate logistic regression was performed and statistical significance was considered at a level of p<0.05.ResultsThree predictors of anemia among pregnant women were identified in this study. An inadequate intake of red meat (i.e. those who consumed red meat 1–2 times a month [AOR=7.245; 95% CI=(2.007–26.151)] or not at all [AOR=8.690; 95% CI=(1.795–42.072)]), and insufficient consumption of green vegetables (i.e. 1–2 times a week [AOR=2.970; 95% CI=(1.012–8.716)] or 1–2 times a month [AOR=8.057; 95% CI=(2.358–27.526)]) were associated with anemia. Also, having a mid-upper arm circumference (MUAC) of less than 23 cm was strongly associated [AOR=16.432; 95% CI= (5.240–51.526)] with anemia.ConclusionThis study revealed three key factors to be associated with anemia among pregnant women in Jigjiga Town, namely reduced intake of red meat and green vegetables, and low MUAC. Interventions including nutrition counselling and enrolling pregnant women with low nutritional status in nutritional programs should be the core components of anemia control strategies, needed to address the high prevalence of anemia during pregnancy in developing countries.

Predictors of Precancerous Cervical Lesions Among Women Screened for Cervical Cancer in Bahir Dar Town, Ethiopia: A Case-Control Study.

PurposeCancer of the cervix is the second most common cancer among women worldwide. Despite it is a serious public health problem in Sub-Saharan African countries including Ethiopia, formation on predictor of the precancerous cervical lesion is not well documented, particularly in the study area. This study aimed to identify the predictors of precancerous cervical lesions among women screened for cervical cancer in Bahir Dar town, North West Ethiopia, 2018/19.Patient and MethodsInstitution-based unmatched case–control study was conducted in selected health facilities in Bahir Dar town from November 15, 2018, to January 16, 2019. Data were collected from 102 cases and 305 controls using an interviewer-administered structured questionnaire and entered into Epi Data version 3.1, then export to SPSS version 23 for analysis. Variables with P-value ≤0.2 in the bivariate analysis were included in the multivariate logistic regression model. Odds ratio with 95% confidence interval was used to identify the predictors of precancerous cervical lesions.ResultsWomen who initiated sexual intercourse before the age of 18 years (AOR = 1.68, 95% CI: 1.015–2.804), history of sexually transmitted infection (AOR =1.74, 95% CI: 1.087–2.790) and two or more lifetime sexual partners (AOR=1.733, 95% CI: 1.069–2.810) were predictors for a precancerous cervical lesions.ConclusionThis study confirms that the initiation of sexual intercourse before the age of 18 years, having history of sexually transmitted infection, and two or more lifetime sexual partners were determinants for precancerous cervical lesions. So that it should be focused on prevention through early detection and treatment of sexually transmitted infection with condom promotion. Women with a higher risk of precancerous lesions should also be encouraged to be screened more frequently for cervical cancer.

Determinants of neonatal mortality at neonatal intensive care unit in Northeast Ethiopia: unmatched case-control study

BackgroundGlobally, in 2016, about 38% and 3% of all neonatal death were recorded in sub-Saharan Africa and Ethiopia, respectively. In the same year, 47 neonates out of 1000 live births were not surviving in the first 28 days of age in the Amhara region, Ethiopia. Despite the highest burden of neonatal death in the region, specific or the proximate determinants of neonatal death in the neonatal intensive care unit were not well identified.ObjectiveThis study aimed to identify the determinants of neonatal mortality at neonatal intensive care unit in Dessie Referral Hospital, Northeast Ethiopia.MethodsAn institution-based unmatched case-control study was conducted on neonates admitted to the neonatal intensive care unit of Dessie Referral Hospital, from January 1, 2016, to December 30, 2017. A total of 390 charts (130 cases and 260 controls) were selected by simple random sampling technique. The data were abstracted from the facility-based data abstraction form. A binary logistic regression analysis was fitted to identify the determinants of neonatal mortality.ResultsPregnancy-induced hypertension (AOR = 4.57; 95% CI 1.45–14.43), prolonged rupture of membrane (AOR = 2.04; 95% CI 1.13–3.68), very low birth weight (AOR = 7.00; 95% CI 2.10–23.35), and low birth weight (AOR = 2.12; 95% CI 1.10–4.20) were identified factors. Moreover, respiratory distress syndrome (AOR = 3.61; 95% CI 1.10–12.04), perinatal asphyxia (AOR = 2.27; 95% CI 1.18–4.39), meconium aspiration syndrome (AOR = 2.35; 95% CI 1.12–4.97), and infection (AOR = 2.26; 95% CI 1.34–3.82) were also significantly associated with neonatal death.ConclusionsPregnancy-induced hypertension, prolonged rupture of membrane, low birth weight, respiratory distress syndrome, perinatal asphyxia, meconium aspiration syndrome, and infections were the major determinants of neonatal mortality. Therefore, special attention will be given to small and sick babies. Moreover, early anticipation of complications and management of mothers who had pregnancy-induced hypertension and prolonged rupture of the membrane would save neonates.

Determinants of Under-Five Pneumonia at Gondar University Hospital, Northwest Ethiopia: An Unmatched Case-Control Study.

Background Pneumonia causes about two million under-five deaths each year, accounting for nearly one in five child deaths globally. Knowing the determinants of under-five pneumonia is useful for prevention and intervention programs that are aimed to control the disease. Thus, the main aim of this study was to assess the determinants of under-five pneumonia at Gondar University Hospital, Ethiopia. Methods An institution-based unmatched case-control study was carried out from April 1 to April 30, 2015, taking a sample size of 435 study participants (145 cases and 290 controls). The researchers used a systematic random sampling technique for selecting cases and controls. Data were entered and cleaned using Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable analysis was performed, and variables with a p value less than 0.2 were entered into multivariable logistic regression. Determinant factors were identified based on p value less than 0.05 and adjusted odds ratio with 95% confidence interval (AOR with 95% CI). Results An increased odds of pneumonia was associated with children who had diarrhea in the past fifteen days of data collection (AOR = 6.183; 95% CI: 3.482, 10.977), children's mothers who did not hear about how to handle domestic smoking (AOR = 5.814; 95% CI: 2.757, 12.261), and children of mothers who did not follow proper handwashing practice (AOR = 3.469; 95% CI: 1.753, 6.863). Conclusions Being infected with diarrhea, not knowing how to handle domestic smoking, and poor compliance with proper handwashing practice were identified as determinants of pneumonia. Dedicated, coordinated, and integrated intervention needs to be taken to enhance proper handwashing practice by mothers/caregivers, improve the indoor air quality, and prevent diarrheal diseases at the community level.

Severe acute malnutrition as a major predictor for poor nutritional outcome among adult HIV patients treated with FPB program: a case-control study

IntroductionDifferent studies had explained the treatment outcomes of the food by prescription (FBP) program among people living with HIV (PLHIV). This study aimed to assess factors affecting nutritional treatment outcome among PLHIV using FBP. MethodsAn institution-based unmatched case control study was conducted from August 1 to September 30, 2017 in public health facilities. A total of 566 samples (283 cases and 283 controls) was drawn using random sampling technique. Data were collected from FBP, ART/PRE-ART registers and client’s follow up charts. Bivariate and multivariate logistic regression analyses were conducted to estimate the relationship of the independent variables with the outcome variable, and a p-value &lt;0.05 was considered as statistically significant at 95% confidence level. All statistical analysis was performed using SPSS version 23.ResultsIn this study severe acute malnutrition at admission (AOR=4.45. 95% CI: 2.63–7.55), moderate acute malnutrition at admission (AOR=3.8, 95% CI: 2.18–6.67), lack of regular follow up (AOR=3.81, 95% CI: 2.18–6.67), low CD4 count below 100 (AOR= 2.93, 95% CI: 1.19–7.20), hemoglobin value below 10mg/dL (AOR=2.72, 95% CI: 1.17, 6.35), and male sex (AOR=1.77, 95% CI: 1.19, 2.63) were found to be significant predictors for poor nutritional treatment outcome.Conclusions Severity of malnutrition was the major predictor for poor nutritional treatment outcome of patients who were on FBP program. The policy makers can use the information to improve HIV and nutrition interventions based on the result.

Factors Associated With Late HIV Diagnosis among Peoples Living with HIV, Northwest Ethiopia: Hospital based Unmatched Case-control Study

Background: Early HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. Methods: Institution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count<350 cells/mm3 or WHO clinical stage III and IV regardless of the CD4 count at first presentation and controls were those who had CD4 count ≥ 350 cells/mm3 or WHO clinical stage I and II. If both criteria were available, the CD4 count was preferred as recommended by World Health Organization. A total of 392 respondents [196 cases and 196 controls] were recruited and selected systematically. The data were collected by trained nurses using chart review and interviewer administered structured questionnaire. Binary Logistic Regression Model was used to identify the factors associated with late HIV diagnosis. Findings: out of the total of 392 participants, 376 [187 cases and 189 controls] people living with HIV provided complete response. Having no understanding, compared to having understanding, about HIV/AIDS [AOR=1.7, 95%CI=1.08-2.79] and ART [AOR=2.1, 95%CI: 1.25-3.72], being tested as a result of symptoms/ illness, compared to being tested for risk exposure [inverted AOR =2.5, 95%CI: 1.64-4.76], and acquiring HIV through sexual contact, compared to acquiring it through other modes [AOR=2.5, 95%CI=1.52-4.76] were positively and independently associated with late HIV diagnosis. Conclusions: Unlike perceived HIV stigma, having no understanding about HIV and ART, being tested for presence of symptoms/illness, and acquiring HIV through sexual contact were independent and significant factors for late HIV diagnosis.

Alcohol and khat use as risk factors for HIV infection among visitors to voluntary counselling and testing centres in Northwest Ethiopia

Alcohol and khat are commonly used substances in Ethiopia and are believed to be risk factors for HIV infection. We assessed alcohol and khat use as risk factors for HIV infection among visitors to voluntary counselling and testing centres. In this institution-based unmatched case control study, a total of 495 respondents aged ≥ 15 years participated. Data were collected using a pretested and structured questionnaire by voluntary counselling and testing service providers. Of the 495 visitors recruited for the study, 155 were cases and 316 were controls. Adjusted for confounding variables, the chewers of khat and alcohol drinkers among the cases were adjusted odds ratio (AOR), 2.68; 95% confidence interval (CI), 1.31-5.47 and AOR, 1.84; 95% CI, 1.10-3.07, respectively. This study revealed that alcohol and khat uses were significantly associated with those infected with HIV.